What happens when quality standards are lax in medical transcription?

Well, it’s as simple as considering the difference between a milligram and a microgram.  Consequences will abound with a misinterpreted dosage; an incorrectly cited diagnosis; the left hand designated for surgery instead of the right. Mistakes can mean a potential breach in compliance, or possible litigation.  (Cue the spine-chilling music.)

The patient’s health record is a document on steroids.  It underwrites medical history, coding and billing.   Medical transcription, in other words, is serious business.

Just ask JD Thankamony, our resident VP of Operations.   Don’t let his good nature mislead you – underneath his friendly demeanor lies the heart and soul of a Six Sigma Quality ninja.  An industry veteran, his signature commitment to Quality at iData has been underwritten by a fierce personal code of conduct. Perfection’s the goal.  From that passion, he’s built a career around creating a culture of Quality.  (I wonder if that makes life difficult at home?)

Quality starts by hiring devotees to dotting i’s and crossing t’s …

According to JD, Quality starts with hiring the right people in the first place.  “Medical transcriptionists belong to an under-appreciated profession in my book – their status should be elevated.  At iData we hire only the very best – those who are skilled and passionate about their profession. Aptitude is only part of the equation.  Attitude is just as essential.”

JD fielded a few questions about how iData manages Quality, and why the job is never done.  (After all, he’s the one who ultimately answers to the customer.  You know – the reason we’re all here!) 

Q:  In medical transcription, how can you define Quality?

A:  Replicating the data exactly as the physician dictated, so that it is transcribed with absolute integrity, error-free.  True – there is some subjectivity – some clients want reports transcribed verbatim.  Others prefer the MT to distill the information into a readable document.  Our first job is to assess what our customer wants.  Speed is also critical.  But we always say we can sometimes sacrifice speed, but never, ever accuracy.  The document has to be error-free.  Still, we strive to deliver in half the turn-around-time set by each customer.

Q:  What processes are in place at iData that ensure superior quality?

A:  At iData, we’re so consumed with Quality we implement a three-tiered approach -

First: The MT transcribes the document; and each MT is subject to Quality audits for a percentage of work produced each day to measure accuracy.  (Imagine your work being scrutinized – every. single. day.)

Second:  One of our thirty Quality Specialists reviews a percentage of documents (with audio) before delivery to the customer.

Third:   On some accounts, a second level of full audio review is performed by more experienced Quality Specialists before delivery.   Some jobs go through a second level of Quality Assurance where blanks and other deficiencies are checked and addressed.

Then, the Quality Assurance Manager, Operations Manager, and 6 Shift in-Charges perform online audits of a predetermined percentage of each account and each QA (predelivery).

Finally, post-production, a percentage of reporting is randomly audited after delivery.  The results of the audit are compiled on a weekly basis and tracked for consistency/variance/improvement.

(Whew!  Sometimes it’s good for a COO to consider exactly what the team does every single day.)

Q:  You’re a firm believer in Six Sigma.  What is it – and how do you apply its practices here?

A:  The name of a business management strategy, Six Sigma was developed for original application in the manufacturing industry in the 80’s.  I got my own certification in 2006, and continued learning under the tutelage of a Six Sigma Black Belt in my former position as a Quality Manager with another company.  It changed the way I look at Quality and always drives me  – and in turn my team – to strive for perfection.  The Quality culture is driven by the concept of trying to find solutions rather than applying fixes. Instead, we work toward eliminating the possibility of the error being committed in the first place, rather than JUST attempting to solve the problem.

When I hear JD talk about how hard he and our team works to deliver top-notch Quality; I get why our customers rave about us.  So let me go on the record by giving due credit to JD and our team – the unsung heroes of medical transcription!

A founding partner at iData, Donna lends two decades of expertise in large systems support.  Contact her at: ddannessa@idata-llc.com

Want to get Off the Record delivered directly to your in-box?  Sign up in the right-hand corner, and join the conversation with your comments! 

Each vendor promises to deliver the same thing.  Quality.  Whether it’s surgical instruments or building maintenance service, everyone claims to be the best.  Once you’ve signed on the dotted line, do the results measure up?

Or, did they over-promise and under-deliver?

It’s an essential question, because it is the healthcare administrator’s task to maximize the return on investment.  In the case of medical transcription, excellence is more than an esoteric goal – it has to be the starting point.  Errors carry a potential for serious consequences.  Each patient history must retain the highest standards of integrity.  So medical transcription providers must work as passionately as their customers to ensure the data is accurate and up-to-the minute – not just managers, but MT’s on the front lines.  (Pun intended.)

What can happen when medical transcription goes “rogue?”

• Safety risks for patients (i.e.:  documentation of incorrect dosage)
• Negative financial impact (paying too much for poor quality, potential litigation)
• Poor document integrity (difficult for specialists or referring docs to understand)

Quality matters.  How then, can we define superior quality in medical transcription?

In the case of voice-to-text conversion, quality should be defined as accurate, clear, consistent, and complete patient healthcare documentation of data extracted from the clinician’s dictation.  

But – don’t doctors sometimes make it difficult to interpret data given human errors?  (Think poor enunciation, rushed diction, background noises.) Yes.  Still, it’s every medical transcription provider’s challenge to work within the context of the customer’s human error.  While delivering none in return – every time, and on time.  (Hey – no one said quality was fair!)

At iData – and this is ON the record – our promise to deliver superior quality when it comes to both speed and accuracy is our lifeblood.  Doctors, patients and administrators depend on us to care as much as they do about their patients, and their bottom line.

We know it’s what everyone says, so don’t just take our word for it.  Make us prove it.

You see – we love to talk about quality, because it’s integrated into our culture.   We’re not satisfied with less than 99% accuracy in 24-hour turn-around-time.  Here’s how we deliver– and your practice or hospital should expect nothing less from your providers.  (You can tell them we said so.)

1. Six Sigma sticklers:  Like Jack Welch, G.E., and Motorola, iData implements Six-Sigma standards for quality.  (Want to learn more about Six-Sigma?  Stay tuned for our next blog post!)
2. Audits, just business as usual:  Each month, we audit 5% of all reports generated for each customer to measure accuracy.  We don’t sleep well unless they point to results.  Really!
3. Constant contact:  (No – not the newsletter kind.) Each quarter, we sit down with our clients and analyze a sampling of reports, together.  We admit it!  Occasionally problems do arise, but we face them square in the eye, eat a slice of humble pie when called for, and design solutions. (There is after all, some subjectivity here.  Some reports are created verbatim, based on capturing every dictated word as is.  Other reports synthesize the information into a readable summary – so we stay on top of best practices for each.)
4. MT accountability:  MT’s don’t enter this line of work (again with the puns -) unless they have a passion for accuracy and speed.  Still, the quality assessment team measures their performance – drum roll please – Every.  Single.  Day.  Imagine that kind of scrutiny!
5. The fastest – or it’s free:  We promise to deliver reports faster then our competitors, so we attached a guarantee that ensures we tow the line.  If reports do not arrive as promised, well, our customers don’t pay.

We’re so passionate about quality we plan to write a series of blog posts on the topic.  Next up, we’ll showcase an interview with our V.P. of Operations, J.D. Thankamony, on how and why iData implements Six-Sigma into passionate pursuit of excellence.  He’s got quality  under control around here.

Think about the vendors that supply your organization with products and service.  Can they say the same?

Want to get Off the Record delivered directly to your in-box?  Sign up in the right-hand corner, and join the conversation with your comments!  As always, if you have a question about Medical Transcription, contact me at ktant@idata-llc.com.  Until then, here’s hoping your day is a successful one – and that’s on the record.

Warmly,

Kendall Tant
President and CEO

410-212-7935
ktant@idata-llc.com

Paperwork.

So the question inevitably arises – exactly how long must a practice, clinic or hospital be required to keep aging or inactive medical records?

The answer is both easy and complex, because there is no one-sized-fits-all solution.  But in the age of HIPAA compliance and the HITECH Act, plus health care reform, the question can no longer be swept under the rug and procrastinated.  (Caught you!)  Now more than ever, it’s critical to reduce your practice’s vulnerability to liabilities by creating a defensible, sustainable records retention process.

That means – you’ve got to face into pruning when necessary.  In other words – you’ve got to purge.  And let’s be honest – it’s not the most glamorous part of your job, but an important one.

Purging is necessary, but to ensure your process is a viable one, check out a few FAQ’s on the topic.

Does the HIPAA Privacy Rule require covered entities to keep patients’ medical records for any period of time? No, the HIPAA Privacy Rule does not include medical record retention requirements.  State laws typically dictate the length of medical records retention. However, the HIPAA Privacy Rule does require that covered entities apply appropriate administrative, technical, and physical safeguards (across the chosen medium) to protect the privacy of medical records and other protected health information (PHI) for whatever period such information is maintained by a covered entity, including through disposal

Where do I source medical record retention laws by state?  Check out your state’s website to find applicable laws or try searching your state’s Department of Health website for legislation passed regarding retention laws. If you have one, your medical records department might be familiar with those regulations or could connect you to legal counsel for direction.

What are Medicare and Medicaid’s requirements for record retention?   HIPAA rules require Medicare Fee-For-Service providers to store required documentation for six years from the date of its creation or the date when it last was in effect, whichever is later.  CMS (Centers for Medicare & Medicaid Services) requires that providers submitting cost reports retain all patient records for at least five years after the closure of the cost report. And if you’re a Medicare managed care program provider, you are required to retain patient records for 10 years.  Medicare requires healthcare providers to retain records for Medicare patients for 5 years; if the provider is a HIPPA covered entity, the HIPAA 6-year requirement takes precedence. As for Medicaid, those vary by state.

As the keeper of all that critical documentation of a patient’s history and care, it pays to get the facts.  Impeccably documented, safeguarded, accessible medical records serve as the lynchpin of your practice’s protection of both patients, and your business.

And, it makes you an unsung hero.  Think about that when you’re down in the trenches!

For more information, visit hhs.gov or cms.gov.

Want to get Off the Record delivered directly to your in-box?  Sign up in the right-hand corner, and join the conversation with your comments!  As always, if you have a question about Medical Transcription, contact me at ktant@idata-llc.com.  Until then, here’s hoping your day is a successful one – and that’s on the record.

Warmly,

Kendall Tant
President and CEO

410-212-7935
ktant@idata-llc.com

She’s wearing a robe and slippers, expertly wrangling two kids, typing with fevered competence and raking in the dough. Isn’t that what you’ve heard about the life of a professional Medical Transcriptionist (MT)?

The myth is almost always more exaggerated than reality. Truth is, if you’re looking to switch professions to one that offers flexible hours, generous wages, and of course, job satisfaction, training to become a Medical Transcriptionist  (MT) might just turn out to be a dream come true.

Then again, it might not.

iData is home to the industry’s sharpest MT’s. (No bias here!)  They would likely tell you that their jobs don’t exactly reflect the pictures you’ve seen – lounging on cozy chairs with laptops, sipping coffee.  Taking care of our customers – hospitals, doctors and records managers that depend on us to transcribe data with integrity, accuracy, and speed happens to be pretty serious business.  It’s often stressful, and it’s fast-paced.

If you’re thinking of becoming an MT, first check out the myths versus realities:

Still sound like your dream job?  Keep reading.

You’ve seen the ads and heard the promises.  Work from home!  (Have you ever tried to get any work done with a 3-year-old nipping at your heels?)  Create your own hours!  (True, but those arrangements often happen once you’ve proven your mettle in the office.)  Before you invest in training, make certain you understand all there is to know about this noble profession.

The reality is this: working as a Medical Transcriptionist requires a knack for learning complicated medical terminology, a passion for accuracy – because there is zero tolerance for mistakes – and a blistering work ethic to churn out enough reports completed on time to make a thriving living.

So some of the rumors are true. Medical transcription is, for passionate devotees, a rewarding, fulfilling and lucrative career.  But it takes work.  Hard work.  If you’re a careful listener, if you’ve got flying fingers and an avid interest in health care issues, and if making a mistake is an affront to your personal sense of pride – then keep doing your homework.  Maybe we’ll even hire you at iData – but don’t say we didn’t tell you so!

Want to get Off the Record delivered directly to your in-box?  Sign up in the right-hand corner, and join the conversation with your comments!  As always, if you have a question about Medical Transcription, contact me at ktant@idata-llc.com.  Until then, here’s hoping your day is a successful one – and that’s on the record.

Warmly, Kendall Tant, CEO, iData

From the Desk of Kendall Tant, CEO, iData Medical Documentation

Did the EHR system in which your practice invested live up to its promise?  Did you enjoy increased productivity, profitability, accessibility to information, and patient satisfaction?  We’re curious.  Let’s get the conversation going!

Even if you haven’t made the significant investment into an EHR system, it’s likely you’re doing some research.  In case you’re new to the industry, the EHR – or Electronic Health Record – is simply software that allows clinical data to be stored, retrieved, organized and edited on a computer.  Sounds good, right?  But at this junction in history, there are still plenty of bugs in the system.

The EHR system has been hailed by some in medical circles as the holy grail of data management.  But we’re far from integrating the EHR across the industry as standard operating procedure.   And there’s a reason for that. Investing in an EHR system requires significant money, time, and training.  Privacy’s an issue too.  Topics for a future blog post!

It’s clear the industry is heading toward their integration – and the government offers an incentive via the Health Information Technology Act of 2009 for those who achieve  ”meaningful use” standards by 2014.

But for our purposes, we want to examine this: EHR systems require physicians to input their own clinical data, toggling between a patient and the computer screen. Do group practices and hospitals really want their most productive – and expensive – employees entering data critical to the integrity of the medical record? And – do physicians themselves really want the distraction of toggling their attention between a computer screen and a real, live patient?

Traditionally, a clinician focuses on his or her patient during a visit, then, dictates data into a hand held device or computer workstation.  The data is carefully extracted, coded, and/or interpreted by a highly skilled medical transcriptionist, then returned as a report, or entered into an EHR or other electronic platform for the physician’s review.

These professionals take extreme care to ensure the data’s integrity is preserved and safeguarded against error.  (I know, because we employ them!) Of course, as a medical transcription company, we’re biased.  But it’s also the reason we’re not quaking in our boots just yet – we aren’t the only ones asking the question.  Though some will say that implementing an EHR eliminates the cost of a medical transcriptionist, we say, not so fast.

As Mark Twain once quipped, “The reports of my death are greatly exaggerated.”  Not everyone is ready to embrace the concept of physicians entering data into an EHR system.  There are still many physicians who never learned typing skills, and plenty others aren’t as technically savvy.  We know one doc who hired a scribe to follow him and take notes for dictation, simply so he would have time for his real mission – to listen to his patients – without distraction.

In addition to the loss of personal connection between doctor and patient, what about the ultimate cost?  We connected with one multispecialty group on the east coast with 200 doctors.  Since the implementation of the EHR system, each doctor sees one less patient each day.  So even if you considered a modest reimbursement of $35 per patient by 175 patients – that works out to a loss of $1.5 million each year.

Does eliminating the cost of partnering with professional medical transcriptionists make up the difference?  Do the upsides of the EHR at this stage of the game make sense when considering the significant investment of time and money?  We want to know what you think.  What’s your experience been?

In the meantime, we’re busy coding data so our customers and doctors can focus on doing what they do best – devoting their expertise and talent to the people who deserve it most, patients.

Want to join the conversation?  Leave a comment, or share this post with colleagues and friends in the industry.  And as always, contact me with your questions and comments at ktant@idata-llc.com.

Theirs is an unlikely relationship.  Not exactly like Demi and Ashton, but still.

If you placed a Physician (Doc, for today’s purposes) alongside a Medical transcriptionist (MT), it’s likely you couldn’t find two people with less in common.  So you think.

It’s true, our imaginary Doc and MT probably hail from very different backgrounds.  One holds advanced degrees, commands a top-dollar salary and enjoys peer respect, and patient gratitude.  (Hopefully.) The other may hold a college degree, but often learns on the job, earns an hourly wage and mostly completes his or work under the radar.  Very often – at home, staving isolation and the jeers of dishes and laundry.

Each one has their share of professional headaches – pun intended.  But each may develop a sort of unspoken animosity toward the other.  Each may look at the other one’s intentions with skepticism, each critical (or oblivious) to the other one’s gifts, talents and challenges.  Docs may become frustrated when the MT makes a mistake that should have been examined; MT’s might assume Docs are just rude when they talk too fast or pause too long – or cough, snort or burp while recording.  They really are human, after all!

Just like any other – this “relationship” requires some empathy and grace.  Easier said than done!

Bound Together by The Almighty Patient History:  Errors Not Permitted

Still, these two share something powerful in common.  They must work in tandem to ensure a patient’s medical history – the chief vehicle through which doctors, specialists and surgeons communicate – is maintained with integrity.  No mistakes allowed.

Funny – a Doc may never meet the MT who painstakingly interprets his or her spoken notes and drafts a report that merges with the patient’s history for all time.  S/he may never get a chance to thank the MT for taking every effort to navigate fast-talkers, murmurs, thick accents or the background noises of a rousing football game – interpreting text where there is no margin for error.

Doctors might not have a reputation for humility.   But the truth is – they would do well to practice manners in recording data that another is required translate and code under the relentless pressure of time.  They might feel an MT’s job is a routine one.  But where would they be without him or her?

Conversely – the MT must try to empathize with Docs.  Can you imagine having to record every single interaction with a patient?  To live with the constant worry that one mistake could cause irreparable unintended consequences?

Come on, you two.  Stand in the other person’s surgical booties.  Or high heels.  (Or slippers!)

A Little R-E-S-P-E-C-T goes a Long Way, Both ways:  What Docs and MT’s Really Want

Of course, at the end of the day, it’s the Doctor who signs the MT’s report.  With his or signature comes the responsibility that the content is accurate and up-to-date.  The two must work out their differences to turn out a perfect report – every time.  Here’s how everyone involved can help the process:

Docs:  A wise physician shows implicit courtesy and respect to the MT on the receiving end by speaking slowly and clearly.  Try to record data in an area free of noise and distraction.

MT’s:  Never assume a Doc doesn’t appreciate your work, even if you don’t get a card.  But send one.  Thank the Docs that do show courtesy, and give grace to the ones who record while driving in rush hour traffic.  Remember, their jobs are stressful too.  (Think cranky patients.)

HIM’s: Create ways for MT’s and Docs to “touch” each other.  Ask to post pictures of MT’s around the administration office.  Distribute a newsletter periodically singing their praises and highlighting their work.  Offer tips to Docs with regard to recording, and periodically distribute a card for their signature to thank the MT staff.

A little mutual respect, empathy and kindness goes a long way in improving the “relationship” between Docs and MT’s.  Patients depend on both to deliver the best care possible!

Like our blog?  Join the conversation.  Got a topic related to medical transcription or health information management you’d like us to cover?  Connect with me at: ktant@idata-llc.com

The tyranny of the urgent.

Does this sound like something you tackle constantly?  Is your day consumed by interruptions?  Are you sucked in by email, text & voice messages when you’re desperately trying to finish that budget report that was due yesterday?

You’re not alone.  Working in health information management means there is never, ever a dull moment. 

If you’re a Medical Records Manager, survival means juggling with expertise.   On a given morning, you’re deftly processing requests from physicians (especially department heads), scheduling staff, reworking my budget for the fifth time, completing a report to the CEO about delinquent reports, fielding requests for software glitches, preparing for three meetings over the next two days – and, well, the list goes on.  From the moment you set foot in the office, you’re running up the escalator – never quite getting off.

Let’s ride down and step off for just a moment.  Grab some coffee.  There is a better way!

Out with the Old Habits, in with the New

At iData, our business is all about fostering efficiency.  The one thing we don’t want you to have to worry about is medical transcription.  So in the name of encouraging efficiency, reducing stress and increasing job satisfaction we thought we’d offer HIM’s a few quick tips.  (We know your time to read is limited!)

Manage Meetings Effectively:  Boundaries, boundaries, boundaries.

Meetings can be time wasters.  Appoint a timekeeper for each meeting who tracks and limits time spent on each topic.  End at the pre-determined time; delegate follow-ups to open issues.

 Examine Email/Smartphone Habits:  “Hello.  My name is Karen. I’m an email addict!”

 Admit it.  You get a little “high” when you hear the little “ping” announcing new mail or text messages.  Who is it?  What’s going on? Does someone need me right this minute? Email breaks up the monotony.  But checking it compulsively can lead to lost time that adds up.  Break the bad habit and create a new one – check your email at the top of every hour, or start out by cutting your average in half. 

 Delegate Tasks:  Let go and let others

We know.  You have a reputation for being the queen (or king) of getting the job done.  And you do – but it’s extracting a price.  You’re always busy but often feel like you don’t accomplish your goals.  The key?  Let go.  Empower someone else by delegating a few tasks.  Your team members will feel more trusted and appreciated; in turn, they’ll work harder and make you look even better!

 Overcome Procrastination:  “Swallow that Frog!”

The spreadsheet the CIO asked for 2 weeks ago is smirking at you in your mind’s eye.  You just can’t seem to shut everything else out and git ‘er done.  Try the “Swallow the Frog” technique.  Each morning, determine the most difficult, unsavory task on your list, and do it first.  Shut the door; tell everyone you’re only accepting truly “urgent” requests.  Once you “swallow the frog” everything else will seem easier by comparison!

Think about which of these new habits you can incorporate in your daily round today. (Also, read, Crazy Busy by Edward Hallowell, M.D. for an eye-opening take on this subject!)

In no time, you’ll earn a new crown – Queen (or King) of Efficiency!

Like our blog?  Join the conversation.  Got a topic related to medical transcription or health information management you’d like us to cover?  Connect with me at: ktant@idata-llc.com

With the continued migration toward the almighty EHR, it is incumbent on the CIO to make sound, cost-effective choices in Clinical Documentation choices.  Oh, and 98% isn’t good enough.  Accuracy is still King.    You’ve heard the chattering about Speech Recognition (SR) – and you’re wondering if it merits a closer look.

As always, iData’s here to sort through the clamor and offer some direction.

Of course you’ve already encountered SR technology.  Your own voice was captured and directed to the appropriate desk when you called the bank today and spoke your selections.  It works – right?  Fair enough.  But the stakes are high here.  There’s a big difference between, “no history of heart attack” and “blisters on his back.”  You’ve got to work with a partner you can trust.

Voice Recognition:  How it Works

Traditional Clinical Documentation (Medical Transcription) works like this: the clinician’s data is recorded via handwritten, hand-held device, laptop, phone or computer workspace.  The information is translated, typed, coded and captured into a report the clinician approves.  Essentially, Speech Recognition (SR) skips the step of typing.  But it doesn’t mean a real live human isn’t necessary.  Here’s how SR works:

1.     The clinician dictates and records patient information into a handheld device.

2.     A voice file is sent directly to a voice recognition server.

3.     After the file is transferred, editors review the notes for accuracy.

4.     Finally, clinicians then review these corrections and sign the stamp of approval.

With SR, The Medical Transcriptionist’s (MT) task becomes that of editor, instead of transcribing verbatim. M*Modal’s Speech Understanding™, for example, fosters medical documentation by transforming narrative into electronic documents that are structured, clinically encoded, searchable, and shareable.

Check out an example of how M*Modal’s software converts data into a structured report:

http://www.mmodal.com/technology.jsp

Many have identified the traditional MT’s job as dying a slow death in light of the evolution of SR.  We say – not so fast.

While some hospitals and practices champion the efficiency and cost savings associated with SR technology, it is just one of a range of solutions we offer at iData.  SR technology is evolving.  There are still issues to tackle.  A clinician’s mumbling, ancillary noise, pronounced accents, and poor speech habits can compromise the accuracy of the data.  (Again – a human touch is still required!)

For the time being, SR offers a cost-effective choice to practices where the data is often repeated and easily categorized and coded, in specialties such as emergency medicine and radiology, for example.  As with any other technology, SR can be assimilated into a range of solutions, so the accuracy so vital to “meaningful use” is safeguarded.

In a large hospital, for example, a “hybrid” approach works well, in which some departments choose SR and assign editors to scour the reports for accuracy.  Other departments may choose to stick with the traditional route, merging the options for a solution that improves efficiency and reduces costs, while preserving the integrity of the data.

As always, we welcome your feedback.  Leave a comment, and keep the conversation going.  Have you used SR technology?  What works in your practice?  (And don’t forget to sign up for our RSS feed, so you can receive blog posts in your mailbox!)

Best,

Kendall

It’s no secret technology’s transforming the Clinical Documentation (formerly known as Medical Transcription) industry.   Like businesses everywhere, the technological revolution to which we’re bearing witness requires every one of us to adapt in ways both significant and sublime.  And in an industry that’s defined by words, it’s big news that we’re changing the verbiage we use to describe just what it is that we do.

A quick visit to the Medical Transcription Industry Association’s (MTIA) website and you’ll notice that while the URL is the same, their name has changed. Our industry’s primary trade association was just recently minted the Clinical Documentation Industry Association (CDIA).   We think that’s pretty big news.

So what’s in a name?

Once upon a time, Medical Transcription entailed transcribing, or converting voice-recorded reports dictated by clinicians, into text format.  From the in-house employee to the outsourced professional, Medical Transcriptionists have long provided a critical service to the healthcare industry in producing those reports used for coding and billing.

Today, new technologies are redefining the task, broadening the scope of our service offerings to include the capture, editing, formatting, security and storage of clinical documentation.  Our industry is adapting to the complexities in today’s legislative, technological and medical advances, offering services that reach every touch point of the clinical documentation spectrum.

In migrating toward the EMR, the role of transcribing the information is also changing.  Voice–to-text, and voice recognition technologies that automate the transcription of data now require exacting editing to ensure the reports are accurate. So the role of the Medical Transcriptionist is also evolving as they embrace a new kind of  “knowledge worker” status.

So, is the news of this evolving technology an indication traditional medical transcription – wherein steady hands and sharp minds decipher the voice of a clinician – is on the decline, as some might predict?

Not so fast.

While iData is equipped with a range of options to meet the varied needs of our customers, we still believe wholeheartedly in the traditional method of transcription.  Newer technologies are still being refined, as is the medical industry’s assimilation to meaningful use of the EMR.  But considering the health history of a patient bears no margin for error, we can tell you the traditional transcriptionist’s skills are still in high demand.

We wonder, though, should we change their titles to, “Clinical Documentation Specialists”?  Stay tuned!

We know.  You’ve sliced open the invoice from your brand new medical transcription service.  After picking yourself up from the floor, overcoming sticker shock and maybe even buyer’s remorse, you wonder, “I thought my rep said they charged 9 cents per line.  Is it just me – or is someone’s math really off?”

No, you’re not crazy. Or alone.  From CIO’s to Records Managers to small-town docs, confusion abounds over just exactly how clinical documentation services assess charges.  It’s why at iData, our customers find exactly what they expected in their invoices.

They’ve got plenty of others things to worry about.

Unfortunately not everyone’s so lucky.  For the time being, there exists no industry wide standardization for how clinical documentation companies charge customers.  It’s true that most of us embrace charging by the line count, but turns out – all lines are not counted equally.  A quote from one company for 9 cents per line can actually cost more than 13 cents per line from another firm – depending on how the lines are counted.   Now that’s come crazy math.
But what constitutes a line?  To clear up the confusion, we’ll offer a brief explanation:

In the early 1990s, the American Association for Medical Transcription (AAMT) defined a line as 65 characters, including spaces and carriage returns.  But – the original AAMT definition did not specify how to treat formatting, so subjectivity (and creativity) led to widespread variation.

Which led to confusion.  Still does.

The actual definition of the AAMT line is as follows:  Any letter, number, symbol or function key necessary for the final appearance and content of a document.

So for example, any additional formatting could be counted as additional characters.  Meaning, if a five – character word is underlined, there would be five additional characters counted those actually underlined – plus, two characters for turning the underlining on and off.  (We heard your gasp!)

You can see why that process didn’t add up, spurring AAMT to drop their endorsement in 1988.  However, there are still numerous organizations and vendors that use this hidden character method today.

Sneaky, that’s what we call it.

So just like all clinical documentation companies don’t offer the same caliber of service, neither can you compare their pricing like apples to apples.  Here’s a brief review of the two most common forms of pricing across our industry:

ASCII Line

The, American Standard Code for Information Interchange (ASCII) Printed Character Line is tabulated by counting all ASCII characters and dividing the total by 65.  (Say that ten times in a row!)  Formatting codes are not included in this count, but spaces and carriage returns are.

The advantage?  Line counts are easily verifiable in any word processing program, because neither ASCII, nor word processing programs count hidden or formatting codes. So, generally the ASCII price per line typically turns out to be higher than AAMT because fewer lines are counted in the report.

Visual Black Character Method

The Visual Black Character (VBC) approach counts the total number of visible characters (letters, numbers, punctuation, etc.) in the document.  This is solely due to the fact that spaces are not “visible” with this approach so there is just a total VBC count for the document.

Formatting codes, such as bolding or underlining, and command codes, such as spell checking, are not included in the character count, nor are carriage returns or spaces.  Again, this counting method is verifiable via almost any word processing program.

The bottom line? All line counts are not the same.  So you have to ask your provider to explain their methodology of choice.  And verify it.

So, you may ask – what pricing strategy does iData use?  We’d be happy to tell you.  Even happier to show you.  Just invite us to come by for a demonstration!

iData uses the Visual Black Character Method (VBC) in pricing reports.  We’re convinced it is the most user-friendly and transparent approach.  Eliminating the confusion over the question of line counts involved in the medical transcription process, we deliver on our promise of transparency.

It’s just the beginning. Wait until you hear what else we’ve got to offer.  (Hint:  Very. Best. Service.)

We hope we cleared up a few things for you; and we’d be happy to analyze your current system to make an accurate comparison to iData.  Email us at sales@100MedicalTranscription.com with your contact information, or call 410-295-0201 and we’ll be glad to dazzle you with how easy we make things for you.

After all, you’ve got bigger fish to fry.  And his name is Dr.…….