“Once we have the platform deployed – the mics – what we do with that voice file, and whether we use voice recognition or outsourced transcription or in-house, are options open to us.”
Roberts suggested that apart from the controlled, quiet environment of radiology, where the language used tends to be very formulaic, there haven’t been many examples of trusts rolling it out into other areas. However, he believes this is more to do with the necessary formatting and processing of files, rather than inadequacies with the technology.
“It’s not just a voice file; it’s the processing of that voice file that needs to occur. Recipient addressees and distribution lists are the real administration tasks that are best done by the administrator.
“You still need to do the topping and tailing. Asking a clinician to dictate a diagnosis on an eye cancer; yes he’ll do that. But asking him to look up a GP and a couple of colleagues and transmitting it to so-and-so specialist, their processes
room and a consultant is working in another after a joint consultation, they can see when the dictation is completed.
“We can now look at performance associated with letter production; how effective our secretaries and doctors are, which historically was completely invisible as there was no way of seeing how quickly letters were produced.
and habits are that they’ll say ‘copy it to Fred, John and Tim’ and the secretaries will do that. Even if you’re using voice recognition, they’ve still got to work out how to do the physical distribution that’s required.
“I think there are process issues. Fundamentally, if you’re still going to have someone doing the topping and tailing then you might as well have them doing the typing. The majority of secretaries are performing that kind of clinical coordinator/personal assistant role and typing is a proportion of that time rather than the whole of that
time,” he said. Visibility
Roberts said the main benefit that digitisation has brought to the trust is greater visibility throughout the process of creating, transcribing and filing records.
He said: “You can see the order of patients in a clinic list, and you can see very quickly that every patient has had a dictation completed. On a tape you might miss one out.
“It’s also easier to see divisions of work. If a registrar is working in one
University of Manchester, has produced a toolkit for researchers to help secure effective transcription services. She talked to NHE about some of the difficulties encountered when using an external agency to transcribe data.
Outsourcing transcription H
azel Burke, communications and development manager at the Morgan Centre,
transcriptions is one of Burke’s key recommendations.
She said: “Do they charge by the minute or by how long it takes to transcribe? Is there a supplement to pay for poor quality recording? Is there a supplement for a quick service or a lower rate for non-urgent jobs?”
“It can be difficult to find a good agency, or one who can meet your particular needs,” Burke said – especially if there are tight turnaround times. And she warned: “The cheapest option may not be the best value if they produce transcripts that aren’t up to scratch.”
Getting as much information as possible about how a prospective agency works before sending
Whether the benefits of transcription outweigh the costs depends on the individual circumstances, she said, adding: “Accurate transcripts can save a lot of time, but poor quality transcripts that need a lot of correcting don’t help at all.”
Data security
Ensuring the security of dictated information is crucial, especially for the NHS, which is responsible
for sensitive patient data. Burke suggested clear communication with the agency.
She explained: “Data security is a really important consideration for the transcription of research data, just as it is for NHS professionals. It is essential to check that you are following your organisation’s data security guidelines and make sure that your transcription agency knows, understands and complies with the same standards.
“I like the move towards uploading recordings onto a secure server and then downloading the finished transcript from the same place – email is much less secure.”
Following instructions If the content is formulaic, giving
“It’s visibility and that’s the key thing for us: the end-to-end process.”
For more information Danny Roberts
Visit
www.uhcw.nhs.uk
Hazel Burke, communications and development manager at the Morgan Centre, University of Manchester, advises on best practice for outsourcing transcription.
detailed instructions for transcription can be very helpful, and giving feedback to the agency can help them to meet expectations.
Instructions can clearly explain how the recording should be transcribed and Burke explained: “This saves the agency time and improves the accuracy of the finish transcript, which saves us time correcting it.
“Using a transcriber who is familiar with the topic will speed things up. Strong regional accents can be harder to transcribe for somebody who isn’t familiar with them, so local transcribers could also be a good idea.”
For more information
Visit
tinyurl.com/morgancentre- transcription
national health executive Jan/Feb 12 55
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