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

do you thing there is a turnabout happening in transcription - anon

Posted: Jul 19, 2013

Just curious if anyone is starting to see a trickle of companies taking back their transcription from the MTSO? I am starting to see some places who once outsourced bring it back in house. No hospitals, unfortunately, but the smaller to medium medical groups, afraid of the liability of having their medical records roaming all over India. I know of an HR person at a large group of clinics here who told me they are bringing it all back in house because of liability and HIPPA issues. They pay $20.00 per hour, but you better have the years of experience and be able to work in house. I think a lot of the smaller to medium sized companies are realizing the value of a very good transcriptionist, at least in my area, and what the liability is of just sending out their work to whomever has the lowest price.

Do you guys see any kind of trend where you are as far as bringing it back in house, not for hospitals so much, but for other kinds of medical groups?

perhaps a small trickle - as I have also been told

[ In Reply To ..]
from two different sources, so far, one a fairly large MTSO, but none of the ones on this site, that the hospitals and clinics who bought into this EMR thing just are not happy, and are gradually coming back. The one person, a very small MTSO, who has a small amount of clients, but enough to keep herself and four or five MTs busy, was almost ready to close her doors and stop the transcription business she had spent the better part of her years building up, because she had lost so many clients to EMR. Well, she says over the past year or so, they have started gradually coming back to her. They were not happy at all with the transition, they liked the previous ability to dictate narratives into their patient records, where with EMR they are very limited in that aspect. The larger MTSO I spoke with just this past week about the very thing, and she said too that they were seeing a gradual return to regular transcription...so maybe...just maybe... things are starting to come back some. keeping fingers crossed. hope I can hold on until retirement. :-)

Yes, even with my hospital - I know it is only one example, but...

[ In Reply To ..]
Let me first preface this with another statement about EMR and no transcription. EMR does not necessarily mean no transcription. EMR simply means electronic medical record. I have been typing into an EMR system on my PT job for 5 years. I currently work with an EPIC system that still utilizes transcription.

Now, having said that, my hospital system is nearing the end of a $200 million Epic conversion. The clinics went first and finished at the end of last year and the first of 7 hospitals went live in June. They did see a reduction in work from the clinics and with the one hospital live so far they have seen a reduction in transcription by about 40%.

Having said that, though, we currently outsource more than 50% of our work to Nuance (we lease Escription from them). The goal/plan/hope is that once the conversion is done, then we will have ALL of our work done in-house and get rid of the outside sources completely.

So, to the original question, even the occasional hospital out there sees the value of having employees in house as opposed to outsourcing all of it. I hope that trend continues and grows.

my thoughts - is there hope?

[ In Reply To ..]
I think those entities whose bottom line is profit will continue to outsource until (hopefully) lawsuits make them think twice.

I think those entities and physicians have ethics and care about quality could help turn the tide.

One can only hope...

trending - sm

[ In Reply To ..]
"No hospitals, unfortunately, but the smaller to medium medical groups, afraid of the liability of having their medical records roaming all over India."

What an absurd statement! Medical records don't "roam" all over India. If your (very faulty) logic held water, and liability was their "fear," they have much, much more to fear by their medical records "roaming" all over the US where Suzy Anybody claiming to be an MT can have your records in her HOME (they dont do this in the home in India) and decide at any moment to sell info or leverage herself to make a quick buck.

The bottom line with transcription is MONEY. If smaller practices are bringing MT back under their umbrella, it's because they've figured out how to do it CHEAPER. PERIOD.

Transcription is, always has been, and always will be a cost for hospitals/clinics/offices, not a profit center. And you can throw out all the ludicrous statements you want (like the one above) but the reality is, it is ALL about money.

trending - wrong!

[ In Reply To ..]
You are WRONG and YOUR statements are ludicrous about the money and doing things cheaper and THAT was the ENTIRE POINT of the OP!

The note the way I read it is saying that a lot of folks did go to outsourcing because it was cheaper, but now they are bringing it back [even though it is MORE] for a lot of reasons. Control over the work might be one reason. QUALITY! Knowing who is doing your work. The OP said they knew a person who did not like their work being outsourced to India. Many accounts require that their work be done on-shore, no off-shoring, so it is a CREDIBLE concern of many companies! SHEESH!

For crying out loud! - Jen

[ In Reply To ..]
I really enjoy this website for MT info but geezum Pete, can't we have ONE conversation without SOMEONE getting PISSY????? It's like a bunch of children on here. We are ALL overworked, underpaid and stressed to the max about our futures. It would be so nice if we could just show a little compassion and if you don't like it, don't respond to it!

On this forum - it is like dealing with

[ In Reply To ..]
kindergartners. EVERYBODY is right and everybody ELSE is wrong. no matter what the original statement is. Some people just have so say something, no matter if it is right, wrong, or indifferent, often pointing the finger at the poster and attempting to make themselves feel better about themselves by "feeling" that they are always right.

Turnaround - Hopeful

[ In Reply To ..]
I don't know if I should say anything after all that but wanted to comment: My facility now sends all the MT work to a company that offshores. I'm the onsite QA person and the quality is horrible, no one is happy with their work. They are saving a boatload in salaries and benefits so I understand it being money driven, and historically transcription departments are money losers. I hope that eventually at least some of it will be brought back on site, but that could take years. One of our other local hospitals tried outsourcing for a while but did bring it back on site due to quality issues and now only use it for stats and weekends. In my area, they are about the only hospital left with any onsite MTs. I don't want to ruffle anyone's feathers, but patient records do not circulate around India. The MT companies are HIPAA compliant, the same as those in the U.S.

for me, everyone has the right to make a point. Just need to learn another way - Right/Wrong need not apply,out of place here.

[ In Reply To ..]
/

I'll take Suzy Anbody over Unknown Foreigner! - PetesSake

[ In Reply To ..]
Wow, way to go bursting bubbles with rubbish. Really, time to take a deep breath in...count to 50...Do you work for an Indian company or something? You don't mind if privacy laws don't apply in a foreign country? And, I happen to know that MTs in India ARE able to work from their homes, too, depending on the company they work for. Also, which US company would allow an impostor, claiming to be an MT, to work for them? I doubt a fake MT would last more than a shift or two! But, hey go ahead and defend off shoring! The thing is, and this is a VALID patient safety risk and threat to the medical provider's profit, off-shoring patient records exposes them to potential lawsuits and hefty awards to claimants.

I am not an unknown foreigner - Hopeful

[ In Reply To ..]
I am speaking the truth. I am a US based MT who had the same MT job with the same employer for nearly 20 years. About a year ago, they laid all of us off and sent all the work to a company whose MT work force is based in India. I was asked to QA the work that was returned from them, I still work for the same employer. You need to work on your reading comprehension skills and read the rest of what I said in my post. None of it is rubbish; the company we use is HIPAA compliant, my employer would never choose a transcription contractor who was not. I'm not defending offshoring, it is what it is. However, you need to do some homework in regard to some of your statements. Also, I am not the one who said that MTs in India are not able to work from their homes.

Try using facts - sm

[ In Reply To ..]
My job involved me in some of the contract negotiations with Indian companies. (They don't work from home btw.) They are held to the same confidentiality and privacy as American MTs are.

Running around being Chicken Little while disregarding the facts, operating from a purely emotional point of view instead of actually arming yourself with the facts, and throwing in "lawsuits" etc for more hysterical-added value is just wrong.

The majority of companies using off-shore labor, and especially the largest of these companies, have had their attorneys crawl all over their contracts. Believe me, it's legal.

And sorry but I stand by my observation that Suzy Anybody is far less trustworthy then anyone sitting in a warehoused building in India.

I tend to agree - about Suzy Anybody

[ In Reply To ..]
Especially when there are multiple people with access to Suzy's home computer and Suzy is a true IC who keeps patient files stored on her hard drive unencrypted. There just does not seem to be that much scrutiny given to Suzy's home computer set up.

To SM - OP

[ In Reply To ..]
I am pretty sure no one here said that having workers typing in India is illegal, but there have been malpractice lawsuits regarding errors on medical records that had been typed in India.

The message really had nothing to do with this anyway. I was asking if people saw a trend of companies bringing their work back in-house. This was one reason that a clinic I know of was bringing their work back. If their doctors were uncomfortable with it and want to bring in back, that's their business. Don't argue with me over why they want to bring tx back in-house.

Also, this is not the cheapest option for them. I happen to work for a very large (different) clinic group that pays very well and has great benefits. They do not, have never, and do not intend to outsource. I have been told this is not the cheapest option for them either, but they have a devoted tx staff and very little in the way of quality issues, etc., so they chose quality over price. It is NOT always the cheapest option that wins the transcription work, but thanks for speaking for everyone on the matter.

WOW - OP here

[ In Reply To ..]
Boy, don't post here often, and I guess it is obvious why. I did not intend to start a thread about whether Indian work is legal/illegal or if it is right or wrong for a company to employ Indian workers or how well each of them are screened, but if Suzy Q sold records, it would be a heck of a lot easier to arrest her than someone in a foreign country.

What I was saying, however, is that my friend, an HR person who deals with and contracts with outsourcing companies on behalf of this multi-office very large practice, was bringing their transcription back IN HOUSE. This person works very closely with the doctors, and this is what they wish and their reasons why. They were not comfortable with the records being all outsourced. If you read my note, you would see that this person has an now fully IN-HOUSE staff. No Suzy Q or Indians. As mentioned the pay is $20.00 per hour to the transcriptionist, plus very generous benefits, and I know from speaking to this HR person that this is not the cheapest option for them. They are an oncology group, however, and patients were starting to ask regarding who had access to, not only their sensitive medical records, but their personal information etc.

I have noticed a couple of practices in my area bringing the work back in and thought that maybe, just maybe, there was a little change in thinking on the part of the higher-ups. I see it in my area and was just wondering if you folks were seeing any changes along these lines?

Signing off now!

What part of country are you in? I am in - MT25

[ In Reply To ..]
Kansas City and sure have not seen that trend, unfortunately. I so wish it were true. I would be glad to work in-house. I'm to the point of losing my home & car and am looking for something full-time somewhere.

In NC - OP

[ In Reply To ..]
Hi, I am in NC. In the past several years, most of the MTs I know ended up being outsourced from their in-house positions. A couple left the field and the others bounced around from various services, just trying to hang on. Now, 3 of those folks are all at in house jobs. Not a trend exactly, but I do see some offices choosing to employ top-notch transcriptionists and paying them an OK to decent wage rather than paying the bill to the MTSO. Just was wondering if this was the smallest start of a trend.

Interesting point! Obamacare requires patient access to - records! And they are horrified

[ In Reply To ..]
frequently at what they find--due to poor quality recordkeeping. I like what this suggests for OUR future.

The only way it could not benefit us as MT/MEs (and as patients ourselves, of course), would be if business interests corrupted the law so that patients didn't actually get to review as much of the record as they are entitled to under the law as written.

Keep an eye on the legislative prize. Whatever you think of Obamacare, we WANT patients to see their medical records and scream and holler bloody murder where appropriate.

BTW, our contribution in MT/ME is NOT a money loss to a business, it's a means of BUILDING profits. We do our part in building the product they sell. No us, bad product, bad sales.

Another option - (see message)

[ In Reply To ..]
Another option that one large medical group does (cannot remember the name, but I think they are out of Virginia) is to employ their own remote MTs instead of going through the MTSO. This group screens and tests individuals, and the candidate actually travels to the location for an in-person interview. I think the pay is still on production and I do not remember if it is considered "IC" or not, but the screening process is more robust, the medical group does not have to pay for the middleman MTSO, and it also enlarges the candidate MT pool from just one locale to an entire region.

In-house MT - GLMT

[ In Reply To ..]
I can only speak for my experience right now, but the hospital system I just hired on with is slowly bringing all MT work back in-house and at home with full bennies. After 20 years working for MTSOs, it's nice to be treated with some respect.

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