Client:	Ascriptus, Inc.	Greely, CO
Project:	HIPAA-Compliant Medical Transcription System
Solution:	XML-Enabled, Voice-Activated Pocket PC Application; Secure Intranet Portal; Office XP-Enabled Transcriptionist Workbench

Ascriptus offers HIPAA-compliant solutions that revolutionize medical transcriptions: XML-enabled, voice-activated Pocket PC applications; fault-tolerant, secure Intranet portals; and an Office XP-enabled transcriptionist workbench.

Ascriptus envisioned a solution that would significantly improve the doctors’ and transcriptionists’ productivity and collaboration. The Office XP custom smart tag technology brings a critical, value-added component to this innovative product. The voice navigation feature enables a major efficiency, which truly improves the way they work.

The solution was built for our customer, Ascriptus, a Colorado-based healthcare company. Their customers are physicians, clinic managers and medical transcriptionists. Medical transcription and coding in the United States is a $20.6 billion annual market. This market is starving for technology advancements that meet the new HIPAA standards and decrease cost and workload.

Physicians dictate medical notes an average of two hours per working day and pay an average of $24,000 per year to have these notes transcribed as part of a patient’s medical record. The document created supports a designated code.

This code is selected from over 8,000 CPT (procedure) codes and 20,000 ICD-9 (diagnostic) codes required by Medicare, Medicaid and insurance companies. The complexity of this system and the required documentation by physicians has resulted in substantial under-coding, and underpayment estimated by the government to average $60,000 per year per family practice physician.

In many cases, individual transcriptionists pick up doctor-dictated tapes and deliver finished transcriptions daily. Many times, however, the tapes reflect patient visits from several days before, meaning the process is always a few days behind.

By building the solution using the Microsoft suite of tools, we were able to develop their product in less than six months, well ahead of their competition. The solution requires the integration of many environments: Pocket PC, Web, Client and Server. In addition, Ascriptus is now well-positioned to expand into new markets, with the agility to rapidly add new features and execute on future product initiatives.

The Office XP custom smart tag technology, along with COM Add-ins, enables custom Word macros to create patient notes with significant time savings. Medical phrases are automatically recognized as Office XP custom smart tags through a memory resident dictionary lookup.

The ability to embed Office XP desktop applications directly into custom business applications is demonstrated in the Virtual Transcriptionist Desktop product.

Digital signature technology supports the need for a physician’s authorization and signature on the patient notes. The Virtual Transcriptionist Desk Module utilizes voice command navigation, which reduces keystrokes and minimizes mouse usage.

The system architecture uses COM in many ways. On the physician’s Pocket PC, an ActiveX control provides an advanced voice recorder control. The transcriptionist client uses COM to automate Microsoft Word as an integral part of the Virtual Transcriptionist Desk Module (VTDM). Smart Tag actions and COM Add-ins use COM to pass information to the VTDM application. SOAP (over SSL) serves as the protocol to make secure calls to the server-based COM components from both the VTDM and the physician’s desktop. COM+ components contain all of the application code on the servers to allow for an N-tier deployment strategy.

The SOAP technology enables secure messaging (via SSL) between the transcription software and the server to acquire server-based information. It also supports the scheduling and dictation uploading features by synchronizing messaging between the clinical manager workstation and the intranet servers.

XML and XSL/T technology facilitate the physician’s prompts used in the dictation process, which allows customized data views for each physician. The web portal product also implements these technologies to display personalized web pages.

Read the Microsoft Case Study