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

Today my hospital account announced its "launch" of EMR in December 2012... - anon4

Posted: Jan 25, 2012

Would appreciate replies from anyone who's actually been through this - how long after it begins will we last? There are maybe 50 of us transcribers, all told. Thanks.

What kind of EMR? - Happy MT Robin

[ In Reply To ..]
That's the very important question. There are some types of EMR that still uses transcription. If it's EPIC based, start brushing up your resume because that will get rid of all of the transcription. Been there, done that and it only took about a week after the implementation. This was with a service though, so if you work directly for the hospital that change over may last longer and they may still keep one or two people around, but figure on 98% of you being laid off. Again, this is only if it is an EPIC system. Other types of EMR are a little more transcription friendly.

Think I'll email my supervisor and ask... - anon4

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and see if she even replies to it. We're a service with other hospital accounts. Oh man, just when I was getting foolish enough to think this might take me into retirement. Thanks for replying, Robin.

I just googled my hospital account and yes, it is EPIC... - anon4

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and they've spent a fortune. Sigh.

I'm really, really sorry. - Happy MT Robin

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I was with ExecuScribe last year when their biggest hospital account went to EPIC. I was laid off after about a week after the "go live." They had given us some warning, but still, it went MUCH faster than they anticipated. I think they still get a little bit here and there from that account, but the majority of it is gone and I think that was what precipitated the sale of ESI to MedQuist. Who'd have thought last year that getting laid off would turn out to be a good thing?

I am really sorry to hear it. I know there are some hospitals that have gone to EPIC and then a couple of years later went back to transcription - point and click is NOT all that and a bag of chips - but when the hospital administrator pays $50 million and spends another $25 million on implementation, you bet they're going to try to make it work.

Good luck to you. Start dusting off your resume now.

Thanks, Robin... - Cynthia Murphy

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after 36 years of transcribing, wish I could retire yesterday, but I have a ways to go yet to get to age 65, what with the mortgage not paid off. Tried to sell the houe a few years ago with not an offer. At least I have no dependents. Oh well, gotta get busy.

EPIC is happening to us too (sm) - CMTx2

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.

The hospital I worked for in-house went to EPIC. - pj

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This was 3 years ago. We were all told at an MT meeting that they would start phasing out our jobs, and that most of us would be out of work within 4 years' time. I appreciated that the hospital was very upfront about the issue. I left immediately and started working for an MTSO. I am glad I left when I did.

Within 1 year, most of my friends had lost their jobs there. Even though they said it would be 4 years, almost everybody had been laid off within the year, starting with the radiology and rehab MTs, then the outpatient/clinical MTs, and now they have gotten rid of most of the inpatient/acute care MTs. They do still have about 4 acute care MTs working there, who transcribe ER and stat inpatient jobs where the hospital staff has to get someone into surgery right away and does not have time to mess around getting the info into the computer system themselves.

Sorry to be the bearer of bad news. My advice would be to jump ship early like I did. I am still in contact with 2 of the MTs that still work at the hospital. They were changed over from an hourly wage to a cpl wage, and they end up sitting there most of the time without any work to do, so they have to do the filing, answer phones, etc., and then transcribe when a job comes in. They make about 1/6 of what they were making with the hourly wage and are getting ready to leave the hospital now. The hourly to cpl change just happened in December, and they can't afford to sit there and wait for work. In my opinion, they should demand pay by the hour if they are having to do filing and answer phones.

I am also still in contact with the MTs who lost their jobs, and because some of them have never worked from home before (one worked for this hospital for 27 years), they are struggling to find a job with an MTSO. Thankfully, I found a job with an MTSO right away, because I left just before the economy tanked and had my pick of several job offers.

Good luck to you and the OP. I hope you are able to find something new right away.

pj - Old Pro

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I am so sorry that this happened to you and that it is happening to others. I am so grateful that because of my age, I am not caught up in the fray any longer, but I am really concerned about the younger MTs. I wish I could reverse this whole electronics thing. As it is, all I can do is offer my sympathy. I truly wish I were still in business and I would expand and give each and every one of you a job.

Thank you for sharing your experience (sm) - CMTx2

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I am going back to school to be a coder. I'm done with MT and am only using it to get me through school. I'll be finishing up right about the time ICD-10 is rolling out, and there will be a plethora of opportunities for those on the frontline of it.

CMTx2 - Old Pro

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I think you're smart.

Be wise - smartmT

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Hi man,

I have read ur statement " see if she even replies to it".

Wiseup, make ur strategies, be all over her, dont even give her time to think.. That's when anxiety creeps in...and u might get ur answer on the dot.

that's what i do, they start mumbling and end up saying "YES" or "OK"

I don't expect her to reply... - anon4

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she'll be affected by this also, I'm sure. There's a ton of us. Possible we could be placed onto other accounts at this company but not sure.

At least I have some heads-up.

For my hospital acct, ER docs refer to things - L&L

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being noted in EPIC, and other docs will say leave a blank and I'll add it later, but we still get TONS of dictation.

We still get dictations - D65

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I've noticed lately we still have a ton of work. What I have noticed is that with allergies/meds they'll say see Epic. Certain clinics will say see Epic, but they still do dictations. Honestly, unless their hands are forced (in which case I think physicians will find other places to work) they'll continue doing what they do. Anybody know 1000+ physicians (at my facility) who will want to take the time to sit at a computer, find the patient, click here, click there, when they can do it a lot easier by just speaking it to us? Same with Dragon. Really? I did a 1:40 minute dictation today. By the time the physician finds a computer that has a microphone attached to it, finds all his patient data, clicks on the right stuff (icon, etc.) and starts to dictate and then have to correct his own errors, gonna take a hell of a lot more time than 1:40 seconds. Don't get me wrong, there are still going to be places out there that are going to force their employees to use it. I see this more in clinics, not so much a hospital. I mean, some docs are good at their job, they won't at all be good at my job and vice versa.

If only we had a crystal ball :)

I was going to say the opposite - clinic versus hospital

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My own impression is that hospital administartors are much more likely to go to EPIC because of perceived cost savings rather than clinics which are physician owned and might be willing to care more about accuracy of their record.

I have nothing on which to base this, just my own feeling.

At my hospital, the doctors were required to do their own - pj

[ In Reply To ..]
work on EPIC if they wanted to continue to have privileges at that hospital. The reason was that the system cost the hospital so much that they had to cut somewhere, and that cut had to be in the transcription and coding departments, so the physicians have to do their own EPIC clicks (which aren't really that hard to learn) or get a PA or NP or RN to do that work for them while they are talking to the patient. The hospital made it mandatory, and, yes, some of the physicians chose not to continue to have privileges at that hospital or to retire.

Will Epic take away coding too? - nm

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nm

Small tutorial on EPIC. This is a rather lengthy message. - pj

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In answer to the coding question, I know that when my hospital went to EPIC, the coding department was cut in half within a year's time. I'm not sure on the coding side how this works, but one of my friends in the coding department said that EPIC is trained to look for key words and phrases in what the health care staff has clicked on or typed into the system, and it assign codes based on those key words and phrases. The coding jobs that are left at that hospital have changed from actually doing coding to just verifying that what the system has assigned is correct, so obviously they do not need as many people to do verification as they needed when they were actually doing the coding from scratch.

For those of you who have never seen EPIC work, here is a little bit of what I have seen. Please keep in mind that it was 3 years ago and things may have changed since then. I have seen it work from both the patient side and the transcription side.

When you are a patient, the health care worker (doctor, nurse, PA, etc.) enters information into a bedside computer or tablet device while they are doing your history and physical, while you are still in the operating room, while they are consulting on you, while they are giving your discharge instructions, etc.

There are various tabs for them to click, such as HPI, past medical history, medications, allergies, etc. The HPI tab has some commonly used phrases and a place for clicking on your personal information, such as age, gender, how long you have had the symptoms, what symptoms you are having, etc.

The past medical history tab has most of the common diseases and conditions loaded, so all they have to do is click on the ones the patient has or has had. Past surgical history tab has almost every operation already loaded into the system, so all they have to do is click on the ones the patient has had.

Medications are all loaded; they just have to click on what you are taking. Same way with allergies to medications, just clicking on the ones you are allergic to, etc. You get the picture. All of the tabs also have an area where they can type information if it is not already there for them to click on the screen.

What this translates to on the transcription side is a screen that has already put this information into the correct format for a finished document, let's say, a history and physical. It puts in the common phrases and picks up information for the fields based on the clicks the health care provider has made. Here is an example in the HPI: The patient is a [field1]-year-old {field2}, who was in {field3} usual state of health until [field4}, when {field5} began experiencing symptoms of {field6}. In this example, field1 is taken from the click on the patient's age, field2 is taken from the click on the gender, field3 fills in as "his" or "her" based on the click on gender, field4 is taken from the click on how long the symptoms have been occurring, field5 fills in as "he" or "she" depending on the gender, and field6 fills in the symptoms based on the health care worker's clicks on the symptoms page. As a result, the HPI would then read something like this: The patient is a 57-year-old female, who was in her usual state of health until 3 days ago, when she began experiencing symptoms of chest pain and shortness of breath.

You can see how this eliminates a lot of the transcriptionist's work and is actually much more accurate because it is coming directly from the health care provider and not depending on us to understand a sometimes mush-mouthed, too fast, or heavily accented dictator.

I hope this post helps some of you understand how the EPIC system works and why it is eliminating jobs. I'm not saying I like it; I just wanted you to know what it is if you have never seen it in action. I'm sure they have perfected it even more since I saw it.

Most of the doctors just proofread and sign their own documents at the hospital I worked for, but there are a few who do not want to proofread their own, so those still go to the 4 transcriptionists that work there. All the operative reports have to be proofread, because each case is different and the system sometimes gets the phrases in the wrong order, and then there are still the ER reports that have to be checked as stat reports, but the work is very sparse for the 4 transcriptionists who are still there, and most of their job is just proofreading, not much typing anymore.

I hope I explained things well enough to be understood. Let me know if you have any questions. I'll try to answer them if I can.

Thank you for your informative post! Know I understand Epic a lot better, thanks. - nm

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nm

Oops, 'now' not 'know'... - nm

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nm

I have a question about EPIC and long narratives - Happy MT Robin

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As I said, I was laid off from ExecuScribe when their big hospital account went to EPIC. One of the things that I still don't get about the system - even thought I can certainly see the appeal on a number of fronts - is in the area of the consults and possibly discharges. I'm in the middle of a consult now where the physician is explaining a lot of information and I would get these consults when I worked at ESI from the residents that would go on for 30 minutes or more with info. Some of that, yes, was the past medical history, meds, etc., that I can absolutely see being able to be "plugged" in, but how does EPIC work with the narrative that so many doctors use?

I have seen doctors who used to go on and on cut their dictation by 80% when using EPIC - sm

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A lot of the report for consults or discharge summaries will simply say refer to HPI, etc.

That's what the 2 people remaining do - nm - YouWantFriesWithThat

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.

The system is programmed to check for... - pj

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similar words and phrases, so if the doctor is repeating some of the information, it will pull from what has been stated in previous sections of the report, as well as previous reports. Also, some of the areas are set so that the doctor can click on spots where he/she wants to add information using voice recognition, and then he/she can come back to that point later and dictate that section of the report. Again, if the doctor is proofreading and editing his/her own reports, then the process is complete at that point -- still with no transcriptionist required.

Please keep in mind that this post is only hearsay from me. I have not actually seen that part of it work. I am only telling you what my doctor told me about the system when they trained the physicians on it. Incidentally, he was close enough to retirement age that he just decided to retire from the hospital rather than learn the new system, and he wasn't the only physician to leave that hospital.

Docs are retiring in DROVES. - ObamaCare

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The EMR is just one reason so many well trained, experienced docs are retiring.

The main reason is ObamaCare -- they want NO PART OF IT. Another reason is that many of them are GOING BROKE already, and ObamaCare hasn't even been fully implemented yet! The doctor shortage will mean MORE FOREIGN DOCS BEING IMPORTED ON A MASSIVE SCALE.

GOOD LUCK finding an American doctor who SPEAKS ENGLISH.

hogwash - docs arent going anywhere

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Doctors were in SUPPORT of the Healthcare initiative. You need to get your facts straight.

High malpractice insurance costs have driven many doctors away, not going to a dang EMR. What a crock.

Contradict yourself much? - LOL

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In your subject line, you stated that they weren't going anywhere. Then in the bottom of your post, you claimed that they were retiring because of high malpractice insurance premiums. So, which is it? Can't have it both ways!! LOL

Then you claimed that docs supported ObamaCare. NO, the AMA supported ObamaCare. The AMA DOES NOT represent all OR EVEN MOST docs -- in fact, only about 17% of all docs are AMA members.

You are obviously yet-another Obama supporter who cannot stand the REALITY, which is that ObamaCare is driving older docs (you know, the experienced, English-speaking ones) out of the business. That was FORECAST by industry experts, and sure enough it has COME TRUE.

Investors' Business Daily Poll Confirms '09 Findings of Date of confinement EXODUS - ReadItAndWeep

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Reform: When we said nearly half of U.S. doctors might close their practices or retire early rather than live under the Democrats' health overhaul, we were heavily criticized. The critics, though, were wrong.

Four in nine doctors responding to an IBD/TIPP poll sent out in August 2009 said they "would consider leaving their practice or taking an early retirement" if Congress passed what has become known as ObamaCare. That means as many as 360,000 physicians have plans to be doing something other than treating the growing number of patients in this country.

The doctors also told us â�� 67% to 22%, with 11% not responding â�� that they expected fewer students to apply for medical school in the future if the plan became law.

Given these views, it's no surprise that 71% were doubtful that the government would be able to cover the 47 million uninsured Americans with better care at lower costs, which ObamaCare supporters have promised.

Other findings from our poll of 1,376 doctors included: six in 10 agreeing that the Democrats' plan would strip drug companies of the incentives they need to make lifesaving pharmaceuticals, and 65% believing that a government overhaul would lead to lower-quality care for seniors.

The critics said our poll was not credible, was "shabby" and "garbage." They accused IBD of being partisan, pursuing an agenda, trying to sway gullible readers with shameless journalism.

Useful rhetoric for keeping the left stirred up, but it was nothing more than an attempt to poison findings the critics didn't like.

Now a Merritt Hawkins survey of 2,379 doctors for the Physicians Foundation completed in August has vindicated our poll. It found that 40% of doctors said they would "retire, seek a nonclinical job in health care, or seek a job or business unrelated to health care" over the next three years as the overhaul is phased in.

Of those who said they planned to retire, 28% are 55 or younger and nearly half (49%) are 60 or younger.

http://news.investors.com/Article/556398/201012091905/New-Poll-Confirms-IBDs-09-Finding-Of-Doctor-Exodus-Under-ObamaCare.htm

Expander is on! Date of confinement = DOC - NM

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nm

Thanks for this! - BlondeMT

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I had never heard of EPIC until reading it on these boards (newcomer to this site). But I just heard my local hospital system advertising it on the radio! How they are the first in my region to start using EPIC, blah, blah, blah, and how terrific it is supposed to be. Wow. Talk about eliminating MTs completely, as if speec rec wasn't insulting enough.

EPIC is just ONE program, too. - MT

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I am really sick and tired of seeing my sister MTs being attacked on this board for posting the TRUTH about coding going the way of the do do bird, just like MT. I wish the posters here would jump in and help defend them, as I have.

Thank you for that very enlightening post!

Software and coding - mt2

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Software has made HUGE strides in coding and doctors are now being incentivized to use more "structured data" so that coding won't need to be as intuitive as it is now. Some places will still use coders, but those places willing to spring the money for the software means it will also be affected.

The thing is ... - CMTx2

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.

Service workers should be smart - MT IS DEAD

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Often times you can tell what a hospital is doing by their job postings. For example, my former hospital, Yale, currently has a LOAD of Epic implementation jobs so you know its coming. I think that's a Medquist account, so get ready MQers. I don't think for a minute that the MQ management team doesn't know Epic is coming to Yale. They aren't going to tell their MTs though. SPREAD THE WORD!
To help prepare yourself for what's coming down the road, take the time to find out what your facility is planning. Even if you are an outsider, you can often times read their newsletters on line, read newspaper articles, anything you can get your hands on so when the time comes, you are not caught with your pants down and out of a job.

Service workers - sm

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Your advice is very wise!

My primary account is due soon for a "software upgrade" in a few months. I asked my supervisor if this meant they were going to ASR, and he replied, "absolutely not!" I therefore started scanning the hospital's website for news releases and career opportunities on an every-other-day basis. I would think that an investment in EPIC or similar package would have such an enormous financial impact on the facility that SOMEthing should be evident. So far nothing, but I guess it could be hush-hush for now.

They say that if it happens, and you weren't aware of it beforehand, you just weren't paying attention.

Of course, Chick Little's hospital just "rocks it out" with EMR - Things are great

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NOT

Well if the sky isn't falling, maybe it's just the bottom falling out from under us.

I'm so sorry for your news. The minute they went live at my facility, we went to transcribing about 100 lines per day down from about 2000 each per day.

Take this time to make as much as you can now, and look for other work. I don't see such a rosy rah-rah MT employment future out there, so I'd consider retraining.

Best of luck to you.

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