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

Future of MTs - but I’ve been wrong before

Posted: Jun 06, 2013

Iâ��ve been doing more research into the future of the MT field and I find that it is morphing into something I do not want to be a part of. Are EMR/EHR really cutting down transcription costs/jobs? If you goggle this you will find a huge disparity of opinion from â��goal being to have no transcriptionists whatsoeverâ�� at one extreme to â��all this new fangled stuff is just some new toys for the kids to play withâ�� being at the other. Some are on the fence and some are crying itâ��s all about money on Capital Hill. Some feel that the danger here is the transcriptionists are looking for other work and schools are eliminating the transcription programs. But the one I agree with the most is---There is a lot of anxiety within the Medical Transcription industry about the popularity of Speech Recognition and how itâ��s going to take away our business. There are scores of different accents, and it takes time even for a human transcriptionist to get accustomed to it. And to the untrained ear, the voice would make very little sense. That kind of Speech Recognition technology would take years to develop if at all it does. In my humble opinion, offices, clinics and hospitals will spend a ton of money and time getting set with EHR/SR because of enticing incentives, fear of penalty and the promise of fingertip efficiency. Regardless of the results (that only time will reveal) does anyone really think that they will go back to the way it was? They will make it work for them and them alone and the MTs will be editing their crap until our fingers fall off.

They could have made this work for them in the 90's if they had listend to the MT rather than t - Angie

[ In Reply To ..]
I doubt there is one single person who has any dictators they edit that do not require editing, reformatting and proofing. These are things VR is not capable of.

The ONLY way they can make this work to reduce their costs, but only by about 25% is if the developers create user-friendly platforms rather than ONLY focusing on doctor-friendly. Time is money and there is no way MTs will stick around doing free labor and being forced to sit and wait through long, unpaid pauses.

If only they taught the doctors to use the pause command, our productivity would escalate tremendously, making it more worth our while to stay in the position rather than find another line of work. Very, very simple concept, yet no one who has the power to make these simple changes seems to be able to see it for what it's worth.

I believe if they simply nipped demographic errors and long pauses in the bud, we would be able to edit in 75% of the time it takes to transcribe, bringing a 25% savings. Why this is such a difficult concept is a mystery!

The other easy fix is to enable adjustment of the auto backspace (sm) - Angie

[ In Reply To ..]
If the MTSOs only know how much time it took to relisten to ONE word which should take less than one second. The shortest setting in my platform for autoback space is one full second which is an entire sentence. For something mispronounced, this is a significant waste of time. We need a 1/4 and 1/2 second auto backspace.

Use your keyboard, not your foot pedal - Hotfish

[ In Reply To ..]
You should focus now on being foot pedal free and using your keyboard commands to transcribe in VR. In EditScript, we are told "the best editors live and die by alt+K" and it's true. It took some getting used to, but I'm entirely foot pedal free even for jobs that need to be transcribed and it saves lots of time.

Off topic, but I HATE ALT K and it slows me down - I still use my mouse

[ In Reply To ..]
I use my foot pedal and I use my mouse and I routinely do 400 to 500 lph. I never use Alt K unless I end up at the end of the paragraph by accident. That slowed me down so much it was crazy. I get that it works for some people, but it doesn't work for everyone.

Medical transcription - oliveoil104

[ In Reply To ..]
Foot pedal allows you to control dictation play-back with your feet. You can play, go back, and move on by hitting different segments of the your pedal with the front side of your feet. Its only drawback is some transcription software will work only with a particular type of connector. So for that my advice is keyboard is better.

Medical transcription

Angie - Old Pro

[ In Reply To ..]
You betcha. Truer words were never spoken.

the way I see it - Fatalist

[ In Reply To ..]
the way I see it, the idea that there has to be any transcribed documentation on the chart at all is a myth. There has to be some kind of documentation, of course, but I no longer believe that it's necessary to have an MT to put it there.

I used to think I was providing a valuable service. I no longer think so. But I will continue to do this until I can't anymore. I have nowhere else to go.

well no I think it can all be electronic but someone will always have to process the information. - x

[ In Reply To ..]
x

but probably it will be the doc - nm

[ In Reply To ..]
nm

no they won't go for that. They will come up with a way, on their own to get out of - doing it.

[ In Reply To ..]
doctors spend less than 10 minutes with you in an office visit. THey sure as heck aren't going to start editing their own reports now. They will pull something together on their own. Those that are left will be there to lead the way

but who says this type of documentation - has to be there at all?

[ In Reply To ..]
There is so much other documentation on a chart. Why does everyone think there has to be this narrative, repeating the past medical history and the allergies and the family history all over and over again?

Nope. No going back. Progress is forward even with bumps along the way. - ElectricityVersusGasLamps

[ In Reply To ..]
All of a major hospital network (including clinics) in my state/region are going to EMR/EHR and MTs are being laid off. Sure, until older docs retire, there will be straight transcription jobs, but they're becoming scarce. Eventually, even editing will dwindle as things rapidly and steadily improve. In the last decade, look at the changes! Imagine what 5 or 10 more years will bring.

My own doctor inputs a few items, and my chart note is complete. If she needs a short narrative, she types it in. Takes her all of a few seconds to add anything unique to my EMR. She doesn't have to re-dictate a narrative of my past medical history, family history, etc. It's all in there, only needing quick updates. The system also flags her if she inputs a medication that I'm allergic to, etc. She can quickly access all of my records, including labs, CT scans, hospital stays, etc. Why would she want to go back to waiting for her dictation to come in?

I've used VR 18 years - The improvement is miniscule - Angie

[ In Reply To ..]
I started using VR in about 1995 to give my hands a break. I created specialty dictionaries and put a lot of time into training the program. It still has most of the same limitations. It still can't differentiate between "he" and "she" or "15" and "50" with a fast dictator. It has never. I watched doctors get really excited about this new software, only to have 80% of them return the product and only the techy ones work with it enough to use for dictation. Still these doctors use MTs for their non-standard complex reports.

The developers have had several decades to improve this software, but improvements are still marginal. Until the developers start to communicate with the real users, not just doctors and hospital buyers, they will not make a product that saves a significant amount of time and money. I do understand TAT is improved, but that is from EMR, not VR.

It's catching fire lately. We all lost our jobs to it. - MTRealist

[ In Reply To ..]
Sure there is some way to go, but it's steadily improving! And, like with all technology, improvements speed up. Same with all technology.

They're eager to eliminate the need for MTs... - YetWeEnableThem

[ In Reply To ..]
"In one recent advance, Nuance, the leading company for voice recognition software, has enhanced its Dictaphone Dragon Naturally Speaking Medical version 9 to have 80 different vocabularies, each specific to a division of medicine (such as radiology), to increase accuracy, says Peter Mahoney, VP and general manager of desktop dictation business units for Nuance's Dictaphone division. That unit has some 500 internal speech scientists working to advance the software's accuracy.

Another recent improvement involves increasing accuracy by calibrating the software to "understand" accents, which greatly helps doctors who don't speak English as their native language. The software's accuracy rate is currently 98 percent and rising, according to the company."

I think we as transcriptionists end to have a narrow - view of why EMR is being implemented

[ In Reply To ..]
Yes, it cuts down on transcription costs, but that is certainly offset by the initial cost of the software itself. If the EMR is a voice recognition program, then someone is always going to be needed to edit the draft output. No EMR is good enough (or ever will be) to be able to adjust when a doctor says "The patient is a graduate...uh, uh, correction, patient has graduated, uh, uh, correction, patient, uh, correction. The patient does not smoke." Yes, that's a pretty accurate quote from a report I did about 2 nights ago and it's very typical of this particular hospitalist, God help me. No EMR can correct for that. The issue then becomes, does the hospital administration make the doctors edit their own reports or do they continue to have a lower paid MT-type do it. Some places are having their doctors edit their own reports which I think is not cost effective. I learned from a very smart business woman that if you have 2 or more people who are capable of doing the same thing, then you get the lowest paid person to do that, thereby freeing up the higher paid person to do something that only that higher paid person can do. Some facilities are having the doctors edit their own work and then finding out how truly cost ineffective it is and then going back to having an MT do it. That takes time to come to that type of realization, though.

The real appeal of EMR is an all-inclusive medical record that is accessible by any physician in the system. The beauty of that is if I am seeing my endocrinologist today and she orders a thyroid panel and I go to see my PCP next week, he can access the results of the thyroid panel as well as other tests and/or info that the endo has entered into my chart. It theoretically makes for better healthcare, which is the whole point of an EMR.

I have found that voice recognition software (I work in EScription) actually does quite well on the accents and it picks up some stuff that I really would have to work quite hard to figure out if I were doing straight typing. All VR is not the same, though, and it's not all managed the same and some is managed quite poorly, thereby making the editing job that much more difficult for 4 freaking cents a line.

The bottom line is technology is making advances in how healthcare is documented. It's not specifically targeted at transcriptionists, per se, we are just the collateral damage. I continue to believe that there is always going to be a need for someone to edit the output of the VR system. There won't be as large a pool of workers required, as happens with any industry that has technological advances. There also won't be any guarantee that the work available will pay enough to make a living wage at it, which won't happen as long as companies are convinced that 4 cpl is adequate because we can edit 600 lph and still put out accurate records. The market hasn't bottomed out yet because there are just too many transcriptionists out there trying to make a living, which is why we are now seeing offers for 5 cpl for typing. That is pure capitalism. When there's a lot of product (transcriptonists) the price (wages) goes down. When there's not a lot of product, the price goes up.

The world of straight typing is dying out. There will still be some jobs with it here and there, but those will gradually go away and it will all be editing. That's just the evolution of this industry.

I think that - VR

[ In Reply To ..]
would actually work quite well if someone could enforce dictators using it correctly, at least well enough so they could eliminate another 75% of proofreaders. Very surprising that hospital bean counters haven't seriously made an effort to enforce this since they have obviously invested so much in the software.

Problem: narrow-minded bean counters not consulting bean producers for the answers only we have. (nm - Angie

[ In Reply To ..]
.

One more perspective on the future of MT. - see msg and link

[ In Reply To ..]
http://blog.nemtinc.com/?p=723

The thing is, there will always be a need for documentation. Now whether or not 100% of medical facilities will use a program such as Epic in the future, no longer requiring MTs, that is the big question. In my neck of the woods, the major clinics and hospitals do not use MTs - my doctor in fact states he "misses the MTs" as he hates doing all of this documentation himself. They use Epic and are doing 100% of their own documentation. The hospitals in my area use mostly scribes, along with Epic. I saw one ad for an MT in my city at a hospital in which the pay was starting at about 12 bucks an hour - pitiful - I made 12.50/hour back in 1998 fresh out of school. The future of MT is really hard to predict, but there is no shortage of people trying to do just that.

Same here and with all of my family/friends. Docs are using EPIC and/or scribes. - MTVet

[ In Reply To ..]
An Epic trainer told me that they have already implemented the program in about 30 hospitals and are moving through my state right now. This includes all of the affiliated clinics. The trainer told me that his company also provides scribes, who are all medical students. They don't hire MTs. Not looking too bright for transcriptionists.

Please get the definition of medical student straight - They have no time for scribe jobs

[ In Reply To ..]
There is a lot of confusion about what a "medical student" is. Loads of college kids claim to be med students because they are taking pre-med courses. They are pre-med students, at most. They are not med students.

This is important because you all here keep spouting that medical students get scribe jobs. Medical students do not have time for outside work like that. They go to class all day and study all evening. Medical students are also not college students. They are college graduates attending a professional school. They don't work.

The students scribe companies hire are PRE-med and nursing students. Those are college kids. They are willing to work for peanuts to get in a hospital door. It is better than the burger industry, which is all they are qualified for otherwise.

Epic and the scribe companies are feeding you a line of you-know-what. They have been misrepresenting their products and services all along, just like EHR providers misrepresent its capabilities.

You might find this link enjoyable. It is pretty much accurate.

http://www.kevinmd.com/blog/2010/11/scribes-lead-unintended-consequences-electronic-medical-records.html

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