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.