ADVANCE Perspective: HIM : Medical Transcription

After Electronic Conversion

Cheryl McEvoy — Wed, 25 Nov 2009 14:51:00 GMT

Yesterday, I read the Nov. 23 article on HISTalk about a multi-group practice that went electronic, and then turned its defunct chart storage room into useful office space. The "before and after" photos were particularly striking. Pre-scanning, the room...(read more)

MTs: Get Thee to Tennessee!

Cheryl McEvoy — Tue, 28 Jul 2009 16:06:00 GMT

I'm off to Nashville tomorrow for the Association for Healthcare Documentation Integrity's (AHDI) Annual Convention and Expo (ACE), and I couldn't be more excited to toss off the headphones (those interviews don't transcribe themselves!) for a few days...(read more)

Worst MT Week Gifts

Lynn Jusinski — Thu, 02 Apr 2009 14:08:00 GMT

National Medical Transcriptionist Week will be here next month, May 18-24. ADVANCE 's nursing publication is asking readers about their worst Nurses Week gifts ever. Did you ever get something truly atrocious for MT Week? There's no special journalists...(read more)

The Speech Rec Results

Lynn Jusinski — Tue, 16 Dec 2008 18:29:00 GMT

Well, the 2008 ADVANCE Salary Survey results are in. Thanks to a bit of outsourcing on ADVANCE's part, I had a new survey tool to play with, and I had fun sifting through the data and really trying to get to the bottom of what HIM professionals are making. Thanks also goes out to the readers who filled out the survey. We had nearly 3,600 take part in the survey, giving us a good number to work with to bring you results that I feel confident in.

Because the PDF documents that we put together on salaries are a bit cumbersome (we had a lot of data and this seemed the best way to present all of it to you), I'd like to quit being a slacker in the blog writing department by picking out a few specific results and looking at them in more detail here at ADVANCE Perspectives: HIM.

First up, I wanted to look at the results for MTs who do speech recognition editing vs. those who do some or no editing. We often hear about pay cuts for those MTs who are moving to speech recognition, and I put a few choices specifically geared toward that thought in the job responsibilities question when I made the survey with the hopes of seeing how the salaries would stack up.

Keep in mind that there are a ton of job responsibilities in HIM, and honestly, I'm sure I didn't even scratch the surface with the survey. I lumped the speech recognition question in with all HIM job responsibilities with the hopes of shaking out some decent data.

Respondents could choose more than one answer. Because I ended up with a 110 percent response rate from full-time MTs/editors, it seems that some people did choose more than one, which I can sort of understand. Maybe they do more than just some editing, and wanted to pick some editing along with all editing. MTs/editors also might work for more than one company, and that could be another explanation, if one company does straight transcription while another does all speech recognition. I can also see how it might be confusing--if you do some editing, then you also have a job responsibility to do SR editing, and a responsibility to do transcription, and you might click on all three. I'll try to figure out how to solve this issue for next year's survey.

At any rate, the responses didn't shake out as perfectly as I'd hoped because I wasn't anticipating that anyone would choose more than one answer. That ends my disclaimer; now on to the results.

The 16 percent of full-time MTs/editors who listed a primary job responsibility as "medical transcription--speech recognition editor" brought in an average of $34,600, according to our survey. Those who listed a primary job responsibility as "medical transcription--some speech recognition editing" (25 percent) reported making an average of $31,400, and the 69 percent of full-time MTs who don't work with speech rec at all averaged $33,000.

Basically, those who seem to be bouncing back and forth between SR and transcription made the least, and accounted for a quarter of all full-time MTs/editors, according to our survey. Editors made the most, and those who do transcription fell into the middle.

I have my theories, but I'd rather hear from people working in the industry. What has your experience been with SR and how does it differ/how is it similar? Do you agree with the averages we ended up with from the survey? I'm also open to suggestions on the salary survey as a whole, so send those my way. If you don't want to comment below, e-mail me at ljusinski@advanceweb.com.

The Dark Side of Medical Transcription

Lynn Jusinski — Thu, 11 Dec 2008 20:30:00 GMT

It's not always sunshine and roses in the world of MTs. We get that--we field a lot of letters from MTs disgruntled by pay decreases or stressing about offshoring of transcription.

I decided to be a brave little toaster and broach the topic of the unhappy side of transcription. This article will not be a place for MTs to vent--rather, I'd like if they could share their stories so that future MTs can learn from them.

I'm seeking out MTs who've dealt with employers who won't pay, independent contractors who've had employees steal from them, victims of schools that took the money and ran. Basically, I'd like to hear about experiences that were so immensely challenging that you wouldn't want anyone else to go through what you did (except maybe the client who wouldn't pay up, the person who embezzled from you or the owner of the scam school, of course).

If you'd like to be included in this story, please contact me at ljusinski@advanceweb.com. Include a brief snippet of your experience with the dark side of MT, and we can possibly set up a phone interview for the article.

Also, if you don't necessarily have a horror story to tell, feel free to e-mail me with some things you'd like to see in the story. You can also comment below if that works better.

I look forward to hearing your stories and ideas!

Just a Little Bit of History Repeating

Lynn Jusinski — Wed, 01 Oct 2008 11:29:00 GMT

OK, so maybe it's not exactly the same story, but it's pretty darn close. In a recent article I did, I talked to Marne Gordan, GRC market manager for Armonk, NY-based IBM Tivoli Software, and I asked her if a situation like the Lubna Baloch case could happen again. Absolutely, Gordan said, and sure enough, a similar case recently played out at Grady Memorial Hospital, Atlanta, GA.

The main point of my article was to stress the importance of following the chain of custody when it comes to outsourcing. Know where your data is, and know who is working on it. If you allow for subcontractors in your contract, be sure that you know who they are and that they know your requirements when it comes to patient privacy.

At Grady, a doctor decided to type his own name into Google (come on, we've all done it). He found a bit more than he might've expected-his patients' health information, right there on the Internet.

A few months ago, Grady knew of the breach, but wasn't sure exactly what had happened, and officials said that data may have been stolen. The story became clearer last week, when Grady officials noted that hackers hadn't taken the data of 45 patients-rather, it was an unsteady chain of command that led to the health information being featured on the Internet. The posted data didn't include Social Security numbers, patients' addresses or financial information.

The breach, like the Lubna Baloch incident, came down to transcription. Grady's notes were transcribed by Metro Transcribing Inc., which in turn sent the work to Renee Lella, a Nevada contractor. Lella then sent the work overseas to Primetech Infosystems in India. The Internet site that that firm posted information to was thought to be completely secure; however, the information from the records was freely available on the Internet, where they were posted for a few weeks, according to The Atlanta Journal-Constitution.

After the breach, there's always the period of reflection on what could have/should have been done. On the XLEMR blog, the writer mused that smaller practices would probably not be vulnerable to this type of breach because of a lack of online data, and noted that care when outsourcing is the final lesson from the breach.

On the Medical Quack site, Barbara Duck writes that the breach may mean it's a good time to look to speech recognition soon. "At least that way it is all kept on local servers, but then you have to train physicians how to use it, but some hospitals are doing great and the military is also a big user of speech recognition and it will save money too," Duck wrote.

According to the AlertBoot blog, the whole breach could've been avoided if file encryption was used. This isn't really a surprise, as it's a vendor site, and the blog is from a few months ago, when the whole story wasn't really out yet. Even LifeLock (yes, the guy who puts his Social Security number on trucks and whatnot and has only had his ID stolen, um, a few times), is in on commenting on the breach. LifeLock uses the breach as an example of (of course) how LifeLock can help you (and after reading the blog, I'm still not sure about that one).

I'm not pitching any wares or anything, and I believe it comes down to contract management, like Gordan preached when I interviewed her. Hopefully, Grady had good contract management in place, and as the blame is doled out, Grady might have had an excellent contract, and the outsourcing firms may have slipped up. I found this online: the Nevada contractor involved in the breach advertising for experienced MTs on The Official Website of the Republic of the Philippines. The responses that she received might make some MTs just a bit queasy, all misspellings and poor grammar.

No matter how it pans out or who is eventually blamed for the breach, one thing is unfortunately certain: this probably isn't the last time an incident like this happens. I'd like to hear your thoughts.

What Are You Hearing?

Lynn Jusinski — Thu, 08 May 2008 13:56:00 GMT

I've heard and read the horror stories: the physician who dictates from her child's swim practice, the doc who treats MTs to his hacking cough, the PA who insists on scarfing a Big Mac while telling MTs about a patient.

I recently finished an article on dictation practices for our May 19 issue, and let me tell you--it's certainly an issue MTs are passionate about. The article focused more on the ways that MTs, MTSOs and HIM managers can quell bad dictation practices, so I didn't get to really go into all of the nasty things that MTs are privy to when they sit down to listen to dictations. I know there are some awful stories out there, so what's yours?

All the sources I spoke to had a particularly nasty story about dictation. One recalled physician who dictated from the bath. She also related a story about a report with 25 blanks. After the MT got two more people involved with the difficult report, they finally got it down to eight blanks--but it took 2 hours to finish--and the report was only 110 lines total. Another source talked about reports where the MT had to listen to 20 minutes of dead air for reports that ended up being less than a page long--where the MT must be a captive audience to the silence because they can't hang up, and they have to listen because the dictator may start speaking again.

All the sources concluded one thing--better dictation practices will mean better reports and better patient care. Gone are the days of the private dictation booths in hospitals. Dictators now find themselves crowded into the nurses' station, huddled and interrupted in a busy environment, at best. Hence, the horror stories.

Can you top the stories above? Not only will venting your dictation horror stories possibly prove to be a bit cathartic, it might also open up some eyes to what MTs really hear when they listen to a patient's story--from chewing to splashes to who knows what else.

Don't Get Ripped Off

Lisa Algeo — Fri, 09 Nov 2007 20:37:00 GMT

"Start earning money in just a few weeks." "Get your degree from home." We've all seen the infomercials, commercials and advertisements that boast "You too can become a medical transcriptionist in 10 days," or "Become a medical coder and earn top dollar."

Unfortunately, there are many people out there looking for a quick, cheap education that will lead them to the promised land of gainful employment. Some people pay a lot of money for these "study-at-home" programs, only to find out later that they received a substandard education and they can't get hired due to lack of education and experience.

The key is doing your homework before you enter a medical transcription or coding program. Many people don't engage in the appropriate research before selecting an educational program and find themselves feeling "ripped off" once they finish.

Visit our Student Center and the Find a School link to start your educational program search. Also, the Association for Healthcare Documentation Integrity (AHDI) has a number of resources to explore before starting your health care documentation career.

According to the Nov. 7 issue of Vitals, the e-newsletter of AHDI and the Medical Transcription Industry Association (MTIA), if you have already spent money and time on a work-at-home program and now believe the program may not be legitimate, contact the company and ask for a refund. Let company representatives know that you plan to notify officials about your experience. If you can't resolve the dispute with the company, file a complaint with these organizations:

The Federal Trade Commission works for the consumer to prevent fraud and deception. Call 1-877-FTC-HELP (1-877-382-4357) or log on to http://www.ftc.gov/.
The Attorney General's office in your state or the state where the company is located. The office will be able to tell you whether you're protected by any state law that may regulate work-at-home programs.
Your local consumer protection offices.
Your local Better Business Bureau.
Your local postmaster. The U.S. Postal Service investigates fraudulent mail practices.
The advertising manager of the publication or television station that ran the ad. The manager may be interested to learn about the problems you've had with the company.

Have you had a bad experience with a coding or transcription program? Share your thoughts.