CBay Systems is unifying its medical transcription, advanced speech and language understanding technologies, coding, HIM professional services and analytics under the moniker of M*Modal Global Services. CBay, which acquired advanced Speech and Natural Language Understanding technology integrator – M*Modal in 2011, counts India as the prime location to support that growth. Juergen Fritsch, Chief Scientist, M*Modal in conversation with Durba Ghosh
Tell us about the reach and scope of the services provided by M*Modal, a CBay Systems company.
We are primarily focused on clinical documentation services such as medical transcription, where we take advantage of various technologies including speech recognition and natural language understanding. Although we believe in the power of technology, we are also aware that services are equally important. Therefore, we combine our technological and service capabilities to offer various services in the healthcare industry. Currently, we handle about four billion lines of transcription per year. Despite that, very little outsourcing is occurring right now and transcription is still largely done in-house by physicians.
What are the key services demanded by the hospitals as of now?
Today, it is primarily about transcription. In the US, adoption levels are about 30-40% for transcription services. Typically, doctors dictate a report over the phone or record it and send it to us. That’s then distributed to our production centers where it is proof read and sent back to the doctor.
What are the trends that you foresee in this space?
Technology is going to play a big role in medical transcription going forward. There is a push towards electronic recording, or directly dictating to the computer, which then translates it into text. There is also a push towards the usage of natural language identification, which will help in creating a database of specific things. We currently use it to determine the doctor’s identity. We are investing heavily in natural language understanding as it’s no longer sufficient to simply create a text. Nowadays physicians need to create more data about the diseases that the patient has had, allergies, history of medication that’s been prescribed, etc. It is all in the dictated text somewhere and natural language understanding helps extract that information and push it to a systematic electronic database.
Hospital chains are trying integrate their databases across hospitals. Moreover, coding services are expected to become vital, which will help in billing and other administrative functions in a hospital.
How important is India to all these services that you offer?
India is vital to what we do as a business. Right now, it is the cost advantage. We have the biggest part of our development team in Bangalore, India. About 15-20 of our production centers are in India. Moreover, we have constantly increased outsourcing to India to reach the present level of about 50%. The plan is to grow as much as we can. The goal is 70-75%, but that is far away. As far as our customers are concerned, they are mostly in the US, Canada, EU and now in Australia. We do not have any customers in India as of now, but there is an uptick, and we do see a push in India for the technology.
What are the typical risk factors involved in this business and to what extent can training minimize said risk?
We try to minimize both risk and errors by executing three to four levels of proofreading and quality checks. In electronic recording, we sometimes send the text to our production centers in order to avoid errors. If the doctor makes an error, we have medical experts who understand the medical terminology and are experts in picking out errors. We usually pass the dictated text through a medical expert and, from there, it goes to the quality assurance team. If that doesn’t work, it is sent to the doctor again for verification. In emergency cases, error rates tend to be higher. In these cases, service becomes crucial.
We take up extensive training on medical language. However, statistically, when we compared our error level with instances wherein physicians transcribe by themselves, we have a lower error rate. We have also started informing doctors about the errors that they make to ensure transparency. We provide physician support telling them if a particular medication will work or not based on past diagnosis. Every hospital has a specific guideline, on formatting and database maintenance and we customize according to that. It can be at a basic level or it can be at a specific level where each doctor has a different set of requirements.
What are the other sectors where these services can be used?
Sectors such as legal services, financial services, brokerages and also telecom, education etc will also find our services to be of use. Having said that, we are completely focused on healthcare right now. If we decide to get into the legal or financial sector, the same technology will be used. Since we develop the technology in-house, we license it to our partners, who in turn have deployed it in various sectors.
