Error Calculation In Medical Transcription

CHAPTER – 4
ERROR CALCULATION IN MEDICAL TRANSCRIPTION

Accuracy in Medical Transcription – A Point that can Save a Life

No one would dispute that accuracy in medical documentation is vital.

Generally, typing accuracy is calculated by the number of correct entries divided by the total
number of entries, and then multiply by 100 to get a percentage. For those who like
formulas,

Accuracy = (1 – # errors) x 100

However, when dealing with medical documentation, errors are not just inconvenient, they
can be outright dangerous to the patient. So, a different formula is used to calculate typing
accuracy when it comes to medical documents.

In this formula, errors are assigned a “point value”. A critical error is given a higher ‘point
value’ than a minor error and the expected degree of accuracy is 98%.

To calculate the ‘point value’ of errors, the ADHI generated a scale of what was considered
unacceptable.

 Critical errors – 3 points
 Major errors – 1 to 1.5 points
 Minor errors – 0.25 to 0.5 points
 Administrative/Educational – 0 points

In 2017 this scoring system was reviewed to remove the Major Error category, with items
within that been either being promoted to a Critical Error or redefined to a Noncritical Error
Category worth 1 point, Minor errors and Administrative/Educational errors remain the
same.

There are two methods of implementing this system, and it should be up to the individual
organisation to determine the one that best meets the needs of their business.

Method 1: Error from 100.

A very simple calculation where every error is multiplied by it’s relative ‘point value’ and
deducted from 100. Therefore one critical error will mean the document fails the QA
assessment.

Accuracy = 100 – ((# x point value) + (# x point value) + (# x point value) + …)

Method 2: Errors by number of lines

This method takes into consideration the length of a report, as well as. While a relatively
short report of only 20 lines will fail QA assessment the first method, so too will a report of
200 lines which is otherwise faultless. This second method factors in the length of the
report.

Accuracy = (100 – (# x point value) + (# x point value) + (# x point value) + …)) ¸ # lines
typed

DEFINITIONS OF DIFFERENT CATEGORIES OF ERRORS:

Now you know the formulas, let’s look at the definitions for each of these error
categories. In summary:

A critical error is one which

 Adversely impacts on patient safety
 Alters a patients’ care or treatment/
 Adversely impacts the accuracy of coding and billing
 Results in a HIPPA violation
 Adversely affects medicolegal outcomes.

Some example of this would include things like incorrect terminology which alters or
obscures or is opposite to the intended meaning (hypo-/hyper-, known/no,
regular/irregular), incorrect medication (including name, dose/dosage, unit of measure and
method of administration), incorrect side/site (left/right, peroneal/perineal), use
of unapproved abbreviations, omitted or inserted (“note/bloat”) text, failure to flag critical
inconsistencies/discrepancies, use of confusing words/phrases.

A noncritical error impacts on document integrity but does not have the potential to affect
patient safety, care or treatment.

Examples would include incorrect spelling of medication or terminology, punctuation that
alters/obscures meaning, nonsense text, incorrect medical homophones, and failure to
follow the Style Guide or individual account specifics.

Differentiation between Minor and Administrative/Educational errors are at the discretion
of the organisation. Companies may choose to limit the number of Repetitive Educational
errors within a report, or may upgrade repetitive educational feedback as a minor error.

These would include things like grammar/punctuation/misspelling (other than mentioned
above), capitalisation (e.g., generic drug names if required by account specifications),
incorrect English homophones.

Reasons Why Errors In Transcription Occur?

Errors in medical transcription can occur in different ways. Some of the most likely causes
for the errors in medical transcription are:-

 Transcriptionists don’t know the medical jargons that doctors use
 The prescribed records are in a non-standard format resulting in contradictory

comment or lack of information
 Deficient sound quality makes it impossible for a transcriptionist to grasp the

dictation
 Words that confuse the transcriptionist with the correct information
 Insufficient quality reviews of the transcribed documents

Effective Ways To Avoid Medical Transcription Errors

1. Pay Attention to the Audio
What you can do is first listen to the audio and then go through the accurate interpretation
after having a good and precise comprehension of the recordings. It will assist you to
overcome the errors to 100%.

2. Quality Check is a Must
If the medical transcription is complete, proofreading must be made. The higher the number
of accuracy tests, the smaller the probability of paper mistakes.