As health care organizations feel the affects of today's economic and political climate, it is even more important than ever to manage the specialized treatments and service offerings that provide the best value and yield. As these changes occur, there is a common theme: manage the variable costs associated with these services with the proper documentation and technologies to support them.

Health care providers will be juggling the regulatory requirements surrounding documentation with the facility's inherent need to reduce medical transcription costs. The increasing demand for medical transcription of patient care has been particularly notable over the past 10 years. This has allowed medical transcription service organizations (MTSOs) to provide higher levels of service with greater customer satisfaction. There are a number of reasons for the increasing demand for transcription: an aging population, the need for streamlined administrative tasks that provide for more time for patient care, perceived greater efficiency, ease and speed of dictating vs. other methodologies, reduction in qualified domestic MTs and of course the need to integrate documentation with the EHR. As we move into the future, there is an even bigger demand on administration to deliver high quality patient care and physician satisfaction while lowering the overall operational expenses of the organization. With the rising demand for medical transcription and technology comes the popular topic of total outsourcing.

Outsourcing as an Option
Depending on who you talk to, outsourcing can be extremely effective or seen as an enemy within an organization. Truth be told, many institutions no longer have the capital budget dollars to purchase new technology. Also, the volume and demand to justify sending work to anyone other than their in-house transcription team may be a foregone conclusion. This often results in using technology or methods that may not give you the most bang for your dollar. However, there are increasing instances where health care organizations cannot keep up with the increasing cost of maintaining technology. In addition, many cannot easily recover from dictation and transcription volume fluctuations. Quite often the need arises to pay overtime to in-house staff, when the back log is becoming unacceptable or ASP provider fees are too costly to manage. There comes a time when an outsourcing alternative appears as a legitimate option and maybe even a necessity.

There is more than one way to outsource transcription, though. Each health care organization can face different versions or levels of service. New alternatives provide many options to health care facilities, which include but are not limited to outsourcing technology and transcription services to one provider or outsourcing technology and partial transcription services while still maintaining an in-house team. These options can reduce or eliminate the high cost of technology maintenance contracts as well as the fear of technology obsolescence.

Reorganization
Naturally, if you have a tight-knit internal staff, the discussion of transcription outsourcing can create major concern and misunderstanding. One of the major misconceptions about reorganization as a result of transcription outsourcing is that in-house MTs risk losing their jobs to the new MTSO. However it is now commonplace for an MTSO to hire the in-house MTs and often move them to a remote position that offers the perks and benefits they were previously receiving. This can be a win-win because the hospital's internal staff can assist other MTs on account specifics and they continue employment while gaining the freedom of working from home, all of which allows for easier transition. Another positive for MTs moving to an MTSO is that they are given access to some of the newest technology within the market to help them become more productive and ultimately advance their careers.

Dedicated Overflow
An alternative to full transcription outsourcing is dedicated overflow, which can be a huge benefit to health care organizations that need assistance but don't require a complete overhaul of their transcription process. As with full outsourcing, dedicated overflow to your MTSO can still cause concern among HIM personnel. Kenneth Clyburn, an HIM director at Beaufort (SC) Hospital, discusses his own experience: "Our in-house MTs had the usual concerns thinking they might be replaced, wondering why we were changing to an MTSO and so on. They soon saw it was a huge advantage to them. When the dictation is overwhelming or they're out sick or on vacation, our MTSO takes care of everything." As you can see, it often takes going through the motions of outsourcing and reorganization for the entire staff to truly experience the benefits.

When outsourcing transcription, the level of reorganization truly depends on what your facility's goals and objectives are. The decision to outsource transcription should not be limited to cost-savings alone. Transcription volume, staff on-hand and your facility's needs all play vital roles in the process. Reorganization does not have to be a negative experience, and in fact can be very positive for the facility, its staff and ultimately, patients.

Tony Incardona is the senior vice president and managing partner of Outsourcing Solutions Inc.