CAC a Threat to MTs?
As I pore over studies and old PowerPoint presentations for an upcoming article on computer-assisted coding (CAC) systems, I'm somewhat amazed that I don't, as a writer for an HIM newsmagazine, hear more about CAC technology. Granted, I haven't been writing for
ADVANCE for long, but so far, I've heard so much about EHRs, speech recognition and computerized physician order entry (CPOE) and I rarely hear a peep about CAC.
I attended a session at the American Health Information Management Association (AHIMA) Conference on CAC and the technology surprised me. It seems like the fears that used to exist surrounding technology in HIM have defused a bit. MTs understand that speech recognition probably won't rob them of their jobs, especially when they're seeing speech recognition that produces such gems as "We will prescribe see Alice for his erectile dysfunction." Hence, MTs are definitely still needed, but some have morphed into editors who ensure that speech recognition is correct.
CAC was feared as something that would take coders' jobs away. Codes would be generated using technology, and coders would no longer be needed. That, of course, hasn't really come to pass. Like MTs, some coders are making a transition, only the coders using CAC are becoming validators instead of editors.
So speech recognition will probably not be replacing MTs anytime soon, and CAC won't be taking the place of coders in the near future either. But one thing surprised me at the AHIMA session and as I researched for this article-did MTs ever think that CAC could take their jobs?
The article I'm working on is on the difference between natural language processing (NLP) CAC technology and structured input (SI) technology. In structured input coding, the physician enters all of the data about the visit or procedure using a series of drop-down menus. The vendor that presented at AHIMA, ProVation, demonstrated its technology, showing the drop-down menus and how the physicians couldn't just cash out in the middle-they had to enter everything in detail and were prompted repeatedly until the information was deemed complete.
Using the information entered by the physician, the SI system generates codes based on the terms entered. A coder/validator then checks the codes to make sure the codes are correct. SI CAC eliminates transcription, as the physician enters all the relevant information about the procedure or visit.
How widespread is this going to be, and will it work? Will physicians belly up to the keyboard and mouse if it means saving some money on transcription costs? The ProVation site shows that the technology is installed currently in more than 300 sites nationwide, with hospitals and ambulatory surgery centers as clients.
MTs-is this just like speech recognition, which Nick van Terheyden, chief medical officer of Philips Speech Recognition Systems, referred to as "2 years away for the last 10 years"? If you're an MT, have you heard of SI CAC technology, or have you heard of anyone losing transcription accounts because of this technology? What are some of the hurdles you predict for this technology, and is this something you expected would come about?