Jennifer Kaukeinen, RN, MS, OCN
Director of Operations
Rochester, New York

With 40 practice groups based at Rochester General Hospital, ViaHealth has watched its annual medical transcription expenses rise each year, to a high of $600,000 in 2007. Several months ago, director of operations Jennifer Kaukeinen and her team began exploring strategies for reducing that significant cost.

After learning about speech recognition software and how it could potentially serve as a transitional step toward the hospital's planned implementation of an electronic medical records (EMR) system in the next couple of years, there seemed to be a good fit. "We also saw that it has larger possible implications," says Jennifer, "for coding, billing, and compliance issues."

The organization turned to Dana Abramson of Achieve Results for help in training the 200+ providers, some of whom had previously had poor results in trying to use the software. Only a few months later, an estimated 50% of the practice groups are already having excellent results with the adoption of the Dragon 9 speech recognition software package and Jennifer has hopes of transitioning the remaining 50% within the coming months. "Dana really tailors the training and assumes success with the system, which puts the person who is trained by her a step ahead," says Jennifer.

In addition to cutting the transcription costs by more than 50% during the first year of implementation, use of speech recognition software has had another benefit – capturing additional revenue.

Physicians were previously going above and beyond in caring for patients, but sometimes failed to adequately document it, explains Jennifer, so the hospital was not able to bill for all of it. Until Dragon 9 was introduced. Now, with the creation of billing templates to help medical staff record all the services provided, the hospital "is seeing the net revenue per encounter increase with better attention to detail," reports Jennifer.

That was possible when ViaHealth partnered with Achieve Results to look at the bigger picture of what speech recognition could do, says Jennifer. That included evaluating what services the physicians were providing, what they were charging for, and where the gap was. "It's a business imperative," says Jennifer, "but it's not just about the money. It's about providing the best possible care to our patients," which we can't continue to do long-term unless we improve the accuracy of our billing.

As a transition tool to EMR, Jennifer says that besides providing a cost savings, speech recognition also helps the organization address issues surrounding legibility, setting benchmarks for standards, creating templates, as well as capturing revenue.


Interview by Marcia Layton Turner, Layton & Co.




Edition 14

Jim Reed
Ziff, Weiermiller, Hayden & Mustico, LLP
Elmira, New York

Jim was the ideal speech recognition student. He is articulate, computer savvy, and excited about what the shift to speaking documents could do for his practice, including speeding his blog posts at www.zifflaw.com/blog, which was taking a fair amount of his time.

In a matter of minutes Jim was using speech recognition software like a pro. It turns out that even the smallest, almost imperceptible difference in accuracy rates can make the difference between frustration and ease-of-use, and reminded me why we always advocate starting with a headset microphone.




Edition 13


Neil A. Goldberg
Goldberg Segalla, LLP
Buffalo, NY
 

With each attorney capable of generating documents by speaking rather than dictating or typing, the firm's reliance on administrative staff will decline. "Our goal is to have 3 - 3.5 attorneys per secretary," says Goldberg, instead of the current ratio of 2-2.5 attorneys per secretary. "It will allow us to be more efficient in our use of staff," he explains. "We're talking a savings of hundreds of thousands of dollars," he says.

Interview by Marcia Layton Turner, Layton & Co.




October 2007

Bess Herbert, MD
Webster Family Medicine
Webster, New York

Hearing of her frustration, Achieve Results returned to explore what was holding Dr. Herbert back and discovered she was so focused on learning the program's features that she was getting bogged down in the actual dictation. Once she turned her focus to simply using the Dragon software, her speed and skill improved immediately. "I do see improvement already," she confirms.


Interview by Marcia Layton Turner, Layton & Co.



August 2007


Molly Parietti Scharf, MD
Family Physician
Thompson Health
Lima Family Practice
Lima, NY
Almost immediately, the use of speech recognition software provided some key benefits. First, Dragon made the documents much more thorough and professional looking, says Dr. Scharf. Second, they were also more accurate because they were longer and more complete. The only downside, says Dr. Scharf, is that "it is tempting to go on and on," though thoroughness isn't a real disadvantage, she readily admits.


Interview by Marcia Layton Turner, Layton & Co.




May 2007

 

James Mason, MD

Eastside Internal Medicine

Fairport, NY


 

"The first week was tough because I had to get used to dictating and the software at the same time," he says, but now, just three weeks later, he estimates he is 25% to 30% faster at writing up notes. "The templates really help," he says.

 

In addition, Dr. Mason finds his patient notes are more thorough because he has plenty of time to record his observations – Dragon is less time-consuming than handwriting. It's also very accurate when he's dictating notes, he says.



Interview by Marcia Layton Turner, Layton & Co.





March 2007

Rachel Forberg

Family Nurse Practitioner

Oak Orchard Health Center

Brockport, NY

 

Besides finishing work hours earlier, Rachel has found "convenience is the biggest piece for me." Notes are neater, since they are typed, not handwritten, and she can generate many letters in the time it used to take her to write up one. "We have to do a lot of letters," she explains – to patients, referring doctors, utility company, service agencies, etc. To help get through the stack more quickly, Achieve Results designed a letter template Rachel now uses to write and print letters in a fraction of the time it used to take her. Other nurses have even adopted the template after seeing how speedy it is to use.


Interview by Marcia Layton Turner, Layton & Co.




 

February 2007

John R.("Jack")Weider

Partner & Chair of the Financial Reorganization practice group

Harter Secrest & Emery, LLP


Using Dragon, Jack estimates that he spends 25%-35% less time responding to email - a significant time savings. But that's only one aspect of the savings the firm enjoys - his practice also saves money through reduced secretarial needs. Because all four of the professionals in the bankruptcy and financial reorganization practice group use Dragon, they have a higher ratio of professionals to administrative assistants than the firm's average.

Interview by Marcia Layton Turner, Layton & Co.




 
January 2007



Rebecca Wortman
Office Manager

The Center for Menstrual Disorders
and Reproductive Choice

 


Until November 2006, Rebecca Wortman spent an average of $700 a month on transcription costs at The Center for Menstrual Disorders and Reproductive Choice, a subspecialty gynecology practice. But after being trained in how to use Dragon NaturallySpeaking software, the office practitioners now dictate and have their patient notes and letters to referring physicians automatically transcribed, bringing transcription costs down to zero.

 

                                 Interview by Marcia Layton Turner, Layton & Co.






December 2006


Hal Carter
Vice President of Legal Affairs

Rochester Genesee Regional Transportation Authority


Today, 70 to 80% of Carter's work is done using Dragon Naturally Speaking software. In fact, "I don't have the patience to type anymore," he admits. Talking into a microphone connected to his computer is that much faster, he has found. "It's definitely much more efficient."

 
                                  Interview by Marcia Layton Turner, Layton & Co.

 





November 2006

Jim White

Assistant Professor of Medicine,
Physiology, and Pharmacology

U of R Medical Center

 


Today, Dr. Jim White does 70% to 80% of all his computer input using Dragon Naturally Speaking software, including all of his patient chart updates. A self-confessed "geek," White has been waiting years for computing power to catch up to the processing requirements of speech recognition software. Now the computing speed is there, he says, and Dragon is faster than typing.

                          
Interview by Marcia Layton Turner, Layton & Co.

 


 



               

SPECIAL FEATURE

Patrick Donohue

Eleventh grader

Batavia High School


...Patrick's required daily journal entries increased from 25 or 30 words a day to 100 or more – tripling or quadrupling his previous output....Most importantly, says Lorrie, Patrick's demeanor, attitude, and facial expressions have been transformed. "His whole outlook has changed." Instead of coming to school sullen and downcast, this year Patrick burst through the front doors on the first day with a smile, excited to be there. 

                          Interview by Marcia Layton Turner, Layton & Co.


  



 
October 2006

John Turano, DPM

Partner

Eastside Podiatry, LLP


"My partner and I were having a hard time with transcription turnaround times," says podiatrist Dr. John Turano, explaining why his practice decided to switch to speech recognition software back in 2004. But it wasn't just the delay in getting notes into patient charts that was their only complaint – they were spending around $750 a month for that delay. 

                           Interview by Marcia Layton Turner, Layton & Co.
  






September 2006

 

Philip Stein, M.D.

Assistant Professor, General Medicine

U of R Medical School

In addition to saving the department thousands of dollars annually in transcription costs, Phil has found that it has dramatically reduced the time it takes to draft a note. "It allows you to do a well-documented note the way you'd like to, without spending your life writing notes."

                           Interview by Marcia Layton Turner, Layton & Co.





 
August 2006




Anthony T. Lee

Partner

Underberg & Kessler LLP


Interestingly, the benefits of using speech recognition software have improved his secretary's efficiency, too. Tony's reduced reliance on her now frees her up to do more work for other attorneys at the firm or to attend to administrative tasks, rather than getting bogged down with his routine correspondence and other work.


Interview by Marcia Layton Turner, Layton & Co.




 



July 2006


 


 

 



Al Campagna
Greater Rochester Orthopaedics


In total, it took six months for all nine professionals to be trained. In that time, the transcription cost dropped from its $100,000 pace to $6,000. In addition to reducing the office's reliance on outside transcription, the Dragon software has also changed the operating process within the office, reports Campagna, because there is far less paper to contend with.


                           Interview by Marcia Layton Turner, Layton & Co.






 

June 2006

 




Stephen Green, CFP®

Financial Advisor

Nixon Peabody Financial Advisors LLC


In three months, Green estimates the use of speech recognition software has improved his document creation speed by 100%. "However long it took me before, it's now taking me half the time," he says.
 
                           Interview by Marcia Layton Turner, Layton & Co.







May 2006



Colette Madison, PA
Lifetime Health
Rochester, NY


After just three weeks, Madison has seen improvements in her speed and accuracy. She sees approximately 25 patients a day and spends a few minutes after each appointment dictating a patient's chart. In three weeks, her speed has jumped an estimated 75%.

                           Interview by Marcia Layton Turner, Layton & Co.







 April 2006






Thomas C. Burke
Attorney
Osborn, Reed & Burke, LLP - Rochester, NY





March 2006


Diane Ahlman, MD
Lifetime Health
Perinton, NY



 
February 2006






Nelson Thomas
Attorney
Dolin,Thomas & Solomom LLP
Rochester, NY




January 2006








Martin Gingras, MD
Westfall Orthopaedics
Rochester, NY




 







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