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EMS Operations: Create Fast, Detailed Patient Care Reports with Voice Technology

Author: Tim Palmer

Copyright: 9-1-1 Magazine, Feature Content,

Date: 2014-03-31
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Digital dictation and transcription are some of the most rapidly adopted technologies by emergency medical service (EMS) professionals, and for good reason. Voice technology allows emergency workers to capture crucial patient care details faster and more efficiently than typing, and it helps EMS companies submit cleaner, more accurate claims and bills. The results are safer handoffs at the hospital, higher quality patient care and faster reimbursement.

Voice technology also integrates with electronic EMS systems, which promotes even faster patient care report (PCR) creation and information transfer with the hospital emergency department (ED).

EMS companies that type their PCRs or still use analog tape and manual transcription for their dictations may be wondering how to get started with implementing digital voice technology. The answer depends on the technical aptitude of the EMS professionals and the company’s current information technology infrastructure. Regardless, nearly every EMS company can benefit from the transition to digital voice technology.


Capture the important details

Verbal information exchanges between EMS professionals and hospital providers during patient handoffs will remain a constant, but relying on spoken words alone is risky for both the patient and the clinicians, according to research. Only 49.2 percent of the verbal information delivered at handoffs by ambulance crews was accurately retained by ED staff, according to a study published in the August 2007 edition of Emergency Medical Journal.1 (Emerg Med J. Aug 2007; 24(8): 539–542. )

As the population of patients with multiple chronic conditions climbs, the amount of clinical data EMS professionals need to capture is also growing. Trying to convey all that relevant information during a hectic handoff can be challenging for the EMS and hospital providers. While an electronic EMS system may help reduce some data loss, the PCR is still limited to the professional’s time and memory. As most emergency workers will attest, speaking is always the fastest way to convey information, and studies have shown that people speak on average seven times faster than they type.

EMS companies that have added voice technology typically either use handheld digital recorders or a dedicated dictation microphone located in the ambulance, and some use both devices. The choice of either device depends on the professional’s dictation workflow preference and the nature of the emergency call, but both offer similar benefits.

Handheld recorders allow professionals to dictate out of the ambulance, which may be more convenient depending on the call and also allows users to describe details as they are seen. With modern voice technology systems, once the dictation is complete, the professional uploads the dictation to their laptop where it can be automatically transcribed using speech recognition software.

With a dictation microphone, EMS professionals record directly into the electronic PCR template, navigating around the screen with voice commands and microphone buttons, watching their dictation be automatically transcribed as they speak. With either workflow, by the time the ambulance arrives at the hospital, the PCR is usually ready to be merged with the hospital’s electronic health record. This does not excuse the EMS professional from performing a careful handoff, but it helps ensure that important data accompanies the patient to the hospital.


Improve workflow and the billing process

Using voice technology, EMS professionals can create a more detailed PCR in less time and more conveniently than typing. This abundance of information also enables the EMS company to submit clean and accurate claims and avoid pitfalls down the road, such as rejections, requests for more information or insurance audits.

With a comprehensive PCR, EMS companies have the data to support the medical necessity and payment level for a successful claim adjudication on the first submittal. If there are subsequent questions from the insurance company, the administrative staff has easy access to the claim and the record and can be confident that there will be ample evidence to satisfy the payer inquiry.

Inadequate documentation, on the other hand, exposes EMS companies to more risk than just a claim rejection. In medical malpractice liability lawsuits, for example, often all providers are named as defendants and have their records subpoenaed. The level of detail possible using voice technology can go a long way in helping EMS professionals protect themselves in litigation. The clarity of digital recordings also far exceeds analog tape in the courtroom and during depositions. Another benefit of adequate documentation is it allows companies to more easily comply with state and federal reporting guidelines for PCRs—especially since many states are now requiring reports to be filed within 24 hours.


Discover the benefits of voice technology

Although EMS professionals work in variable, often hectic, environments, modern voice technology hardware can support quality recordings, no matter what the surroundings. Advanced handheld devices can be operated with a glove-covered hand and are equipped with microphones that support dictation when placed near the mouth or conducting interviews when placed flat on a surface. Dictation microphones and handheld devices also have filters that can block ambient sounds for a higher quality recording.

To implement digital dictation and transcription into their workflow, EMS company leaders must assess their staff’s current technical aptitude, their current computing hardware and network infrastructure, and professionals’ willingness to dictate PCRs. Most EMS professionals are more than happy eliminate typing during calls, but change management is one factor for which leaders need to prepare. When leadership is fully supporting the switch to voice technology and actively promotes the benefits to employees, the staff is usually receptive to learning and incorporating it into more calls.

The use of speech recognition technology, which EMS companies tend to prefer, requires some acclimation because the software needs to learn the unique attributes of the speaker’s voice. Although this typically takes only a few hours, professionals will initially need to repeat some words/phrases and proofread transcribed text more carefully while training the speech recognition software. EMS companies with transcribers on staff, or that outsource these duties, may find they are able to repurpose those employees to only review and proofread the transcriptions that are created by the speech recognition software.

Regardless of the dictation method or voice technology chosen, EMS professionals will quickly discover that using their voice instead of their hands to document care is easier and more efficient. In the long run, the EMS company, hospitals and patients will all appreciate the benefits.


About the author
Tim Palmer is key account manager at Speech Processing Solutions, the manufacturer of Philips dictation solutions.

Photo: Tele Atlas (via 9-1-1 Magazine photo archives).


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