Archive for May 21, 2010

Bar-code technology cuts medication errors: study

By Maureen McKinney

Using bar-code verification technology for medication administration can significantly reduce error rates and decrease the likelihood of adverse events, according to a newly published study in the New England Journal of Medicine.

In the study funded by the Agency for Healthcare Research and Quality, researchers at Brigham and Women’s Hospital, Boston, examined data from several units in the hospital as they rolled out a staggered implementation of an electronic medication administration record, or eMAR, with bar-coding technology. The use of a bar-code eMAR was associated with a 27% decrease in timing errors, such as late or early medication administration, and a 41% drop in the rate of errors not related to timing, which include incorrect dosages and administration without an order.

Also, researchers noted that the rate of potential adverse events associated with errors not related to timing fell from 3.1% to 1.6%—what they described as a nearly 51% relative reduction. Not surprisingly, use of a bar-code eMAR also eliminated transcription errors, which occurred at a rate of 6% on units that did not yet have the system in place.

Bar-code eMAR systems allow nurses to receive medication orders electronically from a pharmacist or from a computerized physician order-entry system, and then use a bar-code scanner to verify medications at the patient’s bedside.

The results of the study demonstrate that bar-coding can have a substantial effect on safety, according to Eric Poon, director of clinical informatics at Brigham and Women’s, and lead author of the study. Poon also expressed confidence that the observed improvements were due to the implementation of bar-code eMAR systems and not another factor.

“We took measurements within a pretty small time frame, and the implementation was the main project we were doing at the hospital during that time period,” Poon said.

Still unclear, however, is whether hospitals with limited resources should implement a CPOE or bar-code eMAR system, Poon said, adding that Brigham and Women’s has had a CPOE system in place for many years. The two systems catch different types of errors and complement one another, he said.

For instance, a CPOE system is more likely to prevent errors related to incorrect judgment or insufficient clinical knowledge when choosing a treatment plan, while a bar-code eMAR usually catches errors associated with lapses in memory or mental slips, the study said.

“If a hospital can only afford one, we need to know which one makes the most sense to implement first,” Poon said. “That question is still unanswered.”

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Medical Transcription Service – Digital Records in Safe Hands

The hospitals, clinics, health care centers and physicians, and all the other medical service providers look for the best medical transcription service. There are many companies which provide these services in conformity with the Health Insurance Portability and Accountability Act. These services are very cost effective and have helped in the efficient record maintenance of the patient’s medical records.

A Transcription Services Company should include transcriptionists of all medical sections like cardiology, radiology, orthopedics, pediatrics, gastro-enology etc. These specialists provide digital medical reports and that too with high quality of accuracy. The Health Insurance Portability and Accountability act was implemented by the US Health and human service department. This act ensures that the medical records of the patients are kept under strict privacy and that the personal information of the patients in not used for any other purpose than the medical or health related issues.

By the year 2014 all the patient’s records will be converted to digital records. This has been designated by the federal government.

The companies which work as per the guidelines of the Health Insurance Portability and Accountability act guarantee that the data of the client would be kept completely confidential. The best medical transcription service will also help in saving a lot of dollars per year.

The data or the information of the patient is recorded as a dictation and is transferred through Voice over Internet Protocol to the company which provides such services and the medical transcriptionist reviews and edits the reports and sends them online only. Along with the transcriptionists there are proof readers, editors and analysts who try their best to maintain the quality standards. For best quality there are there assurance levels that one needs to maintain.

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Transcription trade groups offer ethics guide

By Joseph Conn

The medical transcription industry, represented by its two trade groups, is preparing for what it sees as the possibility of heightened privacy, security and fraud enforcement by coming up with its own guidebook of ethics and best practices.

The Association for Healthcare Documentation Integrity, an association of medical transcription practitioners, formerly known as the American Association for Medical Transcription, and the Medical Transcription Industry Association, the trade group for transcription service providers, have released their “Manual of Ethical Best Practices for the Healthcare Documentation Sector.”

The release of the full guideline is timed to coincide with the MTIA’s annual conference April 28th-May 1st in Daytona Beach, Fla., according to Peter Preziosi, CEO of the two organizations, which formed what they describe as “a strategic legal partnership” in 2007.

Scott Edelstein, a Washington, D.C., lawyer in the healthcare law practice at Squire, Sanders & Dempsey, was the lead author of the manual for the MTIA and AHDI. Edelstein said that more stringent privacy and security protections in the American Recovery and Reinvestment Act of 2009—which include new breach notification provisions and empower state attorneys general to enforce HIPAA privacy laws—as well as the increased fraud-fighting sections of the recently enacted Patient Protection and Affordable Care Act, will likely yield more government enforcement activities going forward, Edelstein said.

And that prompted the two trade groups to take a pro-active approach in producing the manual. “I think just generally, the tone for this administration is going to be increased in enforcement, because there is increased sensitivity for privacy of information,” Edelstein said.

“Most of the companies in the medical transcription industry tend to be small mom-and-pop operations, but they’re handling such sensitive information,” he said. “The concern is that some of these companies may not have taken all the measures needed under HIPAA and fraud and compliance laws, and this manual was to provide guidance for them.”

Data on the medical transcription industry is somewhat sketchy. The federal Bureau of Labor Statistics places the number of medical transcriptionists in the U.S. workforce at around 100,000, but the BLS figures don’t capture independent contractors, according to Preziosi, “and I’d say a good 50% are independent contractors.”

Add in small physician offices where the office manager might double for an MT and, all told, there may be as many as 250,000 to 300,000 medical transcriptions working full or part-time for 1,500 to 1,700 companies, mostly sole proprietorships, though there also are a handful of “giants,” he said.

The manual offers a best practices check list, copies of the codes of ethics of both organizations, guides on billing practices and the rules on hiring employees vs. independent contractors, roughly 170 pages devoted to compliance with Health Insurance Portability and Accountability Act privacy and security rules, a how-to section on establishing a HIPAA-compliant home-based office, and a “50-state data privacy survey,” according to a listing of the manual’s contents on the AHDI website.

Such guidance doesn’t come cheap. Copies of the manual cost $4,000 for non members of the two associations, with prices ranging between free to $750 for MTIA members and $750 or $950 for AHDI members.

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