Quality clinical documentation begins with an effective dictation method. Well, dictation plays a major role in ensuring high-quality, timely reports, which has a direct impact on patient care and reimbursements. Dictating is a skill and requires practice to perfect it. By improving your dictation techniques you can ensure the highest quality transcripts. Here are some of the top tips that medical practitioners follow when outsourcing their dictations to transcription companies.
- Understand your recording gear: Whatever device you choose to capture your recordings – be it a digital recorder or a mobile app, first have a clear understanding of how to use it. Familiarize yourself with the various settings and the options available to ensure high-quality recordings. Be aware of the proper usage of the features like stop, pause, resume, and delete to avoid clipping of words and phrases.
- Choose the perfect environment: Microphones catch noises easily. So, choose a quiet, secure environment and try your best to minimize background noise. Turn off fans, air conditioners and, heaters that tend to create noise. Avoid eating, drinking, chewing gum, shuffling papers or rearranging your desk as all these can make it difficult for the transcriptionist to hear your dictation clearly.
- Get organized: Before you start recording, gather your thoughts and plan your dictations. Keep all records or reports ready that you may need for reference. This helps you with the flow of the dictation without any interruptions to your thoughts, ensuring accurate finished transcripts. Most importantly, you won’t miss out on any important information.
- Speak clearly: Now, position your microphone correctly and start recording. Speak clearly and at a steady pace. Choose to speak in a conversational tone. Never speak too fast because even the experienced transcriptionist will find it difficult to understand what you are saying. Pronounce words clearly and if possible, spell out commonly confused words, complex medical terminologies and jargon. Make it a point to spell out all patient names.
- Give clear instructions: Make sure to give clear instructions with regards to punctuations. This includes a period, a comma, open and close quotation marks, parenthesis, a new line, and a new paragraph. Do not forget to say “end of dictation” or “end of recording” when you are done. This lets your transcriptionist know that it’s the end and there’s nothing more to come.
- Avoid too much usage of abbreviations: Abbreviations and acronyms are generally used to keep dictation succinct and concise. While abbreviations and acronyms may be used to some extent, excessive usage may be interpreted incorrectly or obscure the intended meaning.
- Do not repeat: Never repeat yourself. Instead, pause your recording. Your transcriptionist will rewind and listen to it again if needed. Avoid using a lot of ahhhs, ums, ers and uhhhs. This could be mistaken for the letter “a”. Rather, use the pause option.
- Choose the right transcription company: Once you are done with the recording, the next step is to choose between automated speech recognition software and a human-based transcription service. To ensure accuracy and timeliness, it is better to go for a professional human-generated transcription service.
The above-discussed practical dictation tips will help you dictate with ease and confidence. And trust us, your medical transcriptionist will definitely provide you with consistently high-quality, accurate, and timely medical transcripts, every time.