A community of 30,000 US Transcriptionist serving Medical Transcription Industry
Obama is really pushing Electronic medical records - anonymouse
Posted: Jul 30, 2011
I have heard and read that Obama is really pushing the EMR, and by the year 2014, he wants all hospitals/clinics to implement this or else be taxed. He also is supposed to be offering grants and incentives if they do also. So any hospital or physician office that doesn't will be taxed more and will not get incentives, grants, etc. So I think most will try it cause they don't want more taxes and want the incentives, etc. So where does that leave us? If you work for a hospital, what do you think is going to happen to our jobs? Will we be done away with or will we be transitioned to working in some way with EMR. Will they need us or will they need as many of us? What I'm wondering is even if you have a MT job with a hospital now are you safe when EMR is implemented or will you be left in the cold? I don't have a hospital job right now but may soon, and I'm wondering if I should just take the job and hope I can stay there for a very long time or should I prepare myself and get a degree in something else?
Correct - by 2014 - MR
[ In Reply To ..]That's correct - by 2014. MA hospitals are planning by 2013. If doctors don't comply, they'll be penalized monetarily by the government(for example, will not be reimbursed for Medicare patients). So it's not a matter of "trying", they have to. I worked at the same major hospital for the last 20 years. Tapes, then digital, then straight went to VR, then EMR, and finally the point and click. They eliminated transcription. There are two different types of EMR though. One is the point and click where doctors or their staff input data, and others that still use dictation in some capacity. So eventually the only need for transcriptionists/VR editing will be those facilities that use the type of EMR that still makes use of transcription/VR editing. Grim future as transcription needs dwindle in the next 3 years.
EMR - Sue
[ In Reply To ..]Be prepared!! We were just sold out. Worked for hosp 10 years. They told us not to worry it would be a long time if ever. 3 months later, we were sold out. They got a huge grant and tax savings for doing it early. It's all about the money. They will do whatever they have to in order to keep the doors open. From what we have been told every hospital will have to comply whether they like it or not if they want to keep the doors open. In my opinion find another career choice and get out of this field altogether. Working for a service is not all that and then some!! Much much less money, less benefits and twice the work just to maintain. I wish you good luck. Since being sold out there has not been one hour of one day that has not been hell.
You are confused - about EMR
[ In Reply To ..]I had a long response and I just lost it all to the message ghost. So to make it short and sweet:
1: EMR simply means putting everyone's hospital record on a computer using some type of software that can be interfaced by other facilities. In other words if you are on vacation in New York and you live in Bosie, Idaho, the doctor in New York can see all of your previous records (with your written permission of course). It allows for more continuity of care for all patients. The only thing it has to do with transcription is the reports we tr cocribe have to be entered into that patient's medical record in some manner wherever the records are transcribed.
VR is a totally different subject, it just means how the records are transcribed and there are plenty of hospitals who have already converted over to EMR and are still using traditional transcription. In those cases the transcribed reports are scanned into the patient's chart and are then available to be read by any doc that needs to access them.
If you have been "sold out" it is because they have either found another service to do it or they have sent it off-shore.
I have worked as a consultant at several hospitals doing the EMR conversions and there are alot of steps involved in getting it done...it is not only the current medical records but all past records that by law that they are required to keep on file. It is a huge project and takes more personnel than the hospitals have working in the Medical Records department. The problem and the slowdown seems to be the economy. No one wants to pay to bring the consultants in; they want it to be local people. Most of the time they cannot find qualified local people to do the job so they are holding off doing the switch over.
But if they use the point and click form of EMR - anonymouse
[ In Reply To ..]If they use point and click form of EMR as some clinics are already doing then they wouldn't need MTs.
Anonymouse, you just said it: Point-and-click is a type - of information entry independent of the EMR, which
[ In Reply To ..]does not specifically require use of point-and-click.
BTW, it's just a detail, but providers not compliant by the deadlines will NOT be levied additional taxes.
Instead, a system of incentives to adopt the EHR and, eventually, penalties for not adopting (carrot and stick method) is in place. Note, ***this applies to MEDICARE payments, not direct or insurance company payments.***
The carrot: From this year through 2016, an incentive plan schedule is in place for adoption of the EHR to pay providers MORE than the standard reimbursement fees for their services, helping offset the costs of changing over.
The stick: After 2015 for a few years, those who still have not changed over will receive anywhere from 1% to 4% LESS than the standard Medicare fees for their services.
Also BTW, the whole country is discussing the EHR, and the web is loaded with good information from all viewpoints (and with the other type, of course, do need to be a truthseeker. :)
EMR Reality - zusano
[ In Reply To ..]I have read several posts concerning EMR and how it will not replace transcriptionists. Most people do not have the actual experience with this changeover. I can tell you what is happening with my accounts, and it is real and it is the truth.
I have 3 accounts at doctors' offices. I have had these accounts for 13 years. I have been told BY ALL 3 that by October 1, 2011, they will be implementing EMR. The work will not all of a sudden disappear, but it will start to dwindle until they do not need me anymore. If they implement a certain percentage of their dictation to EMR by October 1, 2011, they get something like $42,000 each doctor as an incentive. I was told this by the office administrators and have no reason to think it is not correct.
Furthermore, all 3 offices have already trained their staff on the new computer EMR systems, and the doctors will begin switching over in September. They have bought the EMR systems and are using them. Not they might buy them, but they have bought them.
Their goal is to eliminate transcription cost. I did make an offer to one of the offices that the doctors could continue to dictate and we could type directly into their EMR system, as long as it was Internet-based and we could access it from home. However, I was told that then they would have the cost not only of the EMR system, but also still have a transcription cost. They were not interested in doing this.
I will not be transcribing for these 3 offices several months from now. That is what they have told me (nicely, of course). I know all 3 office administrators very well and have a good relationship with them. I believe what they are telling me.
Other MTs might have a different experience, but I thought it might be helpful to let people know this is how it is working in my case.
So, I'm looking into whether there will still be other work I can get through my website (national work), or if I need to just change careers.
Sad, but true!!
I totally agree - MR
[ In Reply To ..]I agree. I don't get the MTs who insist that EMR doesn't eliminate the need for transcriptionists. I know the person above did say they were a consultant, so hadn't experienced it directly. As I've mentioned before, I can personally attest that it does. Every EMR platform utilizes Point and Click in some capacity. My company was 30 years with the same major hospital (about 4000 outpatients a day along with a 400-bed acute care). Once they were ready to switch over to EMR/Dragon, the work started dwindling and eventually there was none. This happened this year within a span of 2 months. I'm puzzled why some insist this is not happening.
Those doctors were sold systems based on the idea that - they could eliminate our cost. Many practices, how
[ In Reply To ..]will regret purchasing the complete front-end systems salesmen are pushing at them. It's not that easy to get rid of us, not yet anyway, and every moment they spend editing their own SR (we know what THAT means, but they don't) is time spent saving clerical money, not earning physician money.
It's important to keep in mind that not all systems on the market eliminate us. There are systems that allow practitioners both front-end and back-end choices. Salesmen, though, find promising doing away with all transcription costs a very compelling sales point for front-end systems. Wouldn't you want one?
BTW, small practices with relatively simple recordkeeping are the clients most likely to do away with us, but we've known that for a very long time now--a major reason why I never tried to get my own little clients in the 10 years I've been in the field. I knew I'd be scrambling to hold them eventually--not impossible, just not secure, and I'm too lazy to look forward to the challenge.
For those who do have clients, what they SHOULD be doing is educating and helping their clients choose their EHR system. They need to be the first to raise the subject. They do know things their dictators do not, and should educate themselves on more they need to know. Certainly, whatever is eventually chosen, any IT finding out about it willy-nilly after the fact failed both her own business and her clients'.
EMR - Sorry but it all boils down to cost cutting - Dana
[ In Reply To ..]Kaiser replaced approximately 98% of their MTs nationwide with the EMR system, and hate to tell you this but billing and coding is next. Its called EPIC...... Point and click, yes the reports do look shabby and brief, but again it is all about money Former Kaiser MT 20 plus years.....
Dana, did Kaiser retrain you all for other job functions? nm - WorkingMT
[ In Reply To ..]nm
EMR - prommie
[ In Reply To ..]Dana, You are correct. I also work in a hospital as an MT and they are converting to Epic. Not only will it greatly reduce/eliminate the MT it will also reduce the number of other programs that are redundant thruout the hospital which will also reduce personnel needs in other departments. The people who say "Oh VR is SO bad they can never do without MTs" (so don't you think someone figured that out and created something different which this is?) are only kidding themselves. This program will easily save time in the future, cut personnel costs, reduce dictation times as constantly repeating redundant info like past medical history will be "carried over" not repeated by each consultant and such thruout the hospital course. The program has nothing to do with VR. Accents, yawning, chewing, none of that will matter as the point/click and fill in the blanks of the new programs do not care if you speak Swahili. It is not a consideration or problem. I was also doing part time at home work for a service for other hospitals, and the work is slowly drying up. I agree, billers and coders could easily be replaced and just might be, in a future installment of the software, which I'm sure if it is not already out there, it will be. Nothing stays the same.
EMR - Happy MT
[ In Reply To ..]I have transcribed for over two years for a large clinic who has Allscript/Winscribe EMR. They had the doctors using VR but after a year they hated it, and the time they were personally spending every evening to edit their work. One doctor offered me an example, the system was putting ideaology instead of etiology. One doctor said to me "My wife said I HAVE to use you" (his family never saw him). Some docs are still using VR and their notes look awful (I have full access to all patient notes to look up things). My doctors LOVE dictating again. I just don't ever see all docs getting on board with VR. I have had docs (and still do) that could NEVER slow down enough to use VR or speak clearly enough (ESL AND English speaking docs alike). They LOVE dictating fast and having their evenings free, notes completed in the chart by end of day and signed off. They have told me they LOVE it so I feel my job is pretty secure. It has even grown to the point of my hiring two subs to work on account with me (and I have found it VERY hard to find really good people). I hired a newbie that tested better than 10-15 year MTs and she is AWESOME, had never transcribed for $$$. AND I pay her 9 cpl so please don't think I hired her to save money.
My own family doc has had small hand-held computers for years to quit dictating to save money, macros and some typing themselves. The computers were very expensive but he said they were paying so much in transcription they would eventually pay for themselves. I was interviewing to hire people 15 years ago and had MT's say then "I'm getting out of this field, our jobs will be eliminated by technology soon." I am praying for three more good years (or more) to SS at 62 then part time. I see light at the end of the tunnel (to work less)... This field STILL very good to me and has been for 21 years.
no more MTs - tj
[ In Reply To ..]For physician practices, especially the smaller ones, this is true. There will be no need for an MT, especially a home-based one. There may be need for a "records" person in the office though, so MTs need to start trying to market themselves in that aspect of things.
Hospitals, large practices and clinics will still need MTs, for a while to come. This is where the MT who has only done clinics is going to get trampled on because the need will be for MTs who can do any report type, any specialty.
I hope you're able to find a way to replace your income, that's one heck of a hit.
EMR reality... yes, it happened to me 3 years ago - lka
[ In Reply To ..]I was the only transcriptionist for 5 family practice doctors. I did their stuff with tapes, pickup and deliver. They bought this program hook-line-sinker. They gave me about 3 month warning that they were doing this so I knew about it. Strange thing is that they had this old MS 3.0 system I think and all of a sudden they did this. I know it must have cost a fortune and the docs went kicking and screaming, one in particular was not computer savy and he just hated it, but eventually they all just used to it. That is when I looked on the internet and have been working for MTSO ever since and about a 50% drop in salary, sad but tue.
EMR and MT's - Happy MT
[ In Reply To ..]See my post below. My large clinic has been on EMR (Allscript) for several years now. If you go to Allscript web site, you will see they advertise about the $42,000 incentive if accounts contract with them so your administrators of course are correct. It is my understanding the EMR systems or at least Allscript, compatible with VR OR typing their own notes. My large clinic does all of the above. I find the VR and typed notes are a mess in the charts. I have quite a few doctors who left VR to go back to full dictating, faster and cleaner notes and they LOVE it. Office manager was going to look into a larger service but my doctors went to bat for me writing the President of the group that they were very happy with their transcription, notes done accurately in chart same day and WON. I am finding more and more docs dictating more and leaving VR. My docs I transcribe for are telling other docs about my services, how they don't have to edit VR and have such clean, accurate, COMPLETED notes in matter of hours they can sign off on same day and love it so I get more dictators from their references. Line counts seem to be going up each month. I keep them VERY happy with TAT. That is very important to lot of docs. Fortunately clean notes are important to some docs also.
The clinic IT Dept. has to put the Allscript/Winscribe software on your computer giving you full access to all their charts, so you easily look up a name or lab value, or cardiac cath results they fly through. I LOVE it and hope it lasts for years to come.
EMR does NOT mean no dictation. Perhaps this will help you with your administrators, that you have heard their docs will probably NOT like the time it takes to edit their VR or type their own notes since you know what you suggested CAN be done. The platform is SUPER user friendly, completely compatible with MS Word. Good luck.
Agree with HappyMT - Kay
[ In Reply To ..]I currently work in Allscripts as well. The voice files are on Winscribe, and the transcription is done in Allscripts, and Allscripts pastes the finished transcription right into the patient's EMR. So far all the providers on my account are dictating...no VR yet (fingers crossed).
It just depends on if the salesperson sold the clinics a point-and-click or they end up with something like Allscripts.
I'm with you, HappyMT, I hope this lasts for a few more years!
EMR - Happy MT
[ In Reply To ..]And the system keeps ALL line counts so there is NO accounting done by me at all, even for my subs, as we all have our own log in info and the system keeps track of every report and line done by everyone. I simply get my line counts from their System Reports and send an e-mail. Incredibly user friendly. LOVE everything about it. I just pinch myself I fell into this, even got rid of some local docs on tapes this is so great.
EMR and MTs - prommie
[ In Reply To ..]Happy MT: The newer programs use no VR at all. There are standard sentences already in the computer based on the point/click/fill in blanks areas that are printed out. While WE may not like how the reports look, the reports are for information not writing classes. The docs do not have to type or edit paragraphs. They simply recheck what they clicked on or entered in the blanks, click on accept, and it is done, and the info is available thru the system right then, not in an hour or the next day. Patient care is the goal for them. While I hate that it has put a stop for me to a future as an MT, I do see the reasoning and practicality of it all. Once they learn this, the docs will love it since it will take so much less time to enter the info and to look up other reports and find what they need for reference since the report formats will be the same no matter who entered the info.
fine, all that related to doctor's offices - and the HOSPITAL work? - different all together. no panic here.
[ In Reply To ..]I can see where it would eliminte the doctor office transcriptionist...but not the hospital or imaging facility work. Which is what the majority of us do.
I hate to tell you this, but Allscripts use by a hospital - eliminated my job.
[ In Reply To ..]Don't tell me it doesn't eliminate transcription. It does. The hospital I now only work 1 day a week for uses Eclypsis (Now Allscripts). It is point and click and physician/nurse entry. The transcription is currently done through Express Editor which is interfaced with Allscripts. The Nuance (formerly Dictaphone Express Editor) uses VR.
All of the new physicians at that hospital and all residents are told they HAVE to use the point and click Allscrips/Eclypsis system and do not dictate. They are not given a choice. DO NOT tell me that it won't affect hospital jobs. I am here to tell you it will, it can, and it just did - as of the end of February, 2011.
Oh, and as an aside, M*Modal, who makes Allscripts - who purchased Eclypsis - was just recently purchased by DRUMROLL - The big, the bad, and the Ugly MedQuist! Still happy, Happy MT?
Personal experience - MR
[ In Reply To ..]It's like people have their fingers in their ears. It hasn't happened to them, so that means it's never going to happen. All these personal experiences and it's not even 2014 yet, but they don't want to believe it. Believe me, I wish it wasn't true. Loved my job whose account was a major HOSPITAL with 450 physicians. I had 5 weeks of vacation, flexible schedule, and good pay. Company closed when it lost it to EMR and point-and-click. The doctors did NOT want to do all the extra work this entailed, but guess what? They had no choice.
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