Thursday, September 6, 2007

Learning to Communicate Effectively

Throughout the 20th century, the means of documenting patient care have been changing. Originally, it was the doctor's responsibility to generate and maintain all records documenting a patient's medical history. Many doctors, however, had terrible penmanship. Their handwriting was undecipherable.

It still is!

With the advent of the typewriter and the development of shorthand as a professional office skill, it became possible for a physician to dictate notes to a stenographer who could take down his words and transform them into print at a later time. This marked the first time that a physician did not have to be the person who actually wrote the words used in his patient documentation.

Over the years, new technology has dramatically altered the process of dictating information to someone who can then transform the spoken word into printed matter.

By the late 1960s it was possible for physicians to dictate their reports onto some type of magnetic media (vinyl belts or recording tapes) which would store their speech so that someone else could replay the tape and listen to the speech exactly as it was delivered.

This meant that, for the first time in history, the person transforming the doctor's words into print did not have to be in the same room as the dictating physician (as long as someone had compatible equipment for transcribing dictation from a vinyl belt or magnetic tape, that person could be located in the next room, the next building, or the next city).

Within several years, it became possible for doctors to dial into a central dictation system which employed tape carousels or continuing loops of tape to record dictation in analog format. Although these systems made it possible to "bleed" sound onto tapes (which could then be distributed to medical transcriptionists at remote locations), it was often impossible to track a specific report or access a report on a STAT basis.

Digital recording technology has dramatically changed the dictation/transcription process. Today, transcriptionists in remote locations can easily access a particular piece of dictation, transcribe it, and then transmit the finished report over the Internet to a computer at the location where the report is to be printed.

The change from analog to digital recording (combined with advances in computer technology) has broadened the distance between dictator and transcriptionist from three feet to more than 10,000 miles.

[Cartoon #13]

Next: The Hidden Cost of Substandard Dictation

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