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


The kinds of things ASR will never catch. - Coco


Posted: Apr 13, 2012

I'd love to know how my old hospital feels about the reports that they're putting in their charts, now that they've outsourced everything to a company that uses ASR (which, incidentally, they were not told would be used when they contracted with the MTSO....although they may have assumed it--I don't know).  

There are just soooo many things that ASR will never, ever catch--especially in cases where the doctor is just being absent-minded.  For instance, I once had a doctor say that the patient had "decreased urinary intake."  If you're skimming the report, listening and reading along to see that it matches what you'e hearing, and being a little absent-minded yourself, it is so easy to miss things like that.  

Another time, the doctor was giving the dates of admission and discharge for a previous hospital stay as being, say, 10/15/2012 and 10/17/2012, when it was, in fact, only March 2012 at the time he was dictating.  

The list could go on and on...I'm sure all of you have other examples.

My guess is that not many on the hospital end are even noticing errors like this; or do they not care as long as it's easy to figure out what the intention of the dictator was?  When I worked for the hospital, I was being compensated fairly for my knowledge and attention to catch those errors.  The big problem, as I see it, is that with ASR pay, we are no longer being compensated fairly for our brains and efforts, so many MTs are letting things slide or not caring, unless they don't mind earning about $4 to $5 an hour.  It's hard not to adapt the attitude of, "Well, if the hospitals and doctors don't care about the quality, I guess it doesn't matter."  

I couldn't work for that kind of money, but my conscience and make-up wouldn't let me not care about my quality, so I've left MT'ing for now.

I don't think they care. - LeavingMT

[ In Reply To ..]
I've seen both extremes, where people spend 2-3 hours deciding if he is saying THE patient or THIS patient and then I've seen reports go through where the patient has "decreased b.o. intact" for "decreased p.o. intake." Dates are messed up, medications (300 mg of Xanax really?), etc., etc.

I'm old I guess because when I went to school for this, then got mentored, certified, etc., etc. you WANTED a nice finished project. You used blanks where appropriate, blanks were NOT to be filled in at all costs, and doctors actually signed (well for awhile).

Now the s@it I see coming through makes me see why the companies think $4 an hour is good. I also understand why transcriptionists (and hello we are not transcribers, those are MACHINES) are frustrated. I've seen the same thing in my father's industry and my husband's. It really is about the bottom line and stock holders in ALL fields now. Kind of sucks to know your medical care is dependent on the bottom line, but I remember 20 years ago when I first started having an inkling that would be the future. Unfortunately it is.

To coco - veryoldandtired

[ In Reply To ..]
I hate to say this because I used to feel the way you do. I tried to get the report right and correct little things that I knew the doctor was just in a hurry and made a mistake, I would correct it and make the report "look good." But I have such a bad attitude now after watching my life go down the toilet that my approach now is "if you don't care any more about what you are saying to try and get it right, then neither do I." I don't get paid to care if it's right. Really, it makes me feel like crap to say this. Truthfully, if it was a MAJOR error I would just put a blank and let QA deal with it. But on little things, I'm just like "nobody cares anyway." My job, plain and simply, is to type what I hear. if they say "social history: no tobacco, alcohol, or alcohol," then that's what I'm typing. Not only is it not my job to correct them, I don't get paid to do it. It's also illegal. I can't change what they said because I know what they "probably meant." I either type it the way they said it or put a blank and let QA deal with it, and get on to the next report. It's just not my job to do everybody's job. Please don't misunderstand and think I would put something like "Xanax 300 mg," I would definitely blank that and on to QA, but when it comes to the just plain stupid things they say that will have no effect on the patient's care, I just type it and keep going. Time is money in our industry and I can't waste mine trying to make some PA dictator look good. sad, very sad that it has come to this, but like they say "you get what you pay for."

Couldn't agree more. - Coco

[ In Reply To ..]
What you both are saying is exactly how I felt. I've also been an MT for close to 20 years, and I'm sure we're in the category of MTs who are the "least fond" of the ASR programs, due to our years of training and experience from doing things so differently in the past.

Before I quit, I also got to the point of not correcting every little blip even when I knew it wasn't quite right--or, like one of you said, I would always just replace it with a blank if I knew it was a critical word and figured I'd rather let the doctor fill in what they want. What kind of pained me, though, was when I'd go back and look at the report (if I had to send it through QA because it had more than 2 blanks), and sometimes the QA person had filled in my blank with what the doctor said...even though it wasn't possibly correct!!! That killed me....I could hear what the doctor said, but I couldn't take the liberty to change it, and I knew from experience that the doc was just misspeaking.

Seems like you're darned if you do, darned if you don't. If you leave a blank, it might get filled in by QA with the audible-but-incorrect word(s), and thus put a report with errors on the patient's chart; but if you go ahead and type what you hear (or leave what ASR typed), you risk having QA mark it as you having missed an erroneous word! Arrrrghhh...it felt like I never knew which way the QA person would go with it.

With what my actual hourly pay ended up being when I did a quality job, I, too, would just have to let a lot of things slide (and yes, I know the MTSO would have to round it up to minimum wage, even if you only "earned" $4/hr). Otherwise, I might as well be driving a school bus, which, in my city, pays $12 an hour. It's probably only a few hours a day, and I wouldn't have the right temperament to drive a busload of school-age kids every day, but I'm just sayin' -- it's a regrettable era when the knowledge and skills to do a good job in MT are no longer valued.

I can say one thing--I will request copies of any of my medical records if I'm ever hospitalized from now on!! I have no doubt they could contain significant errors.

back at you Coco - veryoldandwornoutMT

[ In Reply To ..]
THAT IS WHAT I'M TALKING ABOUT!!!!! send it to QA and they just put in what he said. I HEARD what he said, but it was WRONG. why should I care. I could have done that. I thought we were supposed to use QA not only for inaudible things but for things that were OBVIOUS DISCREPANCIES. that makes me madder than fire to see that they just put in "Xanax 300 mg." I could have done that my OWN self but it was WRONG. then when I question QA, I get NO REPLY. so like I said, I just type it and as long as I know it's not MAJOR, I am sending it on through. what do you think is going to happen when the EMR is all there is and people who have absolutely no medical training are hired for $10 an hour to input medical records. scary thought. BUT not my decision and not my choice. one day they will miss us and it will be oh so too damn late.
Agreed (nm) - LeavingMT
[ In Reply To ..]
X

Exactly - LeavingMT

[ In Reply To ..]
The only thing that matters is seemingly NO blanks. I think the people that run companies do NOT comprehend that it is about accuracy, not having no blanks. It seems all about filling those in, even if terribly incorrect.

I totally understand where you are coming from - LeavingMT

[ In Reply To ..]
Because I feel the same. They do not value us as a skill anymore, they want typists...really they seem to want machines to cut down on costs.

Because of how I feel I have decided I have to change careers, because this isn't a career anymore for me. I loved what I did for the greater part of 2 decades and now I feel like not caring about it is negative for me. I don't like feeling negative or bad or whatever.

I wish all transcriptionists REAL transcriptionists not wanna be work the home typists could all find what we went into this for and stay, but I don't think that will happen. I spent the majority of my life telling people "no you don't type exactly what you hear" but now I just don't tell them anything.


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