The Cost of Doing Business - How Can Your Medical Practice ...

Physicians typically use three primary methods of documentation with their Electronic Medical Record (EMR): dictation, structured data entry or voice recognition programs. But how does the cost of each method affect the practice?s bottom line? The following is an example of a typical outpatient visit from an established patient to a doctor of internal medicine. This is assuming that the internist is paid $340,000 a year (all statistical data provided by Medical Group Management Association.) We are also assuming the transcription company charges .16 per line for transcribing and editing, a standard rate for outsourced transcription for a standard 65-character line.

For a doctor to dictate a chart note, it takes approximately one minute, making the cost to dictate about $2.70. It takes the transcription company approximately 4 minutes to transcribe and edit the note, making the cost to the practice $1.60 (on average, a medical transcriptionist can transcribe and edit 2.5 lines a minute at $0.16 a line, making the transcription cost approximately $0.40 a minute or $1.60 for 4 minutes.) This gives us a total cost of $4.30 per note for the practice.

For structured data entry into an EMR ? that is, for the doctor to enter the note him or herself ? the average time it takes is about 5 to 10 minutes (dependent on the doctor?s familiarity with the EMR system and the complexity of the patient issue.) In an EMR, the physician has multiple drop-down and point-and-click menus they must go through, which increases the amount of time it takes to create an original note. This makes the cost to complete a chart note $13.50 to $27.

Although voice recognition systems, such as Dragon Naturally Speaking, spike the interest of many practices for their purported cost and time-saving abilities, the truth is that physicians must speak at a decelerated rate of speed for the system to work (about 4.5 times slower than their normal speech rate,) and even then the accuracy rate for these programs is still at 80% at best. In comparison, skilled medical transcriptionists? accuracy rate is expected to be at 99%. So, when you take into account the increased time the note takes to dictate (about 4.45 minutes) and the increase number of errors that must now be edited by the physician (editing time typically 4.25 minutes,) this makes the total time to create the note 8.70 minutes ? making the cost per note $23.49. Of course, this is also after the initial investment cost of the product.

In chart format:

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Method	Time to Create/Edit Note for Physician	Total Cost to Practice ?
Dictated and Transcribed ?	1 minute for physician, 4 minutes for transcription company ?	$4.30 (Broken down: $2.70 cost for doctor, $1.60 cost to transcription company) ?
Structured Data Entry into EMR ?	5 to 10 minutes	$13.50 to $27
Voice Recognition ?	8.70 minutes	$23.49

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Source: http://www.transcriptionoutsourcing.org/2012/07/the-cost-of-doing-business-how-can-your-medical-practice-reduce-costs/

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