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AAOS Now

Published 9/1/2010
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Adam D. Soyer, DO

Reducing dictation expenses

Dictation is an obligatory part of medical practice. Comprehensive office notes are an essential part of the medical record that detail treatment history and are vital protection in a medical liability event. The detail in your notes directly affects your ability to bill appropriately for the evaluation and management of each patient and thus affects reimbursement.

Outsourced transcription services for dictation can cost the average physician between $1,000 and $1,500 per month—a major expense if there are several physicians in a group.

Hiring a dedicated in-house transcriptionist is an option, but total costs may be comparable to outsourced services.

Electronic medical records (EMRs) have improved paper management and given us more options for dictation. An EMR, for example, gives you the ability to use custom templates, voice recognition software, and macros. When used properly, these features can help reduce dictation expenses.

Custom templates are office notes that you predesign based on your clinical style and workflow. They are designed to be a ‘skeleton’ note that is ‘fleshed out’ with the details of each patient encounter.

These templates can be dropped into the office visit and then annotated appropriately. Annotation can be accomplished by simple typing or using voice recognition software.

Voice recognition software is a practical option for many offices. Advances in voice recognition software have made it much more accurate for medical practices. Specialty-specific vocabularies have been designed and implemented in every field of medicine. Some programs even enable automation of the computer to recognize voice commands while performing Internet-based activities.

Initially, installing voice recognition software may be expensive because it requires specific computer hardware and a quality microphone. Start-up costs may range from $1,500 to $1,800, including audio hardware.

Additionally, using voice recognition requires individual training. It is initially slower to generate standard office notes, but continued use and practice will speed the process. This article was transcribed by voice recognition software.

Macros are a series of computer commands that are simplified into a single command. For example, dictating the same sequence for every joint injection, you would use a simple keystroke or voice command to insert a pretyped description of the procedure. This greatly reduces time and cost in dictation.

We face challenging financial times; using technology and improving office efficiency will ultimately reduce expenses.

Adam D. Soyer, DO, is a member of the AAOS Practice Management Committee. He can be reached at adam.soyer@nyumc.org