A community of 30,000 US Transcriptionist serving Medical Transcription Industry

EMR's , will this mean the end of transcriptionists or is there something we can do to stay in - myka

Posted: Nov 10, 2009

I am curious what the thoughts are about this. Will is be mandatory in a few years that all doctors offices go to EMR? Will this be the end of the medical transcriptionist or is there something we can do now to prepare for the change and still be in this field?

EMR stands for electronic medical record. It does not - ht

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mean that everything is done electronically. Data still needs to be entered into the record, someone has to do that. Some have/will go to voice recognition which has to be edited by a live person, some will continue to dictate as before. Jobs for the MT may just not be as plentiful as before.

Interesting. I did not realize that offices could continue to dictate. sm - myka

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The way my office makes it sound, or maybe it is just the system they have looked into, the doctors would enter information themselves (not that I see that happening!), and a transcriptionist is not needed.

EMRs - ssmt

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Our local hospital does this now, they pressured local clinics into changing to EMR as well, now there are no transcriptionist positions in town. Last year when I was in school there were a dozen openings, today there are none.

My experience in the ER with my husband who was injured at work is that making nurses and doctors type in their own info is a bad idea, just from a patient standpoint. It took several hours for my husband to even be seen, and while in triage I looked around and saw doctors doing nothing but typing and clicking things on drop down menus. Just my own personal thoughts on the matter.

EMRs - passing thru

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Depends on lots of things. There are different systems I'm sure. I was laid off from a clinic that went to an EMR. I was the only transcriptionist for a multispecialty clinic. There just wasn't anything else work-wise for me to do, so I was let go. It only took the doctors about 3-1/2 months to change over completely using the point and click method.

Some EMR still involves transcription, though - Happy MT Robin

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I work on a clinic account that uses EMR and they still dictate notes. It just depends on the provider. It will definitely impact the number of MT jobs available, but I don't think it will wipe out the need for them completely.

They will wipe out MT jobs eventually... yes they will - lindawordlady

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I was the sole MT for a 5 physician office and they spent the big bucks to get the new EMR system and although a lot of the doctors were not going to like it... they said they went to medical school to treat patients, not TYPE. But learn they did, type they did, and I lost my job. They designed a program with drop-down menus and that is how they input the info. Each MD now has like a "notebook" they carry with them, and each nurse, etc and they input the info.

They are not the only ones... all the major clinics here are doing that here in MN.

It is the way of the future with all of the new technologies... that has been the universal plan for about 10-15 yrs to have this implemented, which I thought was going to happen 2012.

There may be a couple jobs, but eventually VR will not even be needed, hence we robots will not be needed.

This was my concern. sm - myka

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So, there is nothing we as transcriptionists can do with the new technology? Nothing that would help us keep our jobs?

Oh, well. The world is supposed to end - in 2012, anyway.

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nm

I like your sense of humor! - myka

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I actually just found out about the world ending in 2012. Where have I been?

Actually I think there was a prior date, but when it - came and went with no mass destruction, -sm

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the people that believe in that sort of thing had to reschedule.

This may be true for clinics, but I really do not - kj

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see hospitals going strict VR. There are too many variables--they cannot do reports from a pull-down menu. I am lucky, I work for a major trauma center and though some reportr are VR, they have to be edited by an MT; then there are us on straight transcription.

at your 5-doctor clinic yes; at my 120+ doctor specialty clinic with - many 10+ minute dictations, no. n/m

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NM

EMR-it's true I have seen it - France

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I took my mom to her PCP appointment in January and there he sat typing away on his lap top during the office visit. He printed out her RX and we were done. It may not happen as soon with specialists and surgeons as they get paid more and PCPs are kinda on salary by insurance companies.

Of note, the docs CAN refuse to go to an exclusive EMR platform...sm - LaurieG.

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My recent position was for a hospital in CA. They actually tried out a speech recognition program in the ER a couple years ago, but the doctors quit using it in less than a week. I believe there were some physicians who did use it, but there were only a handful and when the computer system had any kind of glitch, they were forced to use the call-in system anyway. The good news is that 80% of all physicians still prefer to dictate. Combining MTs with EMR takes the same amount of time as just dictation and transcription, whereas EMR by itself takes 9 x longer and costs more.

EMR - mush

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That is how it works at my Doctor's office. The doctor must enter the info. It takes up to 8 times longer per patient and they are struggling to find enough work for the one transcriptionist they have.

I am thinking it may be time to go back to school! - myka

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nm

The clinic I work for has EMR. The docs dictate, we - anon

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transcribe, and the notes are cut and pasted into the EMR.

Some info that may or may not interest you. - LaurieG.

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Currently, there are over 300 EMR companies promoting EMR to physicians, stating a transcriptionist is no longer needed. However, this software is very expensive and is not cost effective for small practices of less than 10 physicians. Over 50% of PCP offices treat the largest # of patients in only 1-2 physician offices. Medicare is really pushing electronic rx refills by giving a 2% increase in reimbursement. By 2010, they will decrease reimbursement by 2% if still using paper refills. AHDI & MTIA are currently pushing to combine EMR & transcription together and, in fact, recently did a study that showed EMR software to have an average failure rate of 73%. When you add in SR, the failure rate is even higher. EMR also takes 9 x longer than regular dictation. The average physician dictates 30 minutes per day whereas it takes an average of 1-1/2 hours for EMR. All hospitals & physician offices will have to have EMR in place by 2014 or suffer a decrease in reimbursement.

Thank you for explaining that to me. sm - myka

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I work for a 5 doctor office of surgeons. So, if they cannot afford the EMR software by 2014, they will have a decrease in reimbursement only? Meaning will there be fines, etc. imposed on them?

The way I understand it, sm... - LaurieG.

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is that right now Medicare is offering an extra 2% incentive to physicians who purchase EMR software. That incentive percent will decrease each year until 2014, when they will actually subtract 2% from the reimbursement rate they will pay if an EMR is not in place by then. The MT who is willing to keep up with all the new regulations coming in February 2010 and maybe even consider adding coding (eventually) to her/his MT skills will be in the best position to not only keep their current position but will also have a good chance of being paid more. Unfortunately, I feel it's going to be a while before we're there, plus I'm at a place in my life where I cannot afford to do that either financially or time-wise. I actually left the profession at the end of September and have no plans at this point to return.

Does that apply to just the Medicare physicians? - Happy MT Robin

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I work for a small, non-traditional counseling service and we are not medicare providers. I was doing quite a bit of research on it, however, because two of our clients have recently gone onto Medicare. More and more physicians are opting out of Medicare, which is a problem in and of itself for an ever older-growing population.

Are the regulations and fines that refer to EMR strictly for those physicians who are Medicare providers, or is that going to be somehow imposed on all physicians? Anyone know?

My understanding is that...sm - LaurieG.

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that's how it is currently, but it's quite complicated. I believe the new stronger teeth in HIPAA and the HITECH Act will eventually require all to move to an EMR. An EMR has its good points in that the patient's medical info will be available whether he's in an auto accident in his hometown or on vacation in Europe somewhere, thus allowing the treating hospital to know the patient's allergies, etc. The EMR would also contain what they call XML tagging, including electronic prescription info, coding data, etc. However, that also means added security measures have to be implemented to protect each record, thus the new regs coming down the pike. MD-IT is one of the few MT companies endeavoring to combine MTs with EMR software--the entire process is faster that way, much more accurate, and every one is "happy," if you will. Hope that helps a little.

Thank you, LaurieG. That helps a lot. sm - myka

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I have actually been thinking about taking an on line coding course. I think I have given up trying to find work with the MTSO's. I don't have acute care experience, which pretty much cuts me out of everything even though I have 20 years experience as an MT!

What are you doing now since you got out of the profession?

I may well consider coding in the future, but for now...sm - LaurieG.

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I've gone back to just being a wife and mom. We still have one child at home, now a junior in high school, and we are expecting our 9th grandchild in January; therefore, I'm still very busy, just not ridiculously busy! It's a little strange to not be doing MT after 10 years, but I'm enjoying the break.

I have a question for you, what money does it - L

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take for a person to stay in this field? What in 2010 will be different for us, if a person is still working?

I'm sure it will depend on several factors...sm - LaurieG.

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I honestly don't know what the national companies, let alone the smaller MTSOs will or will not do for their employees, but I know that business liability insurance and/or errors & omissions insurance is really being pushed right now. ICs would obviously have to pay for their own. I also know that AHDI and MTIA are both strongly pushing MANDATORY credentialling of all MTs. From where I sit, it appears the plan is to eventually combine coding and MT together under a new title, i.e. "Documentation Specialist" and have each person "bonded" to handle PHI (protected health information). This will obviously make these specialists more valuable and perhaps worthy of an hourly rate instead of pennies per line, but it will also require at least a CMT certificate and probably a coding certificate of some kind eventually. All of this is in the future, obviously, but I really don't think it's as far in the future as some would like to think. I figured I was going to have to come up with approximately $1000 just to stay in the game, so to speak, but that was for my particular set of circumstances. Everyone's will vary, of course.

You are lucky to be taking a break, LaurieG! - myka

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I would love to find something just to supplement my current position, but the more I read on this board, the less I want to work for any of these on line companies. I have 9 more years before my mortgage is paid, so I have to keep plugging along!

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