1. Digital Dictation 1 Steven D. Atwood, M.D., FACP satwood@pol.net www.adultmedicine.com/presentations/digital-dictation.ppt Maybe It’s Time You Step Up To Digital Dictation

2. 2 You dictate in your office Transcriptionist types at home Return the next day Easily printed, saved, or inserted into an EMR

3. Digital Dictation 3 Benefits  No daily trip to office for work or pick up a dictation tape  No files to get stolen from a work-at-home transcriptionist’s car  No irreplaceable files to get lost  Quicker return of work—esp. letters  Add to Electronic Medical Record later

4. Digital Dictation 4 Benefits  Huge increase in number of people that could do this work  Easy to get the services of those with the best expertise  More services by transcriptionist e.g. Excel, Access, Faxes  Greater efficiency of software and equipment e.g.. 1 license for software that manages dozens of doctors  Transcriptionist work environment more comfortable— (work from home)

5. Digital Dictation 5 Benefits  Less payroll expense for office  No benefits—work comp, health insurance, etc.  Less personnel management—e.g. late, sick, slow, chatty, inefficient  No staff to train  No office space needed

6. Digital Dictation 6 Benefits  Greater take home pay for transcriptionist  Better sound quality for transcriptionist  Higher quality digital product– formatted for saving or adding to EMR

7. Digital Dictation 7 Risks  Confidentiality, HIPAA  Cost of hardware, software, computer, and Internet link

8. Digital Dictation 8 Paying for the Service  Pay by key stroke or line 1. 72 characters per line, 8-16 ¢ per line 2. convert to a charge per key stroke --e.g. 10 ¢ per line= 0.0137 ¢ per key stroke

9. Digital Dictation 9 Service Providers  UnlimitedTranscriptions.com  Doctor:Dictate!.com  Medical Transcription.com List at Yahoo>business>health>medical_transcription TranscriptionGear.com

10. Yahoo List—and goes on for 3 pages

11. Digital Dictation 11 Dictaphone

12. Portable Recorders– Many Options

14. Slide bar Panasonic 9300

15. Clever Gear– holds 8 hours dictation

16. Olympus 330 $160 5 hours, 5 folders, compressed file Off-Load by USB Wire not Smart Card USB port

17. Digital Dictation 17 Sound Formats Just Like Picture Formats-- (dozens of options)  WAV– Windows standard, you type your notes from this file  MP3--- compressed 12 to 1  VOX– phone lines  DSS—Olympus format, compressed ~12 to 1  OGG (open source),MSV (Sony), SRF, WMP, etc.

22. Digital Dictation 22 Security  Encryption like a child’s decoder ring e.g. substitute 1=a 2=b 3=c thus cab=312 You Encrypt (or Convert) Then Send Receiver Needs Your System to Decode This Is In The Key You Give Them In Advance You Receive By The Same System In Reverse

23. Digital Dictation 23 Is Basically Encryption from a Web Page With The Computer to Computer Link Having All Data Encrypted This is Called a Secure Socket or SSL (Secure Socket Layer) Bidirectional — Send and Receive SSL or Secure Socket

24. Security Options 1.Password on File 2.Password on Website 3.Encrypted File 4.SSL 5.Modem only on web briefly; then off 6.Firewall 7.Hacker Blocking Software on ISP Webserver 23

25. Upload— e.g. 30 minutes dictation File size: WAV format that is used to play the file for typing (1 MB for 5 minutes) (30 minutes = 6 MB) DSS format from Olympus is Compressed (30 minutes = 1 MB) Size Matters 24

26. Returned Typing—e.g. 1 paragraph Format---File Size TXT 4 Kb RTF 4 HTML 8 PDF 16 DOC 30 Size Matters

27. Returned Typing—e.g. 1 paragraph Format---File Size TXT 4 Kb RTF 4 HTML 8 PDF 16 DOC 30 RTF Format Ideal Because Universal standard Software type and version independent No Macro’s— So Less Virus Risks Size Matters RTF File Upload Typically 3 MBs., Download ½ MB.

28. Time Savers 1.Auto-Text 2.Normal.dot and your own DOT file 3.Header for your office letterhead 4.Digital Signature 5.Bookmarks control+F9 -- insert F11 -- jump

29. Digital Dictation 29 Digital Dictation Summary Soon all dictation will be done this way Start with a digital recorder Improved quality, faster, inexpensive, and better convergence to EMR