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Backlog reduction strategies for LM HIM Transcription Services

Backlog reduction strategies for LM HIM Transcription Services

Current situation:

Lower Mainland Health Information Management Transcription Services (LM HIM TS) currently has turnaround times that far exceed appropriate standards for dictated reports.  
While Discharge Summary and Consult reports are up to date, FHA, VCH and PHSA are currently all experiencing 30+ day backlogs in Operative and Outpatient reports. This backlog includes dictations performed between the dates of September 12th to current date.  
There are many factors causing the backlog. Year over year dictation volume has increased over 10% and the volume increase was not adequately absorbed by our current outsourced vendor Accentus. This is exacerbated by challenges filling transcriptionist vacancies, and a 2% increase in sick time of medical transcriptionists over last year.
We recognize this negatively impacts care delivery and have take action to improve service.  

Strategies to reduce transcription backlog:
We recognize that this backlog is unacceptable and have put in place the following new strategies to expedite the reduction of transcription backlogs:

  • Accentus, our current outsourced transcription services vendor, is now contractually required to take on an additional 10% of dictation volume to address current backlogs. If Accentus cannot meet this target, PHC can award this work to our incoming outsourced vendor, M*Modal.
  • M*Modal has been confirmed as the incoming provider for LM HIM Transcription Services technology and labour. This allows us to transition work from our current labour force (Accentus and internal transcriptionists) to M*Modal’s transcription staff. We anticipate M*Modal staff will have access to our current transcription systems by mid-November and will begin working on reducing the backlogged volumes first.
  • We are offering overtime to internal staff and are reassigning our transcriptionists as necessary.
  • We are reconfiguring internal transcriptionist work processes to address the oldest, backlogged dictations.
  • Despite the outsourcing initiative, we are still actively recruiting to fill current medical transcriptionist vacancies for the interim period.

We anticipate significant service improvement by the end of November. 

Prioritizing reports:
We understand that in a backlog situation it is only natural to begin using the “priority” button in an effort to get reports transcribed in a timely fashion. However, the overuse of the priority button has caused further delays as it interferes with the processes in place to optimize the efficiency of our dictation/transcription system. The dictation/transcription system is designed to send work to transcriptionists in a specific order to maximize overall operational efficiency and allow us to meet our established turnaround time commitments.  
High use of the priority button delays our ability to transcribe our oldest reports and interferes with this established work routing system.  
We are currently working with physicians to develop guidelines on when to use the priority button. We will be uploading these guidelines to the Resources for Physicians section on the LM HIM Transcription Services intranet site in the near future.

Processes for requesting urgent record transcription:
We recognize that transcription work needs to be completed in a timely manner for most effective patient care, and that backlogs are unacceptable.
If you do require urgent dictation, please contact Transcription Services directly at the following numbers:

Cambie Hub (Services PHSA, VCH & PHC)  Reception 604-806-9696


Any questions can be referred to Yoel Robens-Paradise, Executive Director, Lower Mainland Health Information Management at yrparadise@providencehealth.bc.ca or 604-806-8098 or Naomi Brooks, Director, Lower Mainland Health Information Transcription Services at naomi.brooks@vch.ca or 682-2344 ext. 64850.