Archive for June 24, 2009

Medical Transcription

Medical transcription, also known as MT, is an allied health profession, which deals in the process of transcription, or converting voice-recorded reports as dictated by physicians and/or other healthcare professionals into text format.

Traditional medical transcription is a form of document creation that the medical industry considers outdated, but necessary as a means of providing the necessary documentation needed to satisfy regulatory and insurance provider requirements. The practice of modern medicine dictates that the physicians spend more time serving patient needs than creating documents in order to make financial ends meet. More modern methods of document creation are being implemented through the technology of computers and the internet. Voice Recognition (VR) is one of these new-age technologies. With the power to write up to 200 words per minute with 99% accuracy Voice Recognition has freed physicians from the shackles of traditional transcription services.

Medical transcription is still the primary mechanism for a physician to clearly communicate with other healthcare providers who access the patient record; to advise them on the state of the patient’s health and past/current treatment; to assure continuity of care. More recently, following Federal and State Disability Act changes, a written report (IME) became a requirement for documentation of a medical bill or an application for Workers’ Compensation (or continuation thereof) insurance benefits based on requirements of Federal and State agencies.

The medical transcription industry will continue to undergo metamorphosis based on many contributing factors like advancement in technology, practice workflow, regulations etc. The evolution toward the electronic patient record demonstrates that, over time, documentation habits will change either through standards and regulations or through personal preferences. Until recently, there were few standards and regulations that MTs and their employers had to meet. First, we had the Health Insurance Portability and Accountability Act (HIPAA). It wasn’t long ago “experts” stated that HIPAA would not have any effect on the medical transcription industry. Either in a state of denial or ignorance of the law, many transcriptionists and companies have continued on their existing course of providing medical transcription. Many providers are concerned that the majority of the transcription industry will not be able to meet several specific requirements: namely, access controls, policies and procedures, and audits of access to the patient information. Without the knowledge or resources to comply, many in the industry are claiming to comply and signing their Business Associates Agreements without taking the security measures required. Many are uninformed, and some are choosing to remain so, believing that the world of transcription cannot possibly be expected to make these adaptations. The fact is that the employers will demand HIPAA compliance and will change employees and contractors when they don’t get it. There will also be demands to enhance patient safety, increase efficiency, and reduce costs. It is mandatory for service providers and healthcare practices to migrate to a HIPAA compliant environment.

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MTIAPI and MTIA Forged Medical Transcription Accord

The Medical Transcription Industry Association of the Philippines, Inc. (MTIAPI) has forged an agreement with the US-based Medical Transcription Industry Association (MTIA) to protect the interest of the industry.

MTIAPI president Myla Rose Mundo-Reyes, who attended the Building a Viable and Sustainable Relationship with Offshore MT Service Organizations by the Medical Transcription Industry Association (MTIA) conference held recently in Long Beach, California reported.

“I was actually glad that the participants’ concerns on quality, data privacy, public holidays and government support in policy making were openly raised because I was given the opportunity to inform them that the Philippines is addressing exactly the same issues that really matter to our clients,” Reyes said.

Reyes reported that MTIAPI and MTIA agreed to forge a partnership to protect the interests of the industry and its players. Some of the highlighted areas of cooperation were policy enforcement on data privacy protection, intellectual property rights protection of their MT curricula, certification of MT workers and training facility accreditation, a company verification process, and some business matching activities for MTIA’s US Medical Transcription Service

Organizations (MTSO) members looking for offshore partners.

Colin Christie, CEO of MXSecure and MTIAPI director who joined the meeting viewed the meeting as a great step towards future cooperation.

“The well-attended panel discussion has torn down barriers to the Philippines’ emergence as the outsourcing and offshoring destination of choice and presented the country as having viable solutions for US MT companies looking for a virtual extension office so as to expand their businesses.

Reyes, who is also the managing director of Total Transcription Solutions, Inc., explained that the panel discussion corrected some of the participants’ negative perceptions about offshoring and informed them of where to go, who to talk to, and what to consider if they want to explore outsourcing to other countries.

“I was actually glad that the participants’ concerns on quality, data privacy, public holidays and government support in policy making were openly raised because I was given the opportunity to inform them that the Philippines is addressing exactly the same issues that really matter to our clients,” she added.

Another MTIAPI delegate and marketing manager of IQ West, Sammy Pe, said that as a result of the panel discussion, he was able to get a number of leads at the convention.

MTIAPI director and Transkripsyo chief executive officer Michael Chua said, “It was a very good mission. I believe the delegation presented the Philippine value proposition very well. We are looking forward to having more US companies taking a second look at the Philippines for their outsourced transcription needs.”

Reyes added, “The challenge now is for our local stakeholders—the private sector and the government—to ensure that the right components are in place when the investors begin pouring in.”(BCM)

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Medical Transcription as Proven Accelerator of EHR Adoption

AHDI and MTIA bring their message to Capitol Hill.

The transcription sector took a solution-focused message to Capitol Hill June 3-4 in response to President Obama’s provisions and mandate for EHR adoption under the recent HITECH Act. With this administration’s push to have both a definition and criteria for “meaningful use” determined by July of this year, the Medical Transcription Industry Association (MTIA) and the Association for Healthcare Documentation Integrity (AHDI) believe there is a critically narrow window of opportunity for this sector to ensure that such criteria includes provisions for the evolving role of transcription in hybrid capture, where complex narrative is preserved and quality outcomes, not just fiscal savings, drive adoption and integration. The HIT vendor community is positioning itself around key decision-makers in the Department of Health and Human Services (HHS), in whose hands the determination of “meaningful use” now resides. Inarguably, the primary interest of those vendors is in securing widespread EHR adoption through HITECH provisions, and our message to legislators was that HHS needs others at the decision-making table whose interest is geared more toward how these technologies will be deployed and not whether they will be deployed.

Defining “meaningful use” is not the role of HIT but rather of clinicians and experts in health care documentation who can speak to the document workflow process and the complexities of capturing health stories in a way that informs clinical decision-making and promotes coordination of care. If the “meaningful use” definition is shaped only by the vendor community, there is great risk for EHR deployment to fall short of health care’s goals for capturing and consuming health information. All stakeholders, most importantly the patient, lose under such an imprudent integration approach.

More than 120 legislative appointments were held during the 2-day summit through collaborative dialogue from both MTIA business owners and AHDI health care documentation workers who met together with Senate and House members to share the importance of our quality-focused sector in accurately capturing patient health stories. We visited with legislators from 26 states and delivered letters from AHDI members to their respective legislators for 28 states. Each person had an opportunity to share the key talking points and messages prepared for the event, as well as to engage in dialogue with legislators and their aides about the role transcription can and does play in accurate capture. Likewise, we stressed the need to preserve complex narrative in the EHR so that the important nuances of a patient’s story are captured outside of restrictive point-and-click templates. Consideration must be given, as well, to the impact on clinicians who are inefficiently deployed to capture health care encounters rather than engaging in provision of care. And we talked about the value of a knowledge worker positioned in partnership with physicians to ensure the accurate, secure capture and repurposing of health information.

MTIA and AHDI will be engaging the services of a lobbying firm to push this message to the right people on the HELP committee (Health, Education, Labor and Pensions) as well as those in HHS who will ultimately be responsible for the “meaningful use” definition. In addition, through our lobbying firm, we will continue to drive this message and our recommendations to David Blumenthal, the National Coordinator for Health IT, so that the role of transcription is not left out of EHR integration standards, recommendations and regulations. Both medical transcription service organizations (MTSOs) and MTs will have an opportunity to contribute to and participate in this advocacy effort.

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Medical Transcription and EMR

Professional medical transcription companies provide excellent EMR solutions.

With the introduction of the EMR system, medical transcription has become more reliable, cost-effective and systematic. The EMR solution effectively manages records such as death summaries, radiology images, photographs, histories, clinic notes, consultation reports, referrals, laboratory summaries, medical billing, verifications, authorizations, medical coding and patient scheduling. One of the major advantages of EMR is that it permits clients to add, delete and edit records and other medical notes.

Ensures High Accuracy Rates in Transcription

EMR is a typical database system that helps medical practices to make digital formats ensuring high accuracy rates in the transcription process. Professional medical transcription service providers offer excellent EMR solutions, giving maximum automation and security for SOAP notes and other medical data. The latest features of EMR solution include:

-Management of SOAP notes
-Document scanning
-Customized data management
-Medical billing software
-Specialist support for medical billing
-Diagnosis code directory
-HL7 custom interfaces

The Advantages of EMR System in Medical Transcription

An EMR system provides physicians and medical professionals with uncomplicated interface and legible documentation. It helps to convert medical documents into PDF with electronic signature so that the files can be easily sent over the internet. The EMR system runs on a UNIX server that ensures the unique security features of UNIX. You are not required to buy any expensive hardware or software; all you require is a computer with internet connection. The advantages of the EMR system include:

-Reduces storage costs
-On-site and off-site storage facilities
-Reduces human resources
-Lessens transcription errors
-Affordable and systematic
-Speeds workflow
-Various types of data can be stored
-Specific EMR solutions for various specialties

The application of EMR system in medical transcription services ensures high accuracy rates together with a perfect management system to meet specific requirements of the clients.

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Transcription Technology Watch

This is the first in a series of quarterly articles that will focus on technologies relevant to medical transcription. Hopefully, maybe even those MTs who are techno-phobic will find some of the topics enlightening, stimulating and/or of value in making career decisions. But maybe not. To challenge that hope, I’ve started off with everyone’s favorite technology: speech recognition. If you want to really stimulate a transcriptionist, just say “speech recognition.” Or, better yet, assert that “speech recognition will forever change the process of converting physicians’ thoughts and utterances into text.” Then run for cover.

Every transcriptionist out there has heard some form of that assertion. Their reactions range from dismissal to fear to anger. So what’s the truth? What does the future hold? Well, at some point in the future, there will be no medical transcription. Physicians will dictate into a PC or portable device; their speech will be converted to text; and the dictator will make any necessary corrections to finalize the report. No transcription expense. No transcription delay. But that future is at least 3 years off. Just kidding. It’s way more than that. However, there is a future closer than that, related to speech recognition, which has some major implications for this industry.

Doctors hate doing anything that they believe is below their stature or slows down their ability to generate revenue. So we will not see “front-end” recognition-where they correct their own mistakes as described above-in most environments for many years. But there’s a new game in town. It’s called “back-end” speech recognition. Physicians don’t change a thing in their dictation behavior. They continue babbling into telephones or some other dictation device just like they always have. But their voice files are now run through a server-based recognition engine, a draft is produced, and a medical editor corrects the errors both in recognition and dictation.

This technology is truly beginning to get some traction. Physicians love innovation, but they hate change. So this suits them just fine. In fact, they typically don’t even know it’s going on. The goal of back-end speech recognition is to at least double the productivity of transcriptionists. And to do it for about a penny a line. Most implementations are not quite there yet. Speech recognition talk has always been ahead of speech recognition technology. Nonetheless the handwriting is on the wall. This technology will begin to transform transcription in the coming years. So it seems wise for MTs to learn more about it and perhaps even to embrace it.if they like what they learn.

Currently, it is prohibitively expensive for an independent transcriptionist or small transcription company to purchase a recognition server. However, there are a number of ASPs popping up, which charge by the line to produce a draft. I could tell you a lot more groovy stuff about this rather exciting technology, but I’m just about out of my allotted space. So tune in next quarter for the second Watch article, which will explain more about how it works and what it means for medical transcriptionists. Unless, of course, I feel like writing about something else.

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