Author Archives: Julie Clements
Managing Transcription Overflow Efficiently
Transcription work in a healthcare organization fluctuates throughout the year. Despite a transcription manager’s best efforts, overflow occurs. Managing transcription overflow is challenging but can be efficiently managed with some sensible planning. The main cause of overflow is the lack … Continue reading
Read MoreWhy Hospital Discharge Summaries are Very Important
Table of ContentsComponents of a Discharge SummarySignificance of Discharge Summaries often Overlooked, say StudiesIncomplete Discharge Summaries Cause Fragmented CareKey Elements of Discharge SummariesFlawless Discharge Planning A discharge summary is a valuable document that gives an overview of a patient’s hospitalization … Continue reading
Read MoreICD-10 Documentation Tips for Urinary Tract Infection (UTI)
Urinary tract infection (UTI) is a severe health problem that affects millions of people every year. A common type of infection in the body, it can also be a hospital-acquired infection. Not all patients show symptoms though most of them … Continue reading
Read MoreDocumenting Medical Necessity for Joint Replacement Surgery
Joint replacement surgery is recommended for patients whose symptoms do not respond to other treatment. When it comes to reporting claims, it is very important to prove that this procedure is medically necessary for the patient. It requires a specific … Continue reading
Read MoreCloud-based EHR Transcription Entering New Dimensions
Table of ContentsWhat Is an EHR That Is Cloud-based?The Shift to Cloud-based Electronic Health Record (EHR) SystemsThe Role of AI and Automation in Cloud-based EHR Transcription Cloud-based medical transcription services have technically been around ever since the development of this … Continue reading
Read MorePCPs Require Enhanced Clinical Notes to Provide Quality Care
Clinical notes are notes prepared in conjunction with a physician-patient encounter and are very significant for primary care physicians (PCPs) to provide appropriate care for a specific patient. Transcribing clinical notes is an important part of family practice transcription, which … Continue reading
Read MoreEHR Shortcuts – Are They Really Advantageous?
Many providers use shortcuts during EHR documentation to reduce the time taken for documenting a patient encounter. Though shortcut features may make you efficient, there is a greater chance for errors if you use those features inappropriately. Errors entering EHR … Continue reading
Read MoreWhy EHR-integrated Documentation Is the Need of the Hour
EHR-integrated medical transcription and documentation can serve the needs of physicians and practices by enhancing their efficiency and improving patient care. EHR-integrated Medical Documentation The electronic health record was introduced to improve the medical documentation process, and make it more … Continue reading
Read MoreAvoiding Transcription Errors in Medication Administration
Transcribing a medication order or the transfer of information from an order sheet to nursing documentation is a crucial step in medication administration. With accurate transcription, the other steps in medication administration such as dispensing the drug and delivering the … Continue reading
Read MoreDocumenting Physician-Patient Encounters Vital to Diagnose and Treat Chronic Migraine
According to a new study presented at the 57th Annual Scientific Meeting of the American Headache Society, migraines may be underreported and under-treated in teen athletes. In most cases studied, it is unclear whether there occurred an exacerbation of primary … Continue reading
Read More