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

Potential major development for the medical transcription industry - sm - echomt

Posted: Apr 29, 2015

Dr. Wyatt, a physician affiliated with The Joint Commission, just released an article recommending that the TJC become involved in helping to create new standards and protocols for the medical transcription industry. His article addressed the vast majority of the issues that negatively impact the dictation/transcription process and the need to fix these problems because of their potential for jeopardizing patient safety. Among the many things mentioned in the article that he feels need to be addressed included things like outsourcing and offshoring, poor quality of dictation, overly relying on VR to produce useable documents without further editing and scrutiny by others than physicians, nurses, PAs, etc. (who themselves cannot be counted upon to properly identify and correct documentation errors they themselves often create), the inappropriate use of verbatim transcription, and much more.

Handled correctly, this will change our industry in a big way for the better. I have attempted to provide a link to the article, but if it does not work you can email me with a request to view the article and I will forward it to you.

Things may be about to start looking up - WAY UP!

Agree - Me too

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About time. I am still fighting this battle from my end too. Since the politicians are not listening, I wrote a letter to Senator Bernie Sanders today as he seems to really care about the American workers and hopefully, he will do something in Washington. I filled him in on the "whole ball of wax" in my letter.

Great! Send him a followup with a link or reference to this article. NM - echomt

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xx

Please sign the petition! - PowerInNumbers

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I did and I hope you all will too.

https://www.change.org/p/mary-brockway-please-respond-to-our-concerns

Yes, everyone needs to take part. Now is - echomt

[ In Reply To ..]
the time to fan the flames of interest. Perhaps you were one who was skeptical that such action would have any effect and did not sign the petition when it was first brought to your attention, or perhaps you didn't know about it, but it has caught the attention of a national body that carries with it the power of enforcement. We all need to follow through now and make a clear and unified statement that we are collectively bringing real issues to their attention that need to be addressed sooner rather than later. Sign the petition if you have not done so. It is the first best thing any of us can do at this early stage in the developing process to make sure they understand that something needs to be done and done quickly. It took TJC 2 years just to respond to repeated contacts and attempts to get them to indicate interest in even having a dialogue. We don't want another year or 2 or more to go by before any action is taken on these recommendations, so lend your voice of support by signing the petition. This is important, and we all need to make sure TJC treats these issues with the respect and urgency they deserve.

The case that the article refers to at the beginning is - interesting in

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that it mirrors so many of the companies we all work for. Especially enlightening is this paragraph, which mirrors the situation for many of us:

Beginning in 2007, Thomas Hospital authorized its U.S. based outsource transcription vendor â�� Precyse Solutions, LLC â�� to use overseas transcription in India to save 2 cents per line. Through a series of subcontracts, the actual transcription services were moved to India and performed by Medusind Solutions, Inc. in Mumbai and Sam Tech Datasys in New Delhi. Testimony at trial revealed that U.S. based employees of Precyse were highly critical of the poor accuracy of the transcription work performed overseas by Medusind and Samtech. Instead of instituting better quality control procedures, these employees were replaced with overseas reviewers. Consequently, no one in the United States reviewed the transcripts for critical errors before they were provided to Thomas Hospital.

I found it interesting that when TJC was first approached - sm - echomt

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by a colleague of all of ours by the name of Debbie Schwarm, she found that they (TJC) were largely in the dark about how the entire dictation/transcription process worked. They needed initial enlightenment as to exactly what it is we do in terms of what all is involved in the healthcare documentation process. Now that they have been enlightened, they are starting to see the huge problems that we have all been complaining about for so many years and how patient safety is indeed potentially being jeopardized because of a lack of adequate standards and protocols, which protocols you notice in the article have to do also with proper grammar and sentence structure that befits a medicolegal document. Even the best English-speaking foreign nationals doing transcription through offshore contracts do not speak the language well enough at the present time to be able to provide the quality of document that we here in the US had always sought to provide before the greed and the attitude of "good enough" began to take over. This could be a game changer on so many levels, all of which will benefit our industry. For me, if we could just get doctors and others to take the time and make the effort to dictate clearly and understandably with technology that doesn't compromise the voice quality, I would be totally satisfied, and yet it goes so much beyond that.

if wishes were horses - then beggars could ride

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I am afraid that the last line of your erudite post is the true bottom line. The "doctors and others" are simply not responsible for this aspect of patient care, and I don't understand why this is allowed to go on. Don't the hands that hold the scalpel also hold the microphone? I no longer believe that anyone in any level of the HIM hierarchy will ever speak for the MTs, the worker bees who catch and correct the discrepancies and the "personal styles" of those who dictate. Mandatory education and monitoring of the "doctors and others" is a concept that the Joint Commission needs to entertain, as well as sanctioning the companies who simply go to the bank, and do not take responsibility for the introduction and ongoing maintenance of this education. It is just one small piece of the pie, but it is a very good place to start, not with CEOs and upper management, but at the very base of the pyramid, with the hands that hold the microphone.

Yes, it starts with dictation - Debbie from MyMT

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Yes, part of the quality improvement process that I am proposing to TJC would absolutely address that, it starts with dictation. I hope you'll read the many documents provided to them to see what we are up to. It is a project I have worked on for 2 years, and we are making some headway.

Does that mean we will get paid better than - 3rd World Rates?

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x

TJC will not concern itself with our industry problems, per se, but - sm - echomt

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I can envision how the standards that they are recommending be developed and applied to the healthcare documentation process can be used to make the necessary changes that, when applied, could have positive results on the pathetic and unfair wage that the MTSOs currently are offering in order to perpetuate their greedy profiteering. The only thing The Joint Commission is concerned with is patient safety, but the standards that will need to be developed to accomplish the goal of greater patient safety can also be used to pave the way toward improving many aspects of our work environment, including the need to once again pay a fair wage for the quality of work that will be required to meet the standards that are set up.

Really? - enraged

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Here is a quote from the page where you can sign the petition: "... We understand the Joint Commission to place an emphasis on patient safety in areas directly related to patient care, with less focus on supportive roles, such as medical records and medical transcription, housekeeping, central supply. We believe the documentation role is an extremely important process and is not being managed by specific indicators or quality thresholds."

Seriously? SERIOUSLY? MTs are now in the same "supportive role" category as housekeeping and central supply? Where exactly does TJC think the documentation starts? In a sparkling clean bedpan? Lest someone take offense, I am not being disrespectful of anyone involved with housekeeping or central supply. However, I do believe there is a difference in job requirements. For instance, dispensing Kerlix and emptying bedpans likely pays more. Well, I guess there's some small comfort in finally knowing "our place" in the supportive role system of patient safety. Time to abandon all hope, ye who enter here.

Supportive roles? Disagree, too ... - sm

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I disagree with that statement. It is a misunderstanding of what JC addresses. They ALREADY DO address MEDICAL RECORDS, so in that sense the statement is wrong.

Medical record content is reviewed and they have standards for it. It is a huge focus, too. Every JC review involves medical records. A lot of what HIM does revolves around compliance with JC. You can look up their standards online.

The proposed focus now is on ensuring that the content is accurate since it can no longer be assumed to be so.

I disagree with the way that is written. Someone needs to fix that. That whole "supporting role" bit is wrong.

No, the statement is not wrong. TJC addresses medical records, but... - echomt

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they do not address the healthcare documentation process from which those medical records are derived. And for the record, medical transcription of the dictation for the purposes of creating a medical record is a supportive role in the process of caring for patients. That should not be understood to downplay its importance in the whole process that is modern-day healthcare. It is merely a description of where that function falls relative to the overall process of actual patient care.

I think you may be misunderstanding what has just happened - sm - echomt

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The point of that wording was to highlight the misconception TJC had concerning what it is exactly that we do. The point was that medical transcription was being lumped into those same categories by TJC because of their not appreciating exactly what goes into healthcare documentation or how it is negatively impacting patient safety as a process because of a lack of quality guidelines and oversight. It was by enlightening them to what is actually involved in the process that caused them to rethink their position and begin to take a more serious look at what's going on and how they can and should provide greater input into the process for the sake of patient safety. Dr. Wyatt has agreed that a new, much more informed attitude and approach is necessary on the part of TJC. Your question concerning where TJC thinks healthcare documentation starts is exactly the point. They hadn't really thought it through, but now they are doing so and seeing a need to take additional action. We have always known we are an important part of the healthcare team and represent a final safety net for protecting patients from the doctors and the errors they make and cause in the healthcare documentation process. We have now gotten TJC to recognize that fact as well. Their attitude is changing, and so should ours.

The Joint Commission - Debbie from MyMT

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Excellent reply. Thank you for taking the time to clarify here. Appreciate it. You nailed it. While it's frustrating to deal with much of the bashing and bantering that goes on here, and I don't have a lot of energy for it, those who do, like you? helpful. It'd be a good thing to stop the uninformed comments. Thank you, again.

Dear enraged - Cindy

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Actually, the Housekeeping Department in a hospital is pretty darned important. I think she should have written "direct" patient care, but I don't think there is any point to your outrage. In hospitals, it is about what is deemed revenue-producing and non-revenue-producing. The trick would be to convince the powers that be that improved transcription/editing can lower the costs somewhere else. For example, can the amount of time a dictator spends reviewing a report be decreased if the report is edited more thoroughly. Will increasing turnaround by 20% improve the revenue cycle? I don't know the answer to these questions, but generally if you can show that your ideas translate into $$, that's half the battle.

Juno - Anon

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If anyone wants to research further, the plaintiff in this case was Sharon Juno. She was administered 80 units of Levemir instead of 8, with subsequent cardiac arrest, brain death, taken off life support, etc.

Thanks for making us aware of this. - ProudMT

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I had no idea and am delighted to see that the idea that MTSOs push as being so important to them, patient safety, may get a review, forcing implementation of significant reactive changes, driving patient safety to the forefront in healthcare documentation - WHERE IT SHOULD BE. While the MTSOs use patient safety as a way to cut wages (QA review) with a CYA attitude, I would love to see a total system overhaul, in turn creating a better wage structure and deserved compensation for whatever job description would now be entrusted to ensure this. I think good MTs and QAs would carry the perfect skill set. Let's hope the powers that be who drive this action work quickly.

it is just so sad that you buy into this - NM

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you don't even realize that what you are supporting is that the next step will be that students pursuing a medical degree will be the only ones qualified to follow a physician around and eradicate the MT industry as we know it.

But as long as you buy into it...

snoooze............

Very negative and very poorly thought through - end of message! - echomt

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xx

Summary of Events - Debbie from MyMT

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Thank you so much for posting this here. I normally stay away, but was directed by some to have a look at the comments, and I appreciate your explanation. Not sure MTStars will allow my link, but it provides a thorough overview of the nearly 2-year process to getting to where we are. If not, maybe I can direct people to the MyMT website to look under the menu item PROJECTS. Not sure of the posting rules, but the information is vital.

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