Hospital closing its transcription department for outsourcing

A lot has changed since 1963 when Pamela Denny joined the former Nashua Memorial Hospital, now Southern New Hampshire Medical Center, as its first medical transcriptionist.

In the 1960s, doctors dictated their notes into bulky tape recorders and transcriptionists typed the information using manual typewriters.

Eventually, the electric typewriter replaced the manual one, allowing the transcriptionist to type more quickly and with fewer errors. In time, the computer came along, making the typewriter obsolete.

Now, at the dawn of voice-recognition technology, the entire process depends on increasingly advanced equipment that allows transcriptionists to do more work at a faster pace.

As a result, the job Denny has done with pride and love for almost 30 years will be eliminated this week when Southern New Hampshire Medical Center closes it transcription department.

The hospital, which for years has sent out a large portion of its transcription, has made arrangements to outsource the work to a national service. Two of the nine employees in the department will remain at the hospital to oversee the new operation.

Denny isn’t one of them.

“I have so loved it there and so loved the people I worked with,” Denny said, speculating that her job was cut to save the hospital money.

But hospital officials said the decision was based on the growing volume of transcription and the need for a quicker turnaround.

“It’s about patient care and the inability on our part to meet the demand for transcription internally,” said Rick Duguay, vice president for clinical and support services at the hospital. “It’s not a cost-cutting measure, not something we take lightly where employees are involved.”

Indeed, the hospital has been outsourcing about 85 percent of its transcription for a number of years, Duguay said, explaining the volume of work and the need for quicker turnaround drove the decision.

What the hospital gains in speed and volume, however, it may lose in quality, Denny said, pointing out the national service will used transcriptionists who work alone from their homes.

In an office setting, transcriptionists help each other. If one is unable to identify a medical term or other word she has heard, she will ask a colleague to listen for her.

“At home, it’s not the same,” Denny said, adding contracted employees aren’t paid to look up a word or ask a question, pursuits that take time away from meeting production quotas.

“The quality of the work suffers,” she said.Advances in technology, and with them the capacity to do more work at a faster rate, also come at the price of human relationships. In the old days, Denny said, transcriptionists and the doctors for whom they transcribed were colleagues, and friends.

“It was a really intimate atmosphere. We used to see the doctors all the time,” she said, recalling how the physicians with whom she worked regularly invited her to have coffee with them in the hospital coffee shop.

“Now, no doctor comes into our place.”

Indeed, transcriptionists say no one has had a better understanding of what they do than the doctors who for years have forwarded their dictation, depending on the employees in the transcription department to accurately record their notes.

“Back then, it was a lot more like family,” Denny said.

For the uninitiated, transcription conjures images of women wearing headphones and sitting at desks typing.

What remains a mystery to most people is what it takes to do the job: In addition to the ability to type quickly, a transcriptionist needs a good ear, background in anatomy and physiology, and familiarity with medical terminology, including diseases and medications.

Accuracy is critical. The tiniest of mistakes, omitting the word “no” before the word “abnormality,” for example, could have devastating results.

“You can go to college – the local voc tech used to have a medical transcription course – but you really need the experience of listening and typing,” said Penny Rothkopf, the department manager, who has worked at Southern New Hampshire as a transcriptionist since 1988.

Rothkopf, who will remain to oversee the transcription that is outsourced, says the change is bittersweet.

“We’ve had a 9 to 10 percent increase in the volume of work every year in-house, and we’ve been sending out reports,” she said, observing that other hospitals across the state and nation are also closing transcription departments and outsourcing.

Indeed, St. Joseph Hospital in Nashua periodically considers outsourcing transcription, but so far has continued to maintain its 25-year-old service.

“There’s always talk about (outsourcing) because the cost of transcription is significant,” said Diane Hanson, director of health information management at St. Joseph. “We felt we do a much better job in-house, with better turn-around time, better quality, more control.”

Dr. Robert Oot, chairman of the radiology department at Southern New Hampshire, said he will miss the employees he has come to know as “more than just a voice at the other end of the line.”

“Their value and their contribution has been very significant as colleagues for a long time, and we look with real sadness at the change,” Oot said.

“They’re good souls caught in a change in the industry and technology.”

Source :http://www.nashuatelegraph.com/apps/pbcs.dll/article?AID=/20070617/BUSINESS/206170417/-1/news01