Steven D. Atwood, M.D., FACP

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Maybe Its Time You
Step Up To Digital Dictation

• Steven D. Atwood, M.D., FACP
• satwood_at_pol.net
• www.adultmedicine.com/presentations/digital-dictat
  ion-mt.ppt

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Digital Dictation for the MT

• Benefits
• Charges
• Where the Jobs Are
• Dictation Equipment
• File Transfer
• Player Equipment
• Typing Time Savers
• Summary

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Digital Dictation

• Doctor dictates in office
• Transcriptionist types at home
• Return the next day
• Easily printed, saved, or inserted into an EMR

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Benefits

• No daily trip to office for work or pick up
  a dictation tape
• No files to get stolen from a work-at-home
  transcriptionists car
• No irreplaceable files to get lost
• Quicker return of workesp. letters
• Add to Electronic Medical Record later

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Benefits

• Huge increase in number of people that could do
  this work
• Easy to get the services of those with the best
  expertise and greatest skills
• 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)

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Other Office Issues

• Less payroll expense for office
• No benefitswork comp,
  health insurance, etc.
• Less personnel managemente.g. late, sick, slow,
  chatty, inefficient
• No staff to train
• No office space needed

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Benefits

• Greater take home pay for transcriptionistwork
  more, make more
• Better sound quality for transcriptionist
• Higher quality transcribed product formatted
  for saving or adding to EMR

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Risks

• Confidentiality, HIPAA
• Cost of hardware, software, computer, and
  Internet link

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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

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Service Providers

• UnlimitedTranscriptions.com
• DoctorDictate!.com
• Medical Transcription.com
• List at
• Yahoobusinesshealthmedical_transcription
• TranscriptionGear.com

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Yahoo Listand goes on for 3 pages
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Yahoo List of MT Service Providers
list goes on for 3 pages
http//dir.yahoo.com/Business_and_Economy/
Business_to_Business/Health_Care/
Health_Care_Services/Medical_Transcription/
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Dictaphone
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Portable Recorders Many Options

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Panasonic 9300
Slide bar
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Clever Gear holds 8 hours dictation
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Olympus 330 160 5 hours, 5 folders,
compressed file Off-Load by USB Wire not Smart
Card
USBport
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Dictation for the Busy Physician--
hold in your hand, use on the move
Digital Dictation- MT
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Dictation for the Busy Physician--
work from your desk-- just
plug in and record
Digital Dictation- MT
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Dictation for the Busy Physician--
noise canceling microphone can
move about room in needed
Digital Dictation- MT
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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
• DSSOlympus format, compressed 12 to 1
• OGG (open source) ,MSV (Sony) , SRF, WMP, etc.

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Security

• Encryption
• like a childs decoder ring e.g.
  substitute 1a 2b 3c thus cab312
• You Encrypt (or Convert) Then Send
• Receiver Needs Your System to DecodeThis Is
  In The Key You Give Them In Advance
• You Receive By The Same System In Reverse

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SSL or Secure Socket

• Is Basically Encryption from a
  Web Page WithThe Computer to
  Computer Link Having All Data EncryptedThis
  is Called a Secure Socket or SSL (Secure Socket
  Layer)
• BidirectionalSend and Receive

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SSL or Secure Socket

• DropChute SSL like
  online transactions-- sends like Instant
  Messenger-- i.e., only when both
  parties on line

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• Security Options
• Password on File
• Password on Website
• Encrypted File
• SSL
• Modem only on web briefly then off
• Firewall
• Hacker Blocking Software on ISP Webserver

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Size Matters
Uploade.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)
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Size Matters
Returned Typinge.g. 1 paragraph Format---File
Size TXT 4 Kb RTF 4 HTML 8 PDF
16 DOC 30
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Size Matters
Returned Typinge.g. 1 paragraph Format---File
Size TXT 4 Kb RTF 4 HTML 8 PDF
16 DOC 30
RTF Format Ideal BecauseUniversal
standard Software type and version independent
No Macros So Less Virus Risks
RTF
File Upload Typically 3 MBs., Download ½ MB.
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Software to Play the Sound File both
hands on keyboard, foot pedal
Gear Player Voice It Voice Scribe Express
Scribe (free) Start Stop
Windows Media Player Real Player WAV
Player Sound Forge
Digital Dictation- MT
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Useful Features of Player Software
sound word processor speed control
auto-text start / stop
cut and
paste rewind few seconds
templates rewind unlimited fast forward volume
control pitch control
Digital Dictation- MT
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Time Savers

• Auto-Text
• Normal.dot and your own DOT file
• Header for your office letterhead
• Digital Signature
• Bookmarks controlF9 --insert
  F11 --jump

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F-11 Jump to bookmark
Add auto-text
Digital Signature
Digital Dictation- MT
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Digital Dictation Summary

• Soon all dictation will be done this way
  
• Need player,
  headset, foot pedal recorder, transfer to
  computer transfer encrypted via web
• Improved quality, faster, inexpensive,
  and better convergence to EMR

digital -dictation-for-mt