Wav files – Patient encounters with no editing?

In my travels around the state and national AHIMA shows over the last several years I’ve spoken to a number of technology company executives, being interested in their take on where technology is going in healthcare administration.

Speaking with a high-level executive (not a salesperson) from a healthcare technology company, I asked him where he specifically saw transcription in several years. To paraphrase, he said “It’ll be gone; there won’t be any.”

Now, I try to take all information in without judging it (not always successfully) but this comment really gave me pause … for a long time. He said he envisions audio .wav files being attached to the patient’s chart for each healthcare encounter, with no written transcript.

The thought has been stuck in the back of my mind for a couple of years now and speaking with someone recently I finally figured out that in our current and near future (five years at least!?) environment, this just isn’t going to happen.

One major reason is revenue cycle management. Maybe I’m missing something and I’d like to hear other opinions about this, but how can the coding occur from a .wav file? In an era when so many are trying to get to computerized coding, we would now have a voice file with no eyes (brain) at least scanning it for accuracy, when there’s already less human intervention with computerized coding.

The bottom line is the bottom line will suffer. Revenue cycle management, which is already challenging, would be put under even greater pressure.

All of that is before we even consider the issues of time and space. How long will it take to pull up an audio file and listen through it for the relevant statement, versus the time it takes to pull up a text file and glance down for a key word? Multiply that time difference by dozens of patients each day.

And will computers systems even have enough room to store all of those .wav files? This article, as a Word doc, takes up 14 KB on my computer. Read aloud and stored as a .wav file, it takes 195 KB; that’s 14 times more space for one file. Again, multiply that out by tens of thousands of patient encounters at even a small physician practice.

In the current economically challenging and federally mandate-driven landscape, it’s hard to envision this working well and enhancing what we all are concerned about first: patient care.

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4 Responses to Wav files – Patient encounters with no editing?

  1. Vishwa says:

    At least in 10 years this is not going to happen. But I feel e-scription is going to reduce that many transcptionists to become editors.

    Another view — May be the audio wav file is fed in to an e-scription (future) machine which displays what is dictated…. sure will take more time, now that Steve Jobs is not around …!!!

  2. Joe Weber says:

    Linda, I wholeheartedly agree with you. There are multiple reasons why a voice file can’t become the clinical note. But the future of transcription does not look good. Speech recognition, offshore competition, and EHRs are all eroding the demand and value of this professional service.

    I’m now involved in pioneering a new career for MTs. Medical Coordinators listen into clinical encounters from a remote location, documenting the entire clinical note directly into the EHR, using both narrative and codified data entry. The documentation “magically” appears on the screen in the exam room. Early-adopting physicians are ecstatic. They can concentrate on patient care, and the MC’s documentation is superior to what they could have done. They are also able to see an additional patient per hour, more than offsetting the cost of the MC.

    The MCs are equally positive about their new career, being fully responsible for the documentation — not just transcribing what a physician dictates. Information on how this works and on how MTs can get trained to become MCs is at http://www.valadoc.com.

  3. Jim Harter says:

    Docs won’t take the time to listen to a wav file. they will just move forward and make noise to the powers to be. Once Docs can document and capture data while they dictate that will be the new way to be productive. because those trusted insurance reports dictated will update their EHR and produce the same old documents. that capability is on its way.

  4. Laura says:

    My first thought is that this executive has never listened to an actual dictation. There’s simply no way physicians and nurses are going to be able to make sense of dictation unless doctors slow down and articulate clearly. It never ceases to amaze me how often people pontificate about dictation and transcription and how little they actually know.

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