Medical Staff Pulse is
a Publication of the Chief of Staff
MEC Update

Improving Our Medical Transcription Service

In an effort to improve transcription service, MedQuist has begun implementing daily monitoring of turnaround time and weekly calls to Client Services to evaluate quality, at Cedars-Sinai's request.

In addition, specific transcriptionists will be designated to the CSMC account and they will undergo performance review every six weeks. The transcriptionist employment status has also changed from independent contractors -- which is the industry norm -- to wholly MedQuist employees, which will increase accountability for performance and scheduling. CSMC report templates will be reviewed for improvement and physician-specific reviews will be available upon request.

MedQuist is the largest transcription vendor in the United States and, based on volume, CSMC is one of MedQuist's top 10 clients. With the exception of Pathology, MedQuist performs all of Cedars-Sinai's hospital-based transcription, including Imaging and also the Outpatient Clinic areas. MedQuist routinely provides CSMC with an average of 30,000 transcribed reports each month.

"We have been experiencing some recent and ongoing turnaround problems," said Thea Campbell, director of Health Information. "The known reasons for this include vendor staffing, our volume fluctuations (dictation minutes) and server/application performance on vendor equipment caused by our sometime erratic volume through-put."

"It is important to note that not all of the turnaround challenges are solely owned by the vendor," Campbell added. "For example, a report is typed but not uploaded in WebVS because of patient demographic discrepancies. The Health Information Department routinely corrects 70-75 reports daily with such issues. In order to not delay the report return to the dictating/ordering physician(s), it is crucial that this information is as accurate as possible at the point of dictation."

There have also been some concerns regarding the quality of the transcribed documents being returned. The factors that have negatively affected quality include 1) a poor internal overall quality program within MedQuist, 2) vague report templates (by CSMC design) and 3) transcriptionist-specific issues, according to Campbell.

In order to receive physician feedback, Cedars-Sinai has implemented a new problem reporting mechanism in WebVS. Physician feedback as new processes are implemented will be invaluable to improving the service now provided by MedQuist.