MT FORUM

How EMR (EHR) Is Going To Affect Medical Transcription Industry?

2010-08-07T17:03:00.000-07:00

Ever since healthcare reforms started to surface in Obama’s speeches or rather after he signed the stimulus package to law setting aside $19.2 billion for healthcare IT alone to reach a goal of full HER by 2014 promising hundreds of thousands of new jobs by boosting healthcare, the question “How is it going to benefit or affect the medical transcription industry?” started gaining prominence. There were doomsayers as well as welcomers. However, nobody was able to give a clear picture all these days on how medical transcription industry is going to evolve through this phase, whether it will have adverse effects or if it will be an added advantage. Earlier when speech recognition was considered as a challenge, my view was that it would be an advantage to improve productivity and unless we have artificial intelligence and robots understanding each and every command of ours, we will not have a completely reliable voice recognition output with no human intervention needed, so the possibility of speech recognition eliminating medical transcriptionists was completely ruled out. However, this time that is not going to be the same case with EMR as the data here is directly fed by the doctors into the system.

As such, one of MT Herald’s readers who preferred to remain anonymous (as usual?) put forward these questions:

With Obama’s push for implementing EMR in every clinic/hospital, do you see the demand for MT decreasing?

My brother lives in Florida, USA, and he went to see an ENT doctor. His clinic has about 3-4 doctors, and they have implemented EMR in their office and have stopped using transcription altogether.

Do you think widespread EMR adoption will be bad for MT industry?

What are the prospects of gaining business from other countries like UK, Canada, Australia?

We gain a lot of information by exchanging views. You gain more information when you answer questions than when you ask. It is when you teach that you learn a lot than when you are a student.

However, this time before coming to a conclusion on my own for these questions, I thought to put across the question “Do you think widespread EMR adoption will be bad for MT industry?” to all my medical transcriptionist friends and some eminent personalities in the medical transcription industry by email, tweet and instant messaging. Interestingly, when I passed the question to the MTs, both onshore and offshore, many of them were still ignorant of what the acronym EMR deciphers! So do you know what is the difference between an electronic medical record, an electronic health record and a personal health record? The National Alliance for Health Information Technology, (NAHIT) differentiates and defines these terms as follows:

What Is An Electronic Medical Record (EMR)?

An electronic record of health-related information on an individual that can be created, gathered, managed, and consulted by authorized clinicians and staff within one health care organization.

What Is An Electronic Health Record (EHR)?

An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be created, managed, and consulted by authorized clinicians and staff across more than one health care organization.

What Is A Personal Health Record (PHR)?

An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

A research on Google Trends on which term that is extensively searched (electronic medical record v/s electronic health record) reveals that roughly four times more searches are performed for the term ‘electronic medical record’ than for the term ‘electronic health record’ in the searches originating from the US, and that there is a slight spurt in searches of these terms since the turn of this year since Obama got sworn in as President. So despite the NAHIT definitions, market is still figuring out the appropriate term for common usage.

Now that you got some in-depth knowledge of EMR, let’s see have a look at the responses for the question “Do you think widespread EMR adoption will be bad for MT industry?” from some MTs, eminent personalities and CEOs of a couple of MTSOs.

Dr. Akber who witnessed the evolution of medical transcription industry for the past 10 years or more, both onshore and offshore, when contacted to predict the impact of EMR on medical transcriptionists was rather pessimistic and thinks it is hard for the doctors to make a switchover and commented instantly:

What’s it gotta do with MTs? Do you think those lazy doctors also will do it? Before that happens on every medical practice out there and every doctor has to do it or just die, I don’t think we need to worry much, that’s just my 2 cents.

I don’t think it’s going to be that tough for doctors to make a switchover to EMR. They have already been subjected to rigorous training according to the curriculum in their academic portion of life. As a matter of fact, handling an EMR is not that tough than even learning to drive a car! It’s just as the effort as writing a prescription in legible handwriting! So I don’t think a doctor has to be a geek to operate a tablet PC to write a prescription or fill in a template by just a few clicks.

Atif Ullah Khan who has been an MT for 10+ years and worked for several different companies either as an employee or as an independent contractor, says we are already working on electronic medical records by doing transcription from home over the internet and shares his views:

The fact is, we already deal with EMR when we work remotely from home over the internet — dictations are uploaded digitally, downloaded digitally and transcribed, then uploaded digitally and stored digitally. You can’t stay the same and hope to compete in a changing marketplace. I agree with an article I read recently that EMR developers need to stop trying create software to get rid of the MTs (which will NEVER happen, even though our jobs may evolve) and concentrate more on security/privacy, developing a less complex interface and becoming more user friendly. Also, small physician practices may never make the leap to EMR because of cost issues, so that also has to be taken into consideration. I think EMRs have the potential to make our jobs easier (think of being able to go back and read prior reports to be able to figure out what “the mumbler” is saying), but it can also cause problems by perpetuating incorrect information if it’s not caught the first time.

Bottom line, EMR is on the rise, and too many of the powers that be are pushing for it for things to stay the same, but I don’t think it’s going to impact our profession in a negative way. It still has a long way to go, especially in regards to security and privacy. One only has to take a look at the Conficker issue to know that having all records stored electronically can create a maelstrom of a mess if hacked.

To err is human, to really screw things up requires a computer.

Regarding hacking attempts: If extremely sensitive bank, military, space program and government documents can be stored online safely and securely, why not these healthcare documents? Of course, every one of these are have hacking attempts on a day-to-day basis, but have anyone gone back with this technology advance? Regarding the cost factor: We saw in the video that for a subscription amount of mere $300 per month, the physician was able to maintain electronic health records online and the setup just costed him $6000.

It is difficult to say with certainty exactly how the coming widespread use of EMRs is going to affect MTs. This is partly because not all EMR systems take the same approach with regards to the mechanisms used to create patient encounter records. Some EMRs are strictly point-and-click, template-driven systems that make no allowance for dictation and transcription, while other EMRs are DRT enabled, allowing physicians to use traditional dictation as a means of populating the EMR. Obviously if the former type of EMR becomes more prevalent than the latter, the need for transcription is going to decrease. But I believe it is too soon to state definitively whether or not physicians who are accustomed to dictating patient encounters will be willing to switch en masse to template-driven EMR systems. Certainly it’s possible, but it is by no means a certainty, in my opinion.

I wish I had a more definite answer to your question, but right now there just isn’t enough information to make a reliable prediction for what the future holds for the transcription industry.

(DRT stands for Discrete Reportable Transcription)

Okay, it’s a long way to 2014 from now. By that time, even Obama may have moved out of power but, what if the doctors have to do it on their own by that time just because of any legal compulsion from the government to avoid medical errors (the prime focus of making a switching over), leave aside the savings they make eliminating transcription?

Khurram Shehzad, CMT, predicts it could be bad for the industry which is already in turmoil because of advancement of automations like voice recognition and stiff competition due to outsourcing.

My opinion about EMR is it is a tool for interoperability (sharing of information quickly) between hospitals. Nowadays, this sharing of information is through expensive means like faxing, etc., and this also requires that whatever the MT transcribes be printed in a paper, resulting in additional expenses for the hospital. This could be avoided if all the patient information is available through computer network.

There are certain drawbacks with EMR too, like cost, connectivity, health risks, etc. which are being speedily addressed by the US government, especially by President Obama, in a war footing to curb the rising costs of healthcare.

I am not sure how it would impact an MT’s job as “physician notes” still have to be transcribed or edited after going through voice recognition. EMR can be automated and physicians can enter lab values and transmit radiology reports faster; however, reports like discharge summary, history & physical, etc., which require physician notes, need to be transcribed by somebody. I pray to God that the hospital will not retain physician notes in voice format in order to cut costs .

My personal opinion is that if the axe falls on us, we will be required to be more productive and efficient (which is already happening through voice recognition).

In summary, YES, this is bad for our industry and good in terms of healthcare efficiency.

If I’m right, we are already in an arena where there is no permanent salary, instead all the pay structures are production based by which we are already under tremendous pressure to do more and more day by day. How can we be further more productive and efficient?

Iqbal Khawaja, CEO, Medlink Transcriptions, who has over 20 years of experience in the industry witnessing all the ups and downs, evaluates the situation (he also exchanges views on interesting facts and observations at Medlink) and reports that it has already created the dent:

Yes, I see demand decreasing. We’ve been seeing the trend here for the last couple of years and are already feeling the impact.

I’m not sure I’d say it’s good or bad for the industry. I think the industry needs to change and evolve into something else.

He is sure that the industry needs to change or evolve into something or to a more stable form, but not sure how it would be and should be.

Dr. M. Khan, MT-Xpress, assesses the adopting of EMR in healthcare is not going to be a doomsday for medical transcription industry. Here is how he assesses on how is it going to be:

It depends. I think it will affect it as much as voice recognition has done so far in terms of job loss, but it will continue to be adopted because of the need to go to for electronic medical records. It just means that MTs will need to adapt to the changing technology or lose the account. The accounts will be going to EMR but if the MT is willing to dial in and type directly into the EMR or interface with it, they will be fine. Those that continue to see the BIG cassette as the wave of the future will lose. Just because they are going to EMR does not necessarily mean that they will be going to templates of voice recognition. It just means they’re going paperless. The smart MDs that still see the MT as necessary and cheaper than typing/reviewing the reports themselves will still use MTs. I think, like with any new technology, there will be job loss due to the older local MTs unwilling or unable to adapt.

Yes, the busy, highflying doctors, who have hundreds of patients a day, to increase their productivity, to save time and to keep going, instead of themselves incorporating all the details will still have to rely on assistance of medical transcriptionists through dictations even to fill in those details in an EMR but that is not going to be the case with every single doctor. The female doctors or doctors above middle age may be reluctant to adopt new technologies and cost factor also can deter adopting new technology but that won’t prolong for decades.

We end with that expert opinions with a clear answer. Yes, EMR is going to affect the medical transcription industry or has already started affecting but none of them are able to predict the magnitude of the impact. Consumer the king, the ultimate beneficiary of this evolution, is at the greatest advantage of this evolution, after all that is what anyone would need, but how we, the medical transcriptionists, or the medical transcription industry is going to survive these reforms? There’s the fume coming around from the dormant or less active volcano but most of the MTs couldn’t assess the flame and danger behind it. Like Khurram or other MTs whom I didn’t mention here are either still ignorant about the looming guillotine or are overconfident that the doctors are lazy to make a complete switchover that they still have time to enact upon! As long as the doctors are reluctant to change, it will keep us going. However, if the axe falls this time, the impact is going to be much stronger than the already shaken medical transcription industry in the US with voice recognition and outsourcing with the interesting fact that this time it’s going to affect both onshore and offshore alike. Even for planned surgeries, you can have template filling as the procedures will be almost stereotype ones. However, emergency reports may need to be transcribed as the situations, complaints and problems will vary from patient to patient, case on case and I foresee only such rare possibilities of dictation and transcription.

Studies show physicians who use EHRs pay few malpractice claims and we already have reports of medical transcriptionist losing, business as the doctors migrated to EMR, it is time for us to think and enact upon. With cost advantage being remarkable with the adoption of EMR, it is time for MTs to think how to adapt to this growing challenge.

How can the medical transcriptionists be an inevitable part of these reforms? By starting to think and deliver value addition to your services. You should not confine yourself inside a shell as medical transcriptionist alone but have to keep on adding value to your services that the doctors should not be able to do business without you. You should be a complete personal (virtual) assistant doing everything that the doctor wants to do on a computer. Yes, nothing is stable in this ever changing world. Your success lies in how soon you adapt and change yourself to the new things, latest demands and the need of that hour. Unless you develop your skills and keep on polishing your resume, the going as a transcriptionist would get tough and at one point in time within the next few years you may get withered out and give up to EMR due to lack of efficiency.

I wish to thank everybody who shared their views and opinions with me when I contacted them, and their inputs have thrown good amount of light into the issues surrounding the adoption of EMR with reference to medical transcriptionists. I was so amused that the answers were so instantaneous from all those who I quoted here that I think they are keenly watching on how things are turning around and are striving to get informed on this subject. A special big thanks to all of them again.

Now coming to the last part of the question “What are the prospects of gaining business from other countries like UK, Canada, Australia?” Any of the readers in those countries could drop in their views. But generally I’m of the opinion that if a doctor in the US can make a switchover to a completely automated healthcare documentation, won’t it be available for the doctors in the other countries too? May be the cost may vary from country to country but if convenience and reliability outplace the cost factor, which is ought to happen, won’t the doctors in the other countries will also follow suit?

KG TECHNOLOGIES ONLINE MT TRAINING PROGRAM

2010-04-25T07:34:00.000-07:00

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Ours is a leading company also engaged in providing Online medical transcription Training to Individuals throughout the world. We have been providing home based medical transcription jobs to many individuals world wide.

In simple words, medical transcription is just “typing what the doctor/nurse says.” Basically it is a typist’s job. The treatment given for a patient at each point needs to be recorded for various processes including insurance claims in the US. The one who types these medical records is called a transcriber or a transcriptionist and the act of doing that, transcription.

In those earlier days, transcriptionists used to type with a typing machine by listening to audio tapes dictated by the doctors. Times have changed and technology too. Medical transcription has now become an IT enabled service (ITES). Now transcriptionists type with the aid of computer word processors and voice players; there by almost everything in this process confined to computers and internet.

The terminologies involved and the accent of different persons makes it a bit difficult job.

It was in the mid/latter part of the nineties that medical transcription started creeping into Asian countries, creating incredible job opportunity; thanks the advantage and proliferation of internet.

Initially, companies were working with US clients and their medical records, converting them from audio to text. Now clientele of companies have extended to UK, Australia, Canada etc.

Apart from medical transcription, there is business transcription where conferences, discussions, meetings etc., too are transcribed depending upon the requirements of various clients.

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HOMEBASED MEDICAL TRANSCRIPTIONIST REQUIRED

2009-12-22T20:10:00.000-08:00

MT - EXPERTS / KARACHI

Experience:
1 -2 Years
Location:
Karachi, Pakistan

Job Description
The job involves the transcribing of data / information from a sound source into the written text with a high degree of accuracy. Should be very hard working, having a high degree of concentration.

Compensation:
Salaries are paid as per industry standards, based on line count generated

Desired Candidate Profile
Should have electricity and internet backups.

Should have an excellent command of the English Language.

Should possess good comprehensive listening skills with sharp typing skills.

Should be able to work in the morning from 7 to onwards...

Company Profile
MT - EXPERTS

Contact Details
Address:
MT-EXPERTS

Gulshan-e-Iqbal

Karachi, Pakistan

Email Address:
makberkh@yahoo.com

Reference ID:
MEDICAL TRANSCRIPTIONIST

Outsource Medical Transcription Services and Save 60% Transcribing Cost

2009-08-14T10:21:00.000-07:00

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Is Outsourcing Medical Transcription Work Advisible

2009-08-14T10:02:00.000-07:00

In the competitive health care arena, remote medical transcription services have great significance. Every health care facility, whether small or large, has to maintain proper and consistent health care documentation. Even though the demand for medical transcription has gone up steadily over the years, there has been a lack of skilled and trained personnel in key areas of medical transcription.

With the demand for Accuracy, Quality and Speed medical transcription services rising, medical transcription (MT) outsourcing jobs seem to have a bright and secure future. Medical transcription is the most outsourced job in the health care industry and is provided with the aim of reducing both time and cost factors involved in the daily documenting of patient details. As the health care industry in the United States is closely associated with insurance firms, time-bound processing of patient records is essential for the smooth functioning of both health care and insurance firm.

To produce good quality patient records, most of these health care firms have employed highly skilled and experienced professionals in medical transcription, and their skills and knowledge play a key role in the success of these transcription firms. For new recruits, professional training is being given to achieve higher accuracy levels demanded by the industry. With the help of in-house language experts and proofreaders, most processed patient documents maintain high accuracy levels of up to 99%.

By availing of the remote medical transcription services, you can gain many competitive advantages and benefits in terms of higher output and turnaround time.

Apart from these initial benefits, other benefits that can be gained include:

• Superior work product

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• Cost-effective rates

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Another major benefit of outsourcing these medical transcription jobs is that backup copies of patient records are always available at the servers of these outsourcing companies and hence it is easier to search and access patient records which are years old. Moreover, these documents can be sent across multiple destinations through the internet so that doctors, regardless of their location can keep in touch with their patients and their medical treatments.

Medical transcription outsourcing is one of the most important industries in the outsourcing spectrum. It succeeds in efficiently recording patient data for further processing and thereby allows the medical practitioner or health care facility to concentrate more on the core business. Outsource medical transcription to improve your workflow and attend better to the care of your patients.

New MTs Keep a Word Log.....

2009-08-11T14:08:00.001-07:00

When I first started medical transcription, before I developed an ear for transcribing, I started a word log. A word log is very simple thing; it's just a list of medical words that you have trouble hearing (or doctors have trouble pronouncing correctly) when you're a new MT, and you use the list to jog your memory.

My word log was a Word document that I would open, plop the troublesome word into and close. I didn't alphabetize it or number the entries. It was just a quick open/paste/close process done on the fly.

I would also make a note of any routine unintelligible mumbles that certain doctors made, along with the doctors' names, so I could search the list by doctor name. I also included multiple pronunciations, by different doctors, of the same word and sometimes the definition of the word. Also included were incorrect spellings that doctors would offer up, so I'd know the docs were wrong. I'd include my "sounds like" along with the word so I could just search for the sounds-like word and voila, there it would be...well, most of the time.

I don't remember how long I kept making entries in my word log, probably for a couple of years. I don't need it anymore, but it's still on my computer. I took a look at it today, and there were 2870 entries! Just for old times sake, I looked through it today, alphabetized it, and noticed that I had entered some words over and over again. Here are some that I apparently just couldn't get through my thick skull and had entered them repeatedly in my list. Psoas and parenchymal were real troublemakers for me, I see.

ACTeRS Scale

ACTeRS, ADHD

ACTeRS not Actors

B&O suppositories not Beano

B&O

Burstin method - estimating normal PA pressure per Dr. D. griseofulvin - Dr. M. says viziofoma

mesothelioma

mesothelioma - Dr. C. says mesothyloma

MIC-Key G-tube

MIC-Key G-tube NOT McKee or Mickey

Moraxella catarrhalis

Moraxella catarrhalis - Dr. S. says moxala cataralis

NIR Primo stent

NIR Primo

NIR stent – cardiology

Omphalocele

omphalocele - oooomfa seal

parenchyma - Dr. D. says preenka

parenchyma clear

parenchyma

parenchymal – prinkal

parenchymal

psoas muscle (s/l sose)

psoas sign

psoas shadow (s/l 4th shadow)

psoas Rovsings signs

psoas sign

ptosis (sag or fall in eyelid)

Rey-Osterrieth Complex Figure Test

Rey-Osterrieth Complex Figure Test - peds psych

Wenckebach phenomena - Dr. O. says winky doc

Wenckebach

Zeloda - WRONG - spelled Xeloda

Zyrtec, not Certec as Dr. R. spells it

Pounding the Keyboard........

2009-08-10T08:14:00.000-07:00

See how hard one of my colleague work? Maybe she has super-strong fingernails, or maybe they just don't make keyboards like they used to. I took a pic of the damage. The "L" is obliterated, and apparently she use the comma and period keys a lot. The "N" key isn't holding up well either. The "S" key is chipped off at the edges.........

Risks and Benefits of Transcription

2009-08-09T08:55:00.000-07:00

As in any job, there are risks and benefits to working as an MT.

Risks may include but are not limited to:

Earbuzz: Also known simply as "the buzz." Caused by constant use of headphones at high volume to decipher indistinct doctorspeak.

Numbthumb: Caused by repetitive pounding of the space bar, for which payment may or may not be made.

Foothop: A direct effect of "what the what??" syndrome, caused by repeated tapping of the foot pedal in order to rewind the aforementioned doctorspeak.

Chairbutt: Self-explanatory.

Benefits may include but are not limited to:

Armchairdx: You can tell your neighbor and anyone else who asks what that particular color of stool means.

AccentoNoproblemo: You can understand any accent, anywhere, anytime.

GastroRobusto: Nothing makes you throw up.

Proofreading: It's What's For Lunch

2009-08-04T05:09:00.000-07:00

Everyone seems to have their own proofreading strategies and, wouldn't you know it, I'm going to list mine here for you just as if you don't have any of your own. Disclaimer: None of this applies to my blog. If you were to go looking through my posts, you'd find oodles of little bitty, perfectly reasonable errors, all of them inconsequential, some of them charming and possibly even endearing.

If you're still reading, here are my proofreading tips:

I don't proofread my files until I've been away from them for a while. I have a very short memory and can't remember what I transcribed an hour ago, so if I wait a while before I proof them, it's like proofreading somebody's else's work, which is much more fun than proofing my own. If you've ever been in QA, you know what I mean.

Sometimes I proofread documents from the end to the beginning, the same way I read books when I was a kid. (I always wanted to know how they ended before I invested any time in them, which really annoyed the school librarian.) Proofreading backwards gives me a whole new view of the text, and that way I don't just zip along quickly and miss errors.

Speaking of view, I always change the page view before I proof. I make the text much bigger than it was when I transcribed it. That's another way I trick myself into thinking I've never seen this document before. (I am easily tricked; I even set my clock ahead so that, when the alarm goes off, I'm actually up early, and I never catch on.)

Much to my sister’s dismay, I sometimes proof out loud (not the patients' names or any other identifying information, of course, as that would be a HIPAA violation). She has learned a great deal about drug dosages and lab tests because of this habit of mine, enough so that she sometimes understands what's going on when we're watching ER and will turn to me and say, "Isn't that too much heparin?" Proofing out loud makes errors jump off the page.

When proofing, I run my cursor along each line as I'm reading it. I'm easily amused and like to play with the cursor, and it helps guide my eyes along the lines. Otherwise I'll end up proofing the document the same way the doctor transcribed it...bouncing around from paragraph to paragraph, all over the road.

And last, but not least, I do my proofreading while eating lunch. Chewing keeps me from getting bored. Also, when I'm eating, I'm generally very happy, so proofreading isn't a chore for me...it's something I look forward to. I'm afraid that sometimes proofreading is the highlight of my day, but that's fodder for another post altogether.

Power Hour Techniques.....

2009-08-04T04:53:00.000-07:00

The purpose of power hour is to transcribe as many lines as possible in one hour at a nonstop pinky-finger-punishing, thumb-cracking, fingernail-chipping, keyboard-annihilating, full-blast rate of speed. It's brutal. At the end of power hour, you may need to replace your keyboard, so have one handy.

The Rules:

~No bathroom breaks.

~No food on desk.

~No drinks on desk.

~No phone calls.

~No doorbell answering.

~No email checking.

~No responding to children unless they're being locked outside the house.

The Tips:

~Early morning is the best time for power hour.

~The more the merrier: Compete with other medical transcriptionists. The transcriptionist with the most lines at the end of power hour is the winner and gets to gloat mercilessly.

The Prep:

~Pick the dictators. For power hour purposes, we don't want Dr. Um Uhhhh, Dr. Sleepytime or Dr. Phlegm. We want power dictators, someone who can really dish it out.

~Make sure there is at least an hour's worth of work to be transcribed. Line the jobs up.

~Eat.

~Consume a decent dose of caffeine.

~Adjust chair for maximum comfort.

~Lubricate foot pedal.

~Crack knuckles.

~Set timer for one hour.

Bring. It. On.

Secrets of the MT World.....

2009-08-04T04:32:00.000-07:00

Yes, there are secrets in the MT business, secrets only highly skilled MTs know and will never utter to another soul, except to a few chosen innocents who are taken under the wings of aged MTs and munificently ushered into the clandestine world of the MT underground.

Well, unless you happen to be reading my blog, then the cat's out of the bag.

Secret #1:

Never pay retail. I mean, never type a whole word out manually; that's for typists. MTs cheat. We use shortcuts, macros, templates, whatever it takes. Every time we move a finger to hit one key, that move results in a myriad of characters all hitting the page at once. Hopefully, those characters hit the page in the right order and make sense but, if not, QA will clean it up. I did not say that. When you first start out in MT, make good use of your text expander, embrace it, wring every last letter out of it, make it do the work for you. At some point you will be able to hit only a few keys and produce an entire paragraph of doctorese without chipping a nail.

If you look closely at an MT who does not make full use of her text expander, you will note that she has horridly chipped nails. And just look at her keyboard for the evidence. You'll see the pathetic dents her nails have made in the keys, and the letters on the keys will be worn off. This tells a sad, sad story.

Don't be one of those MTs. Use your text expander.

Medical Transcription and Dancing.......

2009-07-29T00:49:00.000-07:00

You may ask, "What, exactly, does MT have to do with dancing?"

It goes like this. Dr. Ditzy works in an ER near a club. As it turns out, pole dancing is a high-injury activity, and Dr. Ditzy occasionally has to treat the dancers for sprains incurred while arching, grinding, dangling perilously from the ankles and spinning around a pole in 5-inch heels. Most of these pole dancing injuries are minor, but still, mothers, don't let your daughters grow up to be pole dancers; they visit the ER as often as football players from the local high school. It's a treacherous profession. Please, send your daughters to law school instead.

Back to MT...Dr. Ditzy is dictating an ER report on a 21-year-old pole dancer who is in for knee pain. It seems she has (in a highly erotic manner, of course) managed to bang her right knee against the pole during her dance routine and subsequently has come into the ER for an x-ray. Once Dr. Ditzy speaks the words "pole dancer," he suddenly becomes tongue-tied and begins fumbling around for words. This is understandable, and a good MT immediately knows what to do...get a cup of tea and wait. He'll come to his senses in a minute. In the meantime, he continues dictating haltingly and breathlessly whispers a word that sounds like "apree." Deciphering the words of a doctor in such a condition is a skill needed by all MTs.

Since the patient is 21 and the doctor had previously dictated that she is sexually active, and you remember those days very well....Oh, the passion!...you suspect that "apree" might be some kind of contraception.

If your cat happens to be sleeping on your drug book, you might want to search online and see what you can find out about apree. That's where MPR, Monthly Prescribing Reference, comes into play.

MPR lets you search by sounds-like criteria and makes suggestions if you don't spell the word in question correctly, just like Google does. If you type "apree" in the search box, it says, "Did you mean to search for 'Apri' (you idiot)?" And there you have your word. And no, it doesn't accuse you of being an idiot, I put that in there myself. It's just that I felt like an idiot when Apri first came out and I hadn't heard of it yet. It's hard being an MT. We have feelings, you know.

MPR also lets you search by therapeutic category. You can choose OB/Gyn, click on Contraceptives, and a list of OCPs pops up. You can scroll down the list until you find the one that you're looking for.

If you are worried about Dr. Ditzy's condition and are looking for a hypertension drug for him to take after the pole dancer leaves, you can choose Cardiovascular System, click on Hypertension, and a list of hypertension drugs pops up for consideration.

Old days.............

2009-07-28T02:51:00.000-07:00

1897 - Woodcut of a typist transcribing dictation using an early wax cylinder phonograph, or gramophone. Although the phonograph was first invented by Thomas A. Edison, the source text says this was a machine called the 'G', invented by Alexander Graham Bell, Chichester A. Bell, and Sumner Tainter. The typist pumps the treadle with his foot, turning the cylinder to play back the recording, and listens to it using 'stethoscope' type earphones. Extra wax cylinders, and a mouthpiece used to record dictation, are seen on the desk. Alterations to image: removed caption, which read, "The Gramophone used in transcribing".

Medical Transcription History in Depth

The evolution of the systems dates back to the year 1960 as per Medical Transcription history. The systems in the yesteryears were designed to assist the manufacturing process. The first transcription that was developed in this process happens to be MRP (medical resource Planning) in the year 1975.This was followed by another advanced version namely MRP2 which is the acronym for Manufacturing Resource planning. None of them yielded the benefit of Medical Transcription.

Drawback of MRP Systems

These softwares were helpful in manufacturing process. Their benefits did not extend to other Sectors. Medical Transcription was developed as multifaceted transcription that gradually stretched its limits into other areas like human resource, finance, marketing and so on. Moreover Medical Transcription offered operational convenience and large reduction in costs coupled with other benefits when compared with earlier soft wares.

MRP solutions attained more fame. Infact it became a hallmark of the manufacturing setups.The MRP solutions did not render the expected results due to exorbitant costs and practical work problems.Inaddition it also called for a huge pool of technical expertise in terms of manpower and machines.

Advent of Medical Transcription

Medical Transcription came into being with effect from 1990 though the fact remained that many people are of the opinion that Medical Transcription existed from the year 1960 in the form of MRP1 and MRP2. In fact MRP2 was more or less Medical Transcription except for its inability to coordinate departments other than marketing. The whole period from the year 1960 is denoted as the age of Medical Transcription. The benefit of Medical Transcription was slowly felt from this stage onwards.

Operating Systems

The operating systems that were in vogue during the period are important in understanding the history of Medical Transcription. JD Edwards Co Founder of moniker (in the year 1977) made use of IBM Systems/38.Baan Corporation utilized UNIX.

Web friendly
While Medical Transcription is a technological innovation in itself its efficiency is multiplied by several times with the help of latest inventions. Nowadays Medical Transcription is tuned to make use of the internet. This is to make sure that the buyers anywhere can have access to the database of the seller by a mouse click and that too by sitting anywhere in the world. This has become the mantra in the 21st century. The latest Medical Transcription tool which is becoming the order of the day is Medical Transcription.

Behind the scenes......

2009-07-27T19:32:00.000-07:00

I always say that MT is a job for behind-the-scenes people. It's great for those who like to be left alone to work, people who like debating about the proper use of punctuation and grammar, people who like reading, writing, editing...people who enjoy working with words. If you always have a book in your hand, were a spelling bee contestant in school, spent a lot of time in the library, enjoyed English lit in school, MT may be a good choice for you.

If you also have an interest in science, enjoyed biology, chemistry, anatomy & physiology in school, MT may be right up your alley.

Most people don't even know what medical transcription is, let alone what it involves. If they've ever heard of it at all, they probably think of it as "medical typing," which sure sounds easy. I've had people approach me and say they want an MT job because they type fast and it sounds easy, their aunt does it for the family doctor, and it's something they can do in their spare time to make a couple extra bucks. When I explain that they need training first, they often scoff and say something like, "I have an MBA, I don't need training to do typing." But when I have them listen to a sample dictation, they usually slink off, tail between legs. It's not as easy as it sounds.

That said, there are those who have learned it on the job, mostly transcribing easy clinic notes involving runny noses and bellyaches. But if you gave those people a CABG op note to transcribe, they'd be lost. They wouldn't know the terminology, the equipment, or the anatomy. But clinic notes, sure, you can learn that on the job sometimes, especially if you have someone to mentor you. But MT companies want their MTs to be well trained these days. They want to know that an MT can handle transcription involving a cardiac catheterization, endarterectomy, Nissen fundoplication, craniectomy, meniscectomy, or a laparoscopic cholecystectomy. They want to know that an MT knows what words like esophagogastroduodenoscopy and salpingo-oophorectomy mean and how to spell them.

The want to know that an MT can recognize and correct transcription errors, knows how to avoid dangerous abbreviations, knows when to flag inconsistencies, understands HIPAA regulations, and can decipher what the dictator is saying, even one with a heavy accent, when he/she is sneezing, yawning, chewing, or drifting off to sleep while dictating.

Although MT is done behind the scenes and few people understand what it involves, medical transcription is very important in that it must be done correctly to avoid critical errors in patient records...which brings us back to choosing a good MT school. If you're well trained and persistent, MT can really pay off for you.

Pakistan Threatens Indian Grip On Offshore Outsourcing

2009-07-24T20:46:00.000-07:00

Pakistan sat quietly as it watched it's Indian neighbors quickly ascended to become the IT outsourcing capitol of the world, however, they were paying attention. Using the same Indian business model, the Pakistani business and economic development community has achieved major successes in carving out their own piece of the lucrative offshore IT outsourcing business. In the global outsourcing market, dominance is hard to achieve for the long haul. As lower wage employees develop highly sought after skills, the cost of retaining these employees leaves companies at an economic disadvantage.

Based on the pure economics of the two countries, it is evident that Pakistani IT companies will outpace Indian companies in the coming years, based on several factors:

India has a developed IT sourcing infrastructure, with established professionals demanding increased salaries. Increased labor expenses for outsourcing solutions makes companies less competitive, unless the output is exceedingly exceptional.

Pakistan has a huge community of émigrés with experience in technology. And like India, it has a culture that values education and hard work. Pakistan, like India, has a large number of English speaking residents.

Pakistan predicts a 45% annual growth in coming years. Although Pakistan IT exports represent only 11% of what India exports, Pakistan is quickly closing the gaps on the lucrative software application development market.

Gartner, in its recent report 'Analysis of Pakistan as an Offshore Service Location' said the major factor behind the progressing status of Pakistan is the lower salaries and better infrastructure advantages than other offshore destinations. "The salaries of IT professionals in Pakistan are approximately 30% lower than those in India, while telecommunication costs are also lower as compared to any other offshore locations, which make Pakistan an attractive outsourcing destination."

The Pakistan government is fully committed to the Pakistani IT initiatives..."According to Gartner research report, government of Pakistan has devised a comprehensive national IT policy, designed to encourage the private sector. In order to drive development, Pakistan Software Export Board (PSEB) plans to construct new IT parks in major cities while 750,000 square feet of space in PSEB-designated parks has already been leased to IT companies."

Funny Medical Transcription Errors with Cartoons

2009-07-20T18:46:00.000-07:00

FUNNY ERRORS WITH CARTOONS: Pakistantranscribe's implish cartoons can be printed and posted in a variety of high-impact placed in hospitals and clinical settings. Highly recommended targets are medical transcriptionist's desks, proofreaders' cafeteria and medical transcription rooms.

Cartoon#1

"The patient arrived with death sitting on her shoulder."

Cartoon#2

"Chief Complaint: Motorcycle versus tree."

Cartoon#3

"The greater trochanter was inserted in the abdomen."

Cartoon#4

"There is no swallowing of the left leg."

Cartoon#5 (sorry friends, pic is censored)

"I asked Dr. O, who did her sigmoidoscopy and colonoscopy, to poke his head in and he, too, though that it did not look like a classic colon cancer."

Cartoon#6

"A baby was born in the toilet of the Emergency Department."

Cartoon#7

"The patient was examined with Dr. M under the microscope."

Cartoon#8

"The patient is breathing oxygen through nasal prawns."

Cartoon#9

"When i got into his mouth i could see why he was bleeding."

Cartoon#10

"The patient is concerned about seborrheic keratosis that she has had treated by a dermatologist on her face."

Cartoon#11

"Her weight has increased 8-10 pounds an hour for the last four years."

Cartoon#12

"The hemorrhoid got worse and finally came to the office."

Cartoon#13

"Apparently, she had a boyfriend who died approximately one month ago and at that point began drinking heavily."

Cartoon#14

"The patient's wife hit him over the head with an ironing board, which now has six stitches in it."

Cartoon#15

"He was Beconase nose spray, two sprays in each, one or two in each nose, two to three times a day."

Cartoon#16

"The infant was discharged to home with Mom in car seat."

Cartoon#17

"Chief Complaint: Spinning of head occasionally."

Cartoon#18

"B12 1 cc i am given." should be "B12 1 cc IM given."

Cartoon#19

"Has cafeterias of fall colitis." should be "Has scattered areas of folliculitis."

Funny Medical Transcription Errors with Cartoons-17

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Funny Medical Transcription Errors with Cartoons-16

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Funny Medical Transcription Errors with Cartoons-15

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Funny Medical Transcription Errors with Cartoons-14

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Funny Medical Transcription Errors with Cartoons-13

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Funny Medical Transcription Errors with Cartoons-12

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Funny Medical Transcription Errors with Cartoons-11

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Funny Medical Transcription Errors with Cartoons-10

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Funny Medical Transcription Errors with Cartoons-9

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Funny Medical Transcription Errors with Cartoons-8

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Funny Medical Transcription Errors with Cartoons-7

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Funny Medical Transcription Errors with Cartoons-6

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Funny Medical Transcription Errors with Cartoons-4

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Funny Medical Transcription Errors with Cartoons-3

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Funny Medical Transcription Errors with Cartoons-2

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Funny Medical Transcription Errors with Cartoons-1

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Language Skills Worksheets

2009-07-18T14:01:00.000-07:00

Obviously, readers of this blog cannot fill in the blanks on these worksheets by entering data on their computer screens. However, readers should feel free to print out any of these worksheets for use as a teaching/learning tool in a professional setting.

Language Skills Worksheet #1
Doctors frequently use abbreviations, eponyms, and other mnemonic devices as a means of communicating vital patient information. However, each abbreviation can stand for more than one medical term.

Language Skills Worksheet #2
Many people fail to understand that someone in a foreign country who is transcribing dictation from doctors in American hospitals will be thinking in textbook English as opposed to the way English is spoken in America.

Language Skills Worksheet #3
Doctors frequently use the wrong word. This can result in either a grammatically incorrect statement or a raging Malapropism.

Language Skills Worksheet #4
Many doctors dictate in a conversational, stream-of-consciousness style. This habit can result in frequent contradictions and statements which make no sense. Poor sentence structure and improper punctuation, can cause further confusion.

Language Skills Worksheet #5
The constant presence of misplaced modifiers and dangling participles in a doctor's dictation offers a clear indication that the dictating physician suffers from impaired language skills.

Language Skills Worksheet #6
Many doctors suffer from the curse of the run-on sentence.

Language Skills Worksheet #7
Doctors will frequently dictate sentences in which the timing of certain events is suspicious, if not downright impossible.

Language Skills Worksheet #8
Doctors frequently dictate sentences which, although well-intentioned, imply that a person other than the patient is being diagnosed or receiving treatment.

Language Skills Worksheet #9
When dictating reports, doctors are attempting to memorialize certain facts and thoughts in print. If their thought processes involve a rambling, stream-of-consciousness approach to the English language, they are likely to dictate medical gobbledygook.

Language Skills Worksheet #10
Often, when documenting a patient's objective findings, a dictating doctor will use incorrect medical terminology in such a way as to defy anatomical standards.

Language Skills Worksheet #11
Many doctors do not listen to what they say. The results make them vulnerable to charges of practicing "nonsense medicine."

Language Skills Worksheets#1

2009-07-18T13:56:00.000-07:00

Doctors frequently use abbreviations, eponyms, and other mnemonic devices as a means of communicating vital patient information. However, each abbreviation can stand for more than one medical term.

Fill in the blanks to see how accurate your dictation would be if the abbreviation you used to communicate your thoughts was misinterpreted by a medical transcriptionist (the figure next to each abbreviation represents the number of meanings listed in Sloane's Medical Abbreviations and Eponyms):

ACE (3)

1.____________________________________

2.____________________________________

3.____________________________________

LP (11)

1.____________________________________

2.____________________________________

3.____________________________________

4.____________________________________

5.____________________________________

6.____________________________________

7.____________________________________

8.____________________________________

9.____________________________________

10.___________________________________

11.___________________________________

MR (10)

1.____________________________________

2.____________________________________

3.____________________________________

4.____________________________________

5.____________________________________

6.____________________________________

7.____________________________________

8.____________________________________

9.____________________________________

10.___________________________________

NAD (5)

1.____________________________________

2.____________________________________

3.____________________________________

4.____________________________________

5.____________________________________

PE (14)

1.____________________________________

2.____________________________________

3.____________________________________

4.____________________________________

5.____________________________________

6.____________________________________

7.____________________________________

8.____________________________________

9.____________________________________

10.___________________________________

11.___________________________________

12.___________________________________

13.___________________________________

14.___________________________________

UA (6)

1.____________________________________

2.____________________________________

3.____________________________________

4.____________________________________

5.____________________________________

6.____________________________________

Language Skills Worksheets#2

2009-07-18T13:52:00.000-07:00

A great deal of effort is being spent teaching medical transcription to overseas workers in the hope that, by combining Internet technology with the cheap labor costs available in places like India, the Philippines and the Caribbean, America's largest transcription agencies can increase their profits to shareholders. While this may be a sound approach to take when manufacturing widgets, the improper use of the English language by foreign transcriptionists (as well as by doctors who speak English as their second language) often creates contextual problems.

Many people fail to understand that someone in a foreign country who is transcribing dictation from doctors in American hospitals will be thinking in textbook English as opposed to the way English is spoken in America.

Conversely, one transcriptionist's favorite Indian physician dictates:

"The patient will return to see us when she returns from wacation. She is feeling wery wery good today."

What goes through the mind of a professional medical language specialist when confronted with such dictation?

"The doctor sounds like Elmer Fudd, the guy in the Bugs Bunny cartoons who is always screaming 'I'll get you, you wascally wabbit," laughs the woman who transcribes this doctor's work.The following quotes are taken from people who speak English as a second language. In each situation, rewrite the text so that it is grammatically correct.

"Excuse me, sir but I am not understanding. Why are they serving me all this meat when I have been a vegetable for 20 years?"
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"The patient has no any problems with more or less shortness of breath."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"The patient complains of pain in the left-sided eye."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"I have spoken with Dr. Y and he recommends you service very highly."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"The complications have been fully informed."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"There is no swallowing of the left leg."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"Patient cannot get an election due to he is deplessed."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"Her car was stroked by another car."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"It was a pressure seeing this patient for you."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"I have saw her and evaluated her in the office."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________
"At the time of the accident, the patient was driving a Dodge Clot."
Diagnosis:
______________________________
______________________________
Corrected Text:
______________________________
______________________________
______________________________
______________________________

Language Skills Worksheets#3

2009-07-18T13:29:00.000-07:00

Doctors frequently use the wrong word. This can result in either a grammatically incorrect statement or a raging Malapropism. Each one of these statements was dictated by a licensed physician.

Diagnose what is wrong with the dictating doctor's statement and write your own version of what the physician failed to communicate.

"I had a blood side glucose done at the bed scene."

Diagnosis: ________________

Corrected Text: _____________

"Temperature was 96 percent."

Diagnosis: _____________

Corrected Text: _____________

"He does live with his wife here in San Francisco and works as a dish water at the XYZ Restaurant."