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In 2010, HHS determined it was time to replace its outdated dictation software. At the time, despite a transcription volume of approximately 4 million lines excluding pathology and the ER, outsourcing wasn’t something HHS was considering. In fact, not only was the health system managing its own needs internally, it was also providing transcription services to other healthcare organizations as an alternative revenue stream. Nonetheless, at the suggestion of its vice president, the Request for Proposal (RFP) HHS was preparing for prospective dictation technology vendors and was expanded to include information on transcription outsourcing. When the responses came in, it was clear outsourcing was something HHS needed to seriously consider.
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Hallmark Health: Amphion Takes Transcription Quality, Speed to the Next Level
CLIENT PROFILE
The premier charitable healthcare provider to Boston’s northern communities, Hallmark Health System (HHS) is one of the most technologically advanced community health systems in the region. It includes two acute care centers, Lawrence Memorial Hospital and Melrose-Wakefi eld Hospital, and is affi liated with Massachusetts General Hospital (cardiology), Tufts-New England Medical Center (neonatology) and Joslin Diabetes Center (diabetes care and management). The system also includes Hallmark Health Medical Center, Hallmark Health System Hematology and Oncology Center, CHEM Center for Radiation Oncology, CHEM Center for MRI, Hallmark Health VNA and Hospice, Hallmark Health Medical Associates and Lawrence Memorial/Regis College Nursing and Radiography Programs.
Founded in 1997, the 357-bed health system has more than 3,250 employees, 650 nurses and 700 affi liated physicians. It averages 65,000 emergency room visits, 17,000 admissions, 22,600 surgical cases and 116,000 home care visits annually.
HHS has earned a national reputation for excellence in patient care, including recognition as a Bariatric Surgery Center of Excellence by the American Society of Bariatric Surgery (Lawrence Memorial) and three-year approval with commendation from the Commission on Cancer of the American College of Surgeons (Hallmark Health Cancer Center). The system also earned above-average national quality ratings for heart attack, heart failure and pneumonia care from The Joint Commission and has been named among the region’s Best Places to Work for fi ve consecutive years by the Boston Business Journal.
A FORTUITOUS PIVOT
In 2010, HHS determined it was time to replace its outdated dictation software. At the time, despite a transcription volume of approximately 4 million lines excluding pathology and the ER, outsourcing wasn’t something HHS was considering. In fact, not only was the health system managing its own needs internally, it was also providing transcription services to other healthcare organizations as an alternative revenue stream.
Nonetheless, at the suggestion of its vice president, the Request for Proposal (RFP) HHS was preparing for prospective
dictation technology vendors and was expanded to include information on transcription outsourcing. When the responses came in, it was clear outsourcing was something HHS needed to seriously consider.
www.amphionmedical.com 8301 Excelsior Drive, Madison, WI 53717 888.830.2644
OUTCOMES
Annual savings of $600,000
Discharge summary turnaround times dropped from 14 days to 6 hours
Operative notes available within 2 hours
State-required reports available within minutes
Response to support requests within 15 minutes
“We originally estimated outsourcing would save $400,000. As it turned out, the savings was closer to $600,000. At that point, it really became a no-brainer.”
Nancy CloutierHallmark HIM Director
CASE STUDY
0
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$400,000
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$1,000,000
$928
,000
$989
,000
$595
,000
2010 Hallmark Actual Costs
2011 Projected Costs-Equipment Replacement
2011 Amphion Quoted Costs
Hallmark projects a cost savingsof $400,000 outsourcing to Amphion
Hallmark Health: Amphion Takes Transcription Quality, Speed to the Next Level
“Outsourcing was defi nitely the solution once we looked at it,” said Nancy Cloutier, HIM Director, Hallmark. “We originally estimated outsourcing would save $400,000. As it turned out, the savings was closer to $600,000. At that point, it really became a no-brainer.”
However, cost savings alone wasn’t suffi cient to convince HHS to turn over its profi table and well-run transcription service to an outsourcing partner. The health system had very lofty expectations of the vendor that would ultimately win its business.
First and foremost was to maintain the exceptionally high standards physicians were accustomed to receiving from the system’s internal transcription team.
“Our transcriptionists were amazing so our physicians were used to perfect dictation 24/7,” said Cloutier. “It was also very important that we have a trustworthy partnership.”
Also required was the ability to provide expedited turnaround times (TATs). Of particular importance was 24-hour TATs for discharge summaries, a criterion for meeting Stage 1 Meaningful Use. Finally, “we wanted to make sure they were accountable for whatever happened. We would consider them to be partners, not vendors, so accountability was important,” said Cloutier.
AMPHION MAKES THE GRADE
HHS ultimately selected Amphion Medical Solutions, a transcription and coding technology and outsourcing services provider. With extensive healthcare expertise and leading-edge technology, Amphion enables organizations to leverage the proven benefi ts of transcription and coding outsourcing. It also provides the technology needed for managing an in-house transcription team.
In addition to meeting all of the requirements laid out in the RFP, Amphion offered several unique services that stood out to HHS. Among these were highly trained and exceptionally qualifi ed transcriptionists capable of delivering the level of service the health system’s physicians had come to expect.
Amphion’s other secret weapon was its Triton Health Document Cloud™, which integrates M*Modal’s advanced
speech and natural language understanding (NLU) technologies to create the next generation of clinical documentation workfl ow. Triton provides transcriptionists with highly accurate documents ready for editing. It also allows clinicians to dictate, review and sign reports in one session or to send partial dictation to transcriptionists for completion. These capabilities deliver greater control over reporting while saving signifi cant time and money when compared to traditional transcription solutions.
Because Triton is based upon Amphion’s “right-sized” demand-based pricing model, hospitals pay only for the transcribed volumes produced. This reduces costs by aligning transcription expenses with actual utilization. The Triton platform also integrates easily with admission-discharge-transfer (ADT) and EHR systems and can be deployed by department or enterprise-wide. Finally, because Triton is cloud-based, no upfront investment in hardware or software is required and ongoing maintenance costs are eliminated.
Finally, robust speech understanding capabilities mean Triton is positioned to help hospitals meet proposed Stage 2 Meaningful Use criteria by translating physician dictation into searchable, structured information. Narrative clinical data is indexed and encoded for download into the hospital’s EHR system, while Triton’s NLU capabilities transform narrative dictation into standardized, structured and codifi ed HL7-compliant CDA output.
“Triton and its integration with M*Modal is phenomenal, especially the ease-of-use when compared to our previous dictation solution. It looked great and people left the Triton demonstration amazed at the platform,” said Cloutier. “Amphion’s pricing and turnaround times were also very competitive, which met our fi nance team’s requirements.”
www.amphionmedical.com 8301 Excelsior Drive, Madison, WI 53717 888.830.2644
Triton is based upon Amphion’s “right-sized” demand-
based pricing model, hospitals pay only for the transcribed volumes produced
CASE STUDY
Hallmark Health: Amphion Takes Transcription Quality, Speed to the Next Level
A SEAMLESS TRANSITION
It took just two months for HHS to transition its transcription services to Amphion, including those outsourced to HHS by other healthcare organizations.
“The entire process went very smoothly. Even the fi rst few months after going live were easy, almost seamless, for our physicians. Today, you talk to the doctors and they are amazed at the quality of the reports and how quickly they are getting turned around,” said Helen Pereira, Transcription Coordinator, HHS. “Amphion helped design the entire process, so it required very little work on our end.”
Of particular note is Triton’s live proofi ng queue, which allows transcriptionists to attach addendums to existing reports in real-time. When there are questions, the live queue enables real-time responses so issues can be resolved before the report is produced. Other favorites are the search functionality and the ability to see all the transcription rules to more quickly identify when modifi cations may be required.
Amphion also takes over HHS’ after-hours transcription phone and email support to ensure physicians can reach someone at any time. Typically, phone messages are returned within 15 minutes, while email is immediate. That attention to detail and responsiveness is also evident in the proactive approach Amphion takes to resolve dictation issues before they can impact TAT or quality.
“Amphion stepped up to take care of all of that. We couldn’t have picked a better company,” said Pereira. “They are reliable, always available and very attentive. When I ask a question or need a solution to a dilemma, they are there with ideas. Not more questions.”
MULTIPLE BENEFITS
In addition to high physician satisfaction rates with Amphion’s transcription services, HHS has realized signifi cant improvements in TATs—something that is critical for healthcare organizations seeking to qualify for Meaningful Use incentive funds.
Cloutier recalls an episode where a cardiologist dictated his surgical note while still in the cardiac suite. He intended to request an expedited report, but the transcription was complete and the report available for review and signature before he could place the call.
That speed is the norm. HHS has seen TATs for discharge summaries drop from 14 days to 2-to-6 hours, while operative notes are typically available within two hours and reports required by the state are turned around in just minutes.
“To this day, everyone is still amazed at the turnaround times,” said Cloutier. “Amphion’s support is amazing. The reporting quality is amazing. The physicians continuously tell us about the quality, and how they don’t need to proof reports as much. They have always held transcriptionists to very high standards and Amphion has exceeded their expectations.”
www.amphionmedical.com 8301 Excelsior Drive, Madison, WI 53717 888.830.2644
CASE STUDY
$840
,000
$989
,000
$458
,000
$478
,000
Replacing Outdated Equipment
Amphion Outsource
Saving more than expected, Hallmark made the right choiceoutsourcing to Amphion.
2011 2012
54%
sav
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43%
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