Healthcare News & Insights

Medical Transcription

Providing Safety and Security with Medical Transcription Technology

One of the most important things that happens when a patient leaves a doctor’s office is medical transcription, where the doctor’s assessments and diagnoses are added to patients’ medical records. In the past, this was done by the doctor, and his/her handwritten notes would be stored in the patient’s manila folder, and then tucked away in a drawer with hundreds of other files. Over time, stacks and stacks of paper files ate up office space, and some of the important records were even lost in the shuffle, leaving patients and doctors without an accurate account of prior visits and health information.

Today, with the integration of electronic storage and data systems as well as EHR and EMR, medical transcription has come a long way. Physicians and other medical professionals now have some other options besides scribbling down their notes by hand; they can dictate patient notes into a recording device for later transcription into a digital record, use a voice-to-text software program or even a shortcut typing tool to help make the process faster and more accurate.

Voice-to-Text software is becoming one of the most popular options due to its convenience, ease of use, and time-saving qualities. It allows caregivers to crate an audio recording of their medical assessment and then automatically have that audio converted to a text file that is stored in a patient’s health record. Some software uses a separate headset or speaker system, while the most recent product launches have integrated applications for use on smart phones or other portable devices that can wirelessly sync with a software program. Physicians can simply open the app, touch to begin and end recording, and then submit the file for storage right from their phone.

Today’s medical technology, especially in the field of medical transcription, has helped  to ensure patient safety in a number of ways, namely in that correct information is recorded for use by other physicians, specialists, pharmacists, and even for a patient’s personal use in medical history.

Key attributes of today’s most popular medical transcription software programs:

  • Medical spell checking and dictionaries ensure that the proper words, terms, and phrases are recorded to protect patients’ safety
  • Support of a wide variety of audio/video formats allow this technology to work on a number of different computers, operating systems, or hardware
  • Clean, easy to use editing features so administration and/or physicians won’t waste time trying to navigate the program just to fix a few typos
  • Easy to use medical document distribution or creation ensures that clinics, hospitals, or offices can share files or create documents with ease
  • Speech recognition capabilities adapting to different users allows the software to adapt to a number of different voices and inputs, wasting no time or risking the recording of improper information
  • Time and code stamp functions to ensure properly detailed records of time, date, primary physician, and more
  • Ease of integration to healthcare systems and programs like medical billing and coding
  • Compliance with all HIPAA standards and regulations to avoid any potential risk of penalty

Medical transcription provides all the information about a specific patient that any doctor or caretaker looking at a medical record would need to know to give that patient the best treatment. In addition to the information being readily available for point-of-care treatment, medical history is also a vital piece of information that enables physicians to determine the best diagnosis and treatment plan for a patient. This also allows the patient to be proactive in living a healthy lifestyle and to prevent the onset of diseases that they are genetically exposed to. In the realm of medical technology, advances in transcription are vitally important and they continue to help protect patients and give physicians the tools they need to provide the best patient care.