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

The future of MT. - Hopeful MT

Posted: Sep 26, 2012

Wondering what thoughts are on this article. I believe MT is changing but is not a dying profession.

Interesting article. And try this on for - a workable solution

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I use Dragon Medical to echo dictate everything. Have been using it for over 2 years now. I have the ability to dictate directly into an EMR. Echo dictating allows me to create a draft in roughly the same amount of time as it took the original author to dictate the report, which then leaves me time to go back and do a full audio review and still generate a report that is 100% accurate in less time than I used to type them.

Pay me 9 cents a line, and I will create a report error free that is instantly available in the medical record, QA'd. Give me nothing but clear dictators, and I will do it for 8 cents a line.

Maintaining 100% accuracy is doable this way. I know, because I've been doing it now for quite some time. If you have time to re-read every report you do for accuracy and still be productive, 100% accuracy can be achieved by everyone.

With clear, understandable dictations to work with, at 8 cents a line I could consistently produce 250 lines an hour providing 100% accurate reports that are instantly available on the patient's chart. That's $20 an hour. The quality would be unprecedented, the MTSO could charge the hospital less for the service while at the same time paying the transcriptionist more and still realize an increase in their overall profit because production would increase dramatically while at the same time practically eliminating the expense of maintaining a QA department. And think what that would do for turnaround time.

There are answers that can benefit everyone. We just need to climb outside the box and take a fresh look at a new approach. This is just one solution that is available right now to anyone who has the impetus to make it happen.

Dragon Medical is expensive from what I remember - not many could afford that as an MT

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That's wonderful that you have it and can give 100% accuracy.

Yes, it is. But I can show you how to get it for half the cost. - see message

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There is a company that will provide the version 11 speech engine, which is the same that comes with Dragon Medical, and then provide medical vocabularies to go with it for a fraction of what Nuance charges for basically the same thing.

Also, a company that wanted to do this could purchase a multiple user license from Nuance and then provide Dragon Medical to its transcriptionists for anywhere from free to whatever. In fact, I know of one company already doing just that.

Can You Link me or e-mail me? - Would love to know more.

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...about how I can get this. I've thought about doing it.

P.S. - If you...

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If you e-mail me directly from the forum, you would remain anonymous. I'm just curious as to where I might be able to purchase this.

Check your e-mail. - No message.

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xx

Thanks, see msg - MT

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Thanks very much. But 7 hours after the time of your post, e-mail is still not in my box. Does it typically take that long when e-mailing from this forum? Will keep checking.

That hasn't been my experience, but I can only remember - email to one other poster.

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She did get the email, and we made contact, but I have no idea how long it took for the email to show up. I did get her email response to my email in less than 7 hours, so it apparently didn't take that long for her to receive my initial contact. If you still don't have it, I will re-send. Let me know.

I Still do not have it :( - Much Appreciated on resend!

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xx

Resent - Let me know - NM

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xx

No. :( - Sent you an e-mail from here

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Let me know here if you get it.

Can you e-mail me the information also? - Please and Thank you

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x

I also would like to know how to get this. - dc

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Would love to know how to get the version you speak of for less than what Dragon Medical costs. Please e-mail me with info. Thanks!

Check e-mail. - Let me know. NM

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xx

if you work for Inscribe, after being an employee for some time - they give it to you to keep, use anywhere

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InScribe does not give Dragon Medical - - Just Dragon

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After passing your first quality evaluation with a required score of 99.5% or higher, you may request a free copy and Dani will send you one.
But, if you want one yourself, ebay has a whole bunch of the same ones she would send you.

Actually, I was under the impression they provide - Dragon Medical 10

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I could be wrong about that, but I can find out easy enough and let everyone know.

The box I have is simply Dragon Naturally Speaking - Version 10.1

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The DVD says Preferred 10, as does the quick start guide.

So, are you trying to build a medical vocabulary yourself? - If so, I can make a suggestion.

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I know where you can get a full medical vocabulary that will work with your Dragon speech engine for about half what Dragon Medical would cost you if you're interested.

I never could understand the value of redictating - everything a second time. (s/m)

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For MTs with carpal tunnel, or other physical disabilities that make typing difficult or impossible, then yes, it makes sense. But I just don't get sitting there and speaking into a VR system all day, when if I can already understand what's being said, it might as well go directly through my own fingers. And if you're already editing VR (which most MT is nowadays, anyway), it would seem even more ridiculous to dictate it a second time, only to go through a second VR system, which would have to be edited, as well.

I think the mechanization of MT has gone too far. Now it's all about gimmicks, and "toys" for the (mostly male) hospital CEOs to play with, or brag about to their colleagues.

I still remember, as an outpatient clinic inhouse MT many years ago, the "next big thing" that was going to replace MT was a system they were trying out whereby all the medical records were stored not as print, but as sound files. Supposedly anytime the docs wanted to check a medical record, they could punch in the MR#, date of procedure or office visit, etc., and listen to the spoken report.

That went over like a lead balloon, because of course, it not only took too long to re-listen to the report and find the part you wanted to listen to, but there was still the problem of not understanding the dictation if it was another doctor, and not one's own report. Not to mention the ease with which they could punch in the wrong MR#, and be listening to the wrong report.

The appearance of "scribes" in medical offices is almost like MT has come full circle, and is now back to a similar job that it was back in the 1950s-60s, when a "medical secretary" sat and took the doctor's chart notes in shorthand, or typed directly from live dictation.

The machinery may be different now, a bit more complicated perhaps, but once again, there is that third person sitting there in the exam room, taking notes (or keyboarding them into an EMR).

Full circle - Leaving MT

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That is a great analogy about scribes and MTs coming full circle.

I would think redictating everything would be hard on one's voice. If medical records were stored and retrieved as voice files, then docs would actually have to speak to be understood, and we all know how likely that is.

Let me help you understand. - see inside

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Can you type a 5-minute report in 5.5 minutes? I'm not talking one with a lot of pausing, but one with a dictator who knows what they want to say and says it. For most, a good average is twice as long to type as it took to dictate. Some people take even more time than that, though most of the time not much more than that, so twice as long is a realistic average. Now how long does it take on average to proof read that 5-minute report (if in fact one even does that, which a lot of us don't because it's hard enough to make any money these days as it is)? I'd say maybe 2-3 minutes for the average reader, and if you proof with a full audio review then you need to add another 5 minutes for proofing not 2-3 minutes. Most try to learn to proof as they type, but that can lead to stressful QAs as everyone is aware. This eliminates that stress. I don't worry about QA any more, because I have read every single report I submitted. I already know they're spot on, and I can do that now in less time than it used to take me when I was just taking my best shot and then counting on the luck of the draw on QA because I knew there had to be some errors somewhere because nobody's perfect. Not any more! How much is no stress worth?

Anyway, moving along. A 5-minute report that takes 10 minutes to type and another 5 minutes to proof with full audio review. That's 15 minutes assuming it was perfect and you didn't have to take any additional time making corrections. In order to produce perfect work all the time, that's what it takes. I can do that in say 12 minutes tops. That's 20% faster, and if you took even 1 extra minute to make a few corrections of typos or whatever, then that 20% faster becomes 25% faster (12 is 80% of 15 but only 75% of 16).

Translating that into line count, 1000 lines a day turns into 1200 lines at 20% faster. At 8 cents a line, that's an additional $16 a day x 5 days a week is $80 a week x 2 weeks in a pay period is $160 a pay period x 2 pay periods a month is $320 a month raise just by using my voice instead of my fingers.

And that's conservative. I say that because the techniques I have developed in proofing allow me to proof a lot of the stuff as I go. Any numbered list, for example, prints out the instant you say it so it is easy to read it as you are dictating. When it comes time to proof, you can fast forward through that section so proofing takes even less time. And there are other tricks, too. Just showing you conservatively what you can do.

Bottom line is, I can talk faster than I can type, and my computer never makes a typo, nothing is ever misspelled, and...well hopefully one can begin to get the picture.

It's not for everyone, that's true. But, it does work and work well. We all have seen the really good drafts that come through VR for editing (albeit precious few). I make those every time, just speaking right with the dictation I'm hearing but enunciating it clearly so Dragon has its best shot at getting it. You don't have to slow way down, in fact it's not as accurate if you do that. You just keep up with the dictation, speak clearly, and sit there and watch entire lines appear all at once - not words one at a time like typing...entire lines and sentences.

Done that (sm) - Morgan

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I did that years ago before Dragon had any specialty dictionaries. I created my own oncology dictionary and spent a LOT of time training phrases. My speed was MUCH faster than transcribing. I had very fast dictators and could redictate as I listend, only having to stop on occasion correct a mistake or train a new phrase. This isn't for everyone as it's definitely multitasking. At that time there were some glitches for example I could never train difference between "he" and "she" and a few other things. Proofing took me 2 hours at the end of the day so it didn't really save me time but broke even.

Do you find that the ability to train the software has improved over the last 5 years or so? Does it still understand you when you have a cold? Are hiccups still transcribed as "the"? How about a dog bark? Do they have specialty dictionaries for oncology and pathology? Just curious as I haven't done this for so long.

I started with version 9.5, and now have 11. - What version were you using?

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Yes, the speech engine is greatly improved over previous versions, including 9.5. Virtually no lag time now in speech to text. Used to be some lag time before Dragon would post what you said on your screen as it took time to decide what it was going to print. Now, the second you stop talking what you just said hits your screen.

Yes, any speech engine, including Dragon, will still try and interpret any sound it hears as a word. If I sniff, I generally get the word "this." The microphone hot key solves that problem, though. There are still little annoyances, which is why I know from firsthand experience that VR is nowhere near ready to replace transcriptionists and may very well never get there. However, the improvement in accuracy is staggeringly better, and because what you just said immediately populates to your screen, proofing is much easier. You can pretty much proof as you go if that's your particular style. My proofing techniques vary depending on the dictation I'm dealing with at the time.

Problems with "he" and "she" and the like are a thing of the past, and there's not much multitasking to it. You just listen, repeat it, and either slow down enough to proof as you go or just stay right with the dictation and proof the whole thing when you're finished dictating it.

Don't know about voice changes affecting it. Accuracy is so much better, and with a good microphone it very likely wouldn't matter. I have not had any kind of a cold or anything that has really drastically changed my voice, but I do get quite congested with year-round allergy problems, and that degree of voice change has never had any impact whatsoever.

As far as vocabularies, Dragon is acute-care ready out of the box. I occasionally come up with an infectious disease bug it doesn't recognize, but for the most part they're all there. That's been one of the surprises I didn't expect. I can hear something I've never heard before and haven't got a clue what it is, but all I have to do is just repeat it as closely as I can to what I think I'm hearing, and more than half the time Dragon gets it because it's in the vocabulary. Plop - there it is on the screen - the medication or strep species or forceps, whatever. That had never occurred to me until it actually happened once. It was a pleasant surprise.

Speech recognition in court - Leaving MT

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A few years ago when I had jury duty, the court reporter used speech recognition to record the proceedings. She was definitely multitasking, but she used a microphone that she held up to her face, and it covered her whole mouth, so the speech engine only "heard" her voice and did not pick up any outside noise. It was very interesting to watch.

Diff'rent strokes for diff'rent folks, I guess! ;) - n/m

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Well, dying is changing in a sense... - Leaving MT

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I think MT is going to change enough that it will no longer be around as we know it at some point, and that seems to be happening fast. I predict it will no longer be a focused, one-task job but will morph into a more broad set of tasks. I sure wouldn't recommend it as a career choice to anyone, especially those who are able-bodied and can work outside the home.

I have to laugh when I read ads for inhouse MTs lately. - -(sm)-Meerkat

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They have a whole laundry list of additional duties: Phones, scheduling, patient rooming, buying office supplies, lobby cleanup, sometimes even medical assistant work, such as taking vital signs. (That job should be titled "Medical Assistant", NOT "medical transcriptionist!") Not to mention the ones that want you to be an Ace in Excel and Powerpoint presentations, or graphic design! It's hard enough to focus on what a dictator is saying when that's the only thing we're doing. Trying to transcribe while rooming patients and being a multiple-line phone/switchboard jockey is beyond ridiculous.

And the pay? $10/hour.

I'll pass.

you're talking doctor's office clerk, not hospital transcription. - and those jobs are going fast. NM

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Actually, the ones I'm talking about were ads I read - specifically because they said "transcriptionist".

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Most were doctor's office, but some were hospital. (The hospital ones probably should've been titled "ward clerk" or "ward secretary", not "medical transcriptionist".

I even applied to a job earlier this year that specifically wanted a radiology transcriptionist, but during the in-person interview, it turned out there actually wasn't going to be any transcription at all. Absurd.

in a doctor's office. they all do a little of everything - and that is usually the norm .NM

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The question is, what if anything will drive pay up at - least on par with regular outside office work? SM

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We currently have no leverage to insist because we're too easily replaced--with housewives working for pin money, with offshore MTs, with speech recognition, and with templates and/or shifting work to the clinician end.

Will this change? When? Why? To what degree? We need to know this to know if we can endure until then--those of us who can't afford to work for pin money.

Transcription and EMR - Jan

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I just got laid off in August, 2012, due to implementation of EMR in the orthopedic practice where I worked for six years. I am having a hard time finding a job. I would like to work for another five years. I am 64 years old, too old to change professions. Help!!

where are you located? - downtime

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I might be able to help you.

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