Newham NHS Trust improves efficiency with outsourced transcription service through Dictate IT

Background

Newham University Hospital NHS Trust is an Acute Hospital Trust based at Newham General Hospital (Plaistow), with some outpatient services located at the Shrewsbury Health (Forest Gate) and the Appleby (Canning Town) Centres.

The hospital primarily serves Newham’s 240,000+ population but also provides services to the residents of Redbridge, Waltham Forest, Barking & Havering, City & Hackney and Tower Hamlets. Its mission is to ensure a secure future for the local provision of high quality, value-for-money health services to the people of Newham and surrounding areas.

The challenge

In early 2008, the Trust found itself struggling to cope with the volume of patient records requiring processing. In some cases the total turnaround time for drafting approved patient notes was weeks – sometimes even months. The result was that medical secretaries were being distracted from important patient work by hours spent transcribing reports.

Newham’s goal was to become a leading Trust with improved services for patients, and it was therefore seen as essential to implement an electronic storage system for patient records. This was particularly relevant after substantial investment in the Trust led to more patients and a corresponding increase in volumes of paperwork.

Medical secretaries were using tape-based or direct dictation from consultants to record patient notes, and were accustomed to these methods. When the Trust deployed a digital dictation system, the adjustment to the new way of receiving electronic notes proved challenging, and the Trust therefore decided to outsource transcription to free up secretaries’ time for important patient work.

A UK-based supplier was selected initially, but the Trust was disappointed with the service and therefore sought a more efficient and cost effective solution.

The solution

The procurement department selected Dictate IT, the specialist provider of digital dictation, speech recognition and outsourced transcription services.

Mark Miller, Managing Director of Dictate IT said: -We analysed Newham’s specific requirements and tailored a solution to suit the Trust’s needs. Our system automatically assigns dictation to speech recognition, depending on the type of text and the turnaround time required, so high priority records are processed first. This was a key feature in this contract win.

Dictate IT outsourced transcription services were fully integrated into the Trust’s existing operating system, which allowed Newham to work with a single contractor rather than having to engage separate outsourcing companies.

Sheila Catt, Manager of Medical Secretaries at the Trust commented: -Dictate IT offers a very straightforward process whereby consultants’ recorded notes are electronically sent to Bangalore, India. We have seen a significant reduction in the turnaround time of dictation tasks – in some cases from weeks to hours.

With the help of Dictate’s unique Dictation system functionality, the Trust is now able to store and access electronic patient records in the form of transcribed documents. By outsourcing dictation, using the latest digital technology and devices, Newham has achieved top quality recordings. Dictate IT’s Outsource Solution (DIOS) has offered the Trust both direct and indirect advantages:

Improved working practices – DIOS has fuelled the drive towards better working practices and improved efficiency among administration teams – the Trust has seen significant savings on secretarial time.

Integration capabilities have harmonised with hospital patient systems, databases and Cerner Millennium electronic patient record system.

Clinicians’ working practices have stayed the same with minimal training required. Also, Efficient the service has been utilised as a first step to reviewing benefits of other technologies including other digital dictation solutions, workflow management and voice recognition.

Pradip Karanjit, Head of Access and Capacity at Newham commented: -Although we still print and store hard copies of clinic letters in patient records, electronic access of clinic letters through Dictate IT’s has simplified the process of accessing information as and when needed.

The system enables consultants to dictate there and then allowing secretaries to action immediately, which has helped reduce our turn around time. The Trust aims to move away gradually from paper notes and eventually aim towards the electronic records that will help improve access to our services.

Results

Having used the services for over a year now, secretaries at Newham now report that they have more time to focus on other significant tasks. Improvements have led to the Trust receiving the award for Most Improved Hospital in the Caspe Healthcare Knowledge Systems (CHKS) Top Hospitals Awards in 2008. Newham gained the award based on achievements made by reducing waiting times and improving access, reducing mortality and infection rates and the quality of data produced. The Trust was able to reduce its expected deficit by almost half, down from £4.1million to £2.3 million in 2008 – a considerable achievement and one which has been made alongside a number of improvements to the patient experience.

Sheila Catt said: -The initial negative perception surrounding outsourcing was proved wrong as soon as the staff realised the benefits of being able to focus on other important jobs, leading to increased efficiency. We haven’t lost a single employee as a direct consequence of outsourcing and the error rates are minimal.

With pertinent, up-to-date, confidential patient information converted to a written text document, the Trust has been able to achieve high standards of patient satisfaction.