Customer Successes
SmartScribe Medical Transcription gives doctor his family life back
Overview
Dr. Sanjeev Goel runs a family medical practice in a
Challenges: How to make detailed notes and save time
A convert to Nightingale On Demand Electronic Medical Records (EMR) solution for making his office paperless, Dr. Sanjeev Goel found there was one thing preventing the full transition: he found it challenging to keep up with note taking and his charts were backing-up. And he didn’t like the idea of keeping patients waiting while typed notes into his Electronic Medical Records (EMR). “We see a huge number of patients during the day, 40 or 50. And it was becoming very difficult to write my notes completely between encounters. I even took a medical record keeping course to help me improve the speed and quality of taking notes but my charts were still backing up,” says Dr. Goel.
But he still found himself completing his charts at home spending two to three hours a night. “We learned you must try to finish the chart when you see the patient. With Nightingale SmartScribe you can dictate a note very quickly. That’s why it works rather than typing. And if you do it right after seeing the patients the quality is much better,” says Dr. Goel. His one concern about using a transcription service however, was whether it could accommodate the unique aspects of a family medical practice. Notes Dr. Goel: “Every note is completely unique for each family doctor. It’s very difficult to make a common template for all physicians. So that was one of the challenge we wanted Nightingale SmartScribe to address.”
Nightingale Solutions in Action
Knowing exactly what his needs were made things easier when it came to choosing a system. “Nightingale is on the cutting edge of EMR and that’s why I went with them. They’re one of the first and true Internet-based EMR programs and that was very important to me. They offer a low set of costs and their customer service is quite good. When you call for help they’re there,” says Dr. Goel. Within a week of contacting his account manager he had Nightingale SmartScribe dictation software in place and a digital voice recorder.
Fully integrated with Nightingale On Demand Electronic Medical Records (EMR), Nightingale hosts the server onto which mp3 files are easily loaded from the recorder. Nightingale’s professionally trained medical transcriptionists transcribe the dictation directly into a patient’s electronic medical record in real time – soon after it is uploaded by the physician. Known for the quality of work they produce, Nightingale’s transcriptionists go through three phases of testing and must meet stringent standards to qualify. As an additional check a team of quality control editors review transcriptions to maintain accuracy and completeness of records.
Typically a doctor carries the portable dictation device when seeing patients and records notes verbally for 15 to 20 seconds per patient. At the end of the day the dictator is placed on a dock where it recharges and immediately downloads voice files to the computer. “I just wait until the next day when they’re all typed in, review the codes and sign it off [electronically]. It just takes a few minutes. I may do it either in the evenings for a few minutes or between patients or in the morning at the office,” says Dr. Goel.
Results: Better records in record time
After the first two-weeks Dr. Goel began to see the benefits. “With Nightingale SmartScribe all my charts are completed between patient visits. It’s remarkable how much time it’s saved me. I still see the same number of patients, but when I leave the office my day is done,” says Dr. Goel.
Part of this was due to Dr. Goel’s commitment to have Nightingale create the customized templates his practice needed. A drop down menu features his most commonly used templates – there are over 20. “The physical template would be the top template I use. We always use baby records. And I use templates for common cold, bronchitis, and sinusitis,” says Dr. Goel. He also has specific notes for tracking patients who are smokers. It’s requested by the Ontario Ministry of Health so doctors can provide counseling. “I’ll say open smoking cessation note. It opens up. And whatever we’re supposed to have done, that goes down in the record. So that saves time,” says Dr. Goel.
Before dictation begins Nightingale customizes templates to a doctor’s specifications. Taking anywhere from one to eight hours to build, templates are based on the form letters used for the different types of patients a doctor sees and the reason for the visit.
While Dr. Goel admits he could be using a computer to populate his records he’s not always near a laptop. He’s moving around seeing patients, and he’s more comfortable speaking than typing his notes. “If you’re just between rooms you can dictate a note very quickly. That’s why it works rather than typing. It takes a bit longer to do the typing, and nothing compares to speaking. If you do it right after seeing the patient the quality is much better,” says Dr. Goel.
Saves time and money
It’s also proven to be the most cost effective way to transition into a paperless office. “The cost for Nightingale’s Medical Transcription SmartScribe pays off in huge amounts. It’s easy to recover that in time saved or in seeing more patients. Doctors can be really cost-conscious, and they may not want to add another expense, but they have to look at the big picture,” suggests Dr. Goel who considers the cost reasonable.
Other improvements include cutting down on actual dictation time. Anything from the doctor’s clinical notes can instantly be attached to a referral letter. For generating an OHIP bill doctors must attach a diagnosis code. Those codes can be added to the favourites list. For example if treating a patient with diabetes, just dictate “DM” and code 250 automatically goes on the bill. Nightingale’s Medical Transcription system SmartScribe is also cost effective. It charges clients by the minute, not by the line as with other transcription services.
He could take on more patients with the time he has freed up but he’s choosing to spend it at home with his family. “Thanks to Nightingale SmartScribe I’ve got my evenings back to myself. I’m not charting notes at midnight, which is what I used to do before, and after the kids went to bed.”
