Sunday, October 19, 2008

Related Occupations

Related Occupations
Workers in other occupations also type, record information, and process paperwork. Among these are court reporters; human resources assistants, except payroll and timekeeping; receptionists and information clerks; and secretaries and administrative assistants. Other workers who provide medical support include medical assistants and medical records and health information technicians.

Projections Data

Projections Data

Projections data from the National Employment Matrix
Occupational title
SOC Code
Employment, 2006
Projected employment,2016
Change, 2006-16
Detailed statistics

Number
Percent

Medical transcriptionists
31-9094
98,000
112,000
13,000
14
PDF
zipped XLS

NOTE: Data in this table are rounded. See the discussion of the employment projections table in the Handbook introductory chapter on Occupational Information Included in the Handbook.


Earnings
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Wage-and-salary medical transcriptionists had median hourly earnings of $14.40 in May 2006. The middle 50 percent earned between $12.17 and $17.06. The lowest 10 percent earned less than $10.22, and the highest 10 percent earned more than $20.15. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists were:
Medical and diagnostic laboratories
$15.68
General medical and surgical hospitals
14.62
Business support services
14.34
Outpatient care centers
14.31
Offices of physicians
14.00
Compensation methods for medical transcriptionists vary. Some are paid based on the number of hours they work or on the number of lines they transcribe. Others receive a base pay per hour with incentives for extra production. Employees of transcription services and independent contractors almost always receive production-based pay. Independent contractors earn more than do transcriptionists who work for others, but independent contractors have higher expenses than their corporate counterparts, receive no benefits, and may face higher risk of termination than do wage-and-salary transcriptionists.
For the latest wage information:
The above wage data are from the Occupational Employment Statistics (OES) survey program, unless otherwise noted. For the latest National, State, and local earnings data, visit the following pages:
· Medical transcriptionists

Job Outlook

Job Outlook
Growing numbers of medical transcriptionists will be needed to amend patients’ records, edit documents from speech recognition systems, and identify discrepancies in medical reports.
Contracting out transcription work overseas and advancements in speech recognition technology are not expected to significantly reduce the need for well-trained medical transcriptionists. Outsourcing transcription work abroad—to countries such as India, Pakistan, Philippines, and the Caribbean—has grown more popular as transmitting confidential health information over the Internet has become more secure; however, the demand for overseas transcription services is expected only to supplement the demand for well-trained domestic medical transcriptionists. In addition, reports transcribed by overseas medical transcription services usually require editing for accuracy by domestic medical transcriptionists before they meet U.S. quality standards. for those who are certified.
Employment change. Employment of medical transcriptionists is projected to grow 14 percent from 2006 to 2016, faster than the average for all occupations. Demand for medical transcription services will be spurred by a growing and aging population. Older age groups receive proportionately greater numbers of medical tests, treatments, and procedures that require documentation. A high level of demand for transcription services also will be sustained by the continued need for electronic documentation that can be shared easily among providers, third-party payers, regulators, consumers, and health inf
Speech-recognition technology allows physicians and other health professionals to dictate medical reports to a computer that immediately creates an electronic document. In spite of the advances in this technology, the software has been slow to grasp and analyze the human voice and the English language, and the medical vernacular with all its diversity. As a result, there will continue to be a need for skilled medical transcriptionists to identify and appropriately edit the inevitable errors created by speech recognition systems, and to create a final document.
Job prospects. Job opportunities will be good, especially for those who are certified. Hospitals will continue to employ a large percentage of medical transcriptionists, but job growth there will not be as fast as in other industries. An increasing demand for standardized records should result in rapid employment growth in physicians’ offices, especially in large group practicesEmployment of medical transcriptionists is projected to grow faster than the average; job opportunities should be good, especially.

Employment

Employment
Medical transcriptionists held about 98,000 jobs in 20006. About 41 percent worked in hospitals and another 29 percent worked in offices of physicians. Others worked for business support services; medical and diagnostic laboratories; outpatient care centers; and offices of physical, occupational, and speech therapists, and audiologists.

Training, Other Qualifications, and Advancement

Training, Other Qualifications, and Advancement
Postsecondary training in medical transcription is preferred by employers; writing and computer skills also are important.
Education and training. Employers prefer to hire transcriptionists who have completed postsecondary training in medical transcription offered by many vocational schools, community colleges, and distance-learning programs.
Completion of a 2-year associate degree or 1-year certificate program—including coursework in anatomy, medical terminology, legal issues relating to health care documentation, and English grammar and punctuation—is highly recommended, but not always required. Many of these programs include supervised on-the-job experience. Some transcriptionists, especially those already familiar with medical terminology from previous experience as a nurse or medical secretary, become proficient through refresher courses and training.
Formal accreditation is not required for medical transcription programs. However, the Approval Committee for Certificate Programs (AACP)—established by the Association for Healthcare Documentation Integrity (AHDI) and the American Health Information Management Association—offers voluntary accreditation for medical transcription programs. Although voluntary, completion of an ACCP approved program may be required for transcriptionists seeking certification.
Certification and other qualifications. The AHDI awards two voluntary designations, the Registered Medical Transcriptionist (RMT) and the Certified Medical Transcriptionist (CMT). Medical transcriptionists who are recent graduates of medical transcription educational programs, or have fewer than 2 years experience in acute care, may become a registered RMT. The RMT credential is awarded upon successfully passing the AHDI level 1 registered medical transcription exam. The CMT designation requires at least 2 years of acute care experience working in multiple specialty surgery areas using different format, report, and dictation types. Candidates also must earn a passing score on a certification examination. Because medicine is constantly evolving, medical transcriptionists are encouraged to update their skills regularly. RMTs and CMTs must earn continuing education credits every 3 years to be recertified. As in many other fields, certification is recognized as a sign of competence.
Graduates of an ACCP approved program who earn the RMT credential are eligible to participate in the Registered Apprenticeship Program sponsored by the Medical Transcription Industry Association through the U.S. Department of Labor. The Registered Apprenticeship program offers structured on-the-job learning and related technical instruction for qualified medical transcriptionists entering the profession.
In addition to understanding medical terminology, transcriptionists must have good English grammar and punctuation skills and proficiency with personal computers and word processing software. Normal hearing acuity and good listening skills also are necessary. Employers usually require applicants to take pre-employment tests.Advancement. With experience, medical transcriptionists can advance to supervisory positions, home-based work, editing, consulting, or teaching. Some become owners of medical transcription businesses. With additional education or training, some become medical records and health information technicians, medical coders, or medical records and health information administrators.

Related Occupations

Related Occupations
Workers in other occupations also type, record information, and process paperwork. Among these are court reporters; human resources assistants, except payroll and timekeeping; receptionists and information clerks; and secretaries and administrative assistants. Other workers who provide medical support include medical assistants and medical records and health information technicians

Metropolitan area profile for this occupation

Metropolitan area profile for this occupation
Metropolitan areas with the highest published employment concentrations and wages for this occupation are provided. For a list of all Metropolitan areas with employment in this occupation, see the Create Customized Tables function.
Metropolitan areas with the highest concentration of workers in this occupation:
MSA
Employment
Hourly mean wage
Annual mean wage
Percent of MSA employment
Michigan City-La Porte, IN
150
$13.26
$27,580
0.338%
Eau Claire, WI
220
$15.84
$32,940
0.283%
Grand Forks, ND-MN
130
$15.28
$31,780
0.261%
Cedar Rapids, IA
340
$13.09
$27,240
0.254%
Rapid City, SD
140
$14.23
$29,590
0.238%
Top paying Metropolitan areas for this occupation:
MSA
Employment
Hourly mean wage
Annual mean wage
Percent of MSA employment
Framingham, MA NECTA Division
(8)
$24.25
$50,440
(8)
Salinas, CA
80
$23.05
$47,950
0.051%
San Jose-Sunnyvale-Santa Clara, CA
360
$21.82
$45,380
0.040%
Reno-Sparks, NV
70
$21.18
$44,060
0.031%
Oakland-Fremont-Hayward, CA Metropolitan Division
250
$20.76
$43,180
0.024%

About May 2007 National, State, Metropolitan, and Nonmetropolitan Area Occupational Employment and Wage Estimates
These estimates are calculated with data collected from employers in all industry sectors in metropolitan and nonmetropolitan areas in every State and the District of Columbia. The top five employment and wage figures are provided above. The complete list is available in the downloadable Excel files (XLS).
Percentile wage estimates show the percentage of workers in an occupation that earn less than a given wage and the percentage that earn more. The median wage is the 50th percentile wage estimate—50 percent of workers earn less than the median and 50 percent of workers earn more than the median. More about percentile wages.

(1) Estimates for detailed occupations do not sum to the totals because the totals include occupations not shown separately. Estimates do not include self-employed workers.
(2) Annual wages have been calculated by multiplying the hourly mean wage by a "year-round, full-time" hours figure of 2,080 hours; for those occupations where there is not an hourly mean wage published, the annual wage has been directly calculated from the reported survey data.
(3) The relative standard error (RSE) is a measure of the reliability of a survey statistic. The smaller the relative standard error, the more precise the estimate.
(8) Estimate not released.
Other OES estimates and related information:
May 2007 National Occupational Employment and Wage Estimates
May 2007 State Occupational Employment and Wage Estimates
May 2007 Metropolitan and Nonmetropolitan Area Occupational Employment and Wage Estimates
May 2007 National Industry-Specific Occupational Employment and Wage Estimates
List of Occupations in SOC Code Number Order
List of Occupations in Alphabetical Order
Download May 2007 Occupational Employment and Wage Estimates in Zipped Excel files
Technical notes
Last Modified Date: April 3, 2008

State profile for this occupation

State profile for this occupation
States with the highest published employment concentrations and wages for this occupation are provided. For a list of all States with employment in this occupation, see the Create Customized Tables function.
States with the highest concentration of workers in this occupation:
State
Employment
Hourly mean wage
Annual mean wage
Percent of State employment
South Dakota
700
$13.28
$27,620
0.180%
North Dakota
570
$13.11
$27,260
0.167%
Wisconsin
4,020
$15.39
$32,020
0.145%
Iowa
2,140
$13.76
$28,620
0.144%
Minnesota
3,410
$16.76
$34,870
0.127%
Top paying States for this occupation:
State
Employment
Hourly mean wage
Annual mean wage
Percent of State employment
California
6,440
$19.15
$39,840
0.042%
Alaska
140
$19.11
$39,750
0.046%
Massachusetts
1,790
$18.94
$39,400
0.056%
New Jersey
2,050
$18.03
$37,510
0.052%
Washington
1,850
$17.86
$37,140
0.066%

Industry profile for this occupation

Industry profile for this occupation
Industries with the highest published employment and wages for this occupation are provided. For a list of all industries with employment in this occupation, see the Create Customized Tables function.
Industries with the highest levels of employment in this occupation:
Industry
Employment
Hourly mean wage
Annual mean wage
General Medical and Surgical Hospitals
37,270
$15.69
$32,630
Offices of Physicians
27,110
$15.02
$31,250
Business Support Services
9,940
$15.39
$32,010
Medical and Diagnostic Laboratories
2,250
$17.61
$36,640
Outpatient Care Centers
2,250
$15.42
$32,080
Top paying industries for this occupation:
Industry
Employment
Hourly mean wage
Annual mean wage
Agencies, Brokerages, and Other Insurance Related Activities
50
$18.38
$38,230
Medical and Diagnostic Laboratories
2,250
$17.61
$36,640
Management, Scientific, and Technical Consulting Services
280
$17.59
$36,600
Local Government (OES designation)
(8)
$17.57
$36,550
Office Administrative Services
340
$16.82
$34,980

National estimates for this occupation

National estimates for this occupation
Employment estimate and mean wage estimates for this occupation:
Employment (1)
EmploymentRSE (3)
Mean hourlywage
Mean annualwage (2)
Wage RSE (3)
86,990
1.4 %
$15.44
$32,120
0.4 %
Percentile wage estimates for this occupation:
Percentile
10%
25%
50%(Median)
75%
90%
Hourly Wage
$10.65
$12.73
$15.02
$17.95
$21.19
Annual Wage (2)
$22,160
$26,470
$31,250
$37,330
$44,070

cupational Employment and Wages, May 200731-9094 Medical Transcriptionists

cupational Employment and Wages, May 200731-9094 Medical Transcriptionists
Use transcribing machines with headset and foot pedal to listen to recordings by physicians and other healthcare professionals dictating a variety of medical reports, such as emergency room visits, diagnostic imaging studies, operations, chart reviews, and final summaries. Transcribe dictated reports and translate medical jargon and abbreviations into their expanded forms. Edit as necessary and return reports in either printed or electronic form to the dictator for review and signature, or correction.National estimates for this occupationIndustry profile for this occupationState profile for this occupationMetropolitan area profile for this occupation

Earnings

Earnings
Wage-and-salary medical transcriptionists had median hourly earnings of $14.40 in May 2006. The middle 50 percent earned between $12.17 and $17.06. The lowest 10 percent earned less than $10.22, and the highest 10 percent earned more than $20.15. Median hourly earnings in the industries employing the largest numbers of medical transcriptionists were:
Medical and diagnostic laboratories
$15.68
General medical and surgical hospitals
14.62
Business support services
14.34
Outpatient care centers
14.31
Offices of physicians
14.00Compensation methods for medical transcriptionists vary. Some are paid based on the number of hours they work or on the number of lines they transcribe. Others receive a base pay per hour with incentives for extra production. Employees of transcription services and independent contractors almost always receive production-based pay. Independent contractors earn more than do transcriptionists who work for others, but independent contractors have higher expenses than their corporate counterparts, receive no benefits, and may face higher risk of termination than do wage-and-salary transcriptionists.

Projections Data


Projections Data
[About this section]
Back to Top

Projections data from the National Employment Matrix
Occupational title
SOC Code
Employment, 2006
Projected employment,2016
Change, 2006-16
Detailed statistics

Number
Percent

Medical transcriptionists
31-9094
98,000
112,000
13,000
14
PDF
zipped XLS

NOTE: Data in this table are rounded. See the discussion of the employment projections table in the Handbook introductory chapter on Occupational Information Included in the Handbook.
Job prospects.

Job opportunities will be good, especially for those who are certified. Hospitals will continue to employ a large percentage of medical transcriptionists, but job growth there will not be as fast as in other industries. An increasing demand for standardized records should result in rapid employment growth in physicians’ offices, especially in large group practices.

Job Outlook

Job Outlook

Employment of medical transcriptionists is projected to grow faster than the average; job opportunities should be good, especially for those who are certified.
Employment change. Employment of medical transcriptionists is projected to grow 14 percent from 2006 to 2016, faster than the average for all occupations. Demand for medical transcription services will be spurred by a growing and aging population. Older age groups receive proportionately greater numbers of medical tests, treatments, and procedures that require documentation. A high level of demand for transcription services also will be sustained by the continued need for electronic documentation that can be shared easily among providers, third-party payers, regulators, consumers, and health information systems. Growing numbers of medical transcriptionists will be needed to amend patients’ records, edit documents from speech recognition systems, and identify discrepancies in medical reports.
Contracting out transcription work overseas and advancements in speech recognition technology are not expected to significantly reduce the need for well-trained medical transcriptionists. Outsourcing transcription work abroad—to countries such as India, Pakistan, Philippines, and the Caribbean—has grown more popular as transmitting confidential health information over the Internet has become more secure; however, the demand for overseas transcription services is expected only to supplement the demand for well-trained domestic medical transcriptionists. In addition, reports transcribed by overseas medical transcription services usually require editing for accuracy by domestic medical transcriptionists before they meet U.S. quality standards.Speech-recognition technology allows physicians and other health professionals to dictate medical reports to a computer that immediately creates an electronic document. In spite of the advances in this technology, the software has been slow to grasp and analyze the human voice and the English language, and the medical vernacular with all its diversity. As a result, there will continue to be a need for skilled medical transcriptionists to identify and appropriately edit the inevitable errors created by speech recognition systems, and to create a final document.

Employment

Employment

Medical transcriptionists held about 98,000 jobs in 20006. About 41 percent worked in hospitals and another 29 percent worked in offices of physicians. Others worked for business support services; medical and diagnostic laboratories; outpatient care centers; and offices of physical, occupational, and speech therapists, and audiologists.
Advancement.

With experience, medical transcriptionists can advance to supervisory positions, home-based work, editing, consulting, or teaching. Some become owners of medical transcription businesses. With additional education or training, some become medical records and health information technicians, medical coders, or medical records and health information administrators.

CERTIFICATION AND OTHER QUALIFICATION

Certification and other qualifications.

The AHDI awards two voluntary designations, the Registered Medical Transcriptionist (RMT) and the Certified Medical Transcriptionist (CMT). Medical transcriptionists who are recent graduates of medical transcription educational programs, or have fewer than 2 years experience in acute care, may become a registered RMT. The RMT credential is awarded upon successfully passing the AHDI level 1 registered medical transcription exam. The CMT designation requires at least 2 years of acute care experience working in multiple specialty surgery areas using different format, report, and dictation types. Candidates also must earn a passing score on a certification examination. Because medicine is constantly evolving, medical transcriptionists are encouraged to update their skills regularly. RMTs and CMTs must earn continuing education credits every 3 years to be recertified. As in many other fields, certification is recognized as a sign of competence.
Graduates of an ACCP approved program who earn the RMT credential are eligible to participate in the Registered Apprenticeship Program sponsored by the Medical Transcription Industry Association through the U.S. Department of Labor. The Registered Apprenticeship program offers structured on-the-job learning and related technical instruction for qualified medical transcriptionists entering the profession.In addition to understanding medical terminology, transcriptionists must have good English grammar and punctuation skills and proficiency with personal computers and word processing software. Normal hearing acuity and good listening skills also are necessary. Employers usually require applicants to take pre-employment tests

EDUCATION AND TRAINING

Education and training. Employers prefer to hire transcriptionists who have completed postsecondary training in medical transcription offered by many vocational schools, community colleges, and distance-learning programs.
Completion of a 2-year associate degree or 1-year certificate program—including coursework in anatomy, medical terminology, legal issues relating to health care documentation, and English grammar and punctuation—is highly recommended, but not always required. Many of these programs include supervised on-the-job experience. Some transcriptionists, especially those already familiar with medical terminology from previous experience as a nurse or medical secretary, become proficient through refresher courses and training.Formal accreditation is not required for medical transcription programs. However, the Approval Committee for Certificate Programs (AACP)—established by the Association for Healthcare Documentation Integrity (AHDI) and the American Health Information Management Association—offers voluntary accreditation for medical transcription programs. Although voluntary, completion of an ACCP approved program may be required for transcriptionists seeking certification.

Training, Other Qualifications, and Advancement

Postsecondary training in medical transcription is preferred by employers; writing and computer skills also are important

Work environment

Work environment.
The majority of these workers are employed in comfortable settings, such as hospitals, physicians’ offices, transcription service offices, clinics, laboratories, medical libraries, government medical facilities, or their own homes. Many medical transcriptionists telecommute from home-based offices.
Workers usually sit in the same position for long periods. They can suffer wrist, back, neck, or eye problems due to strain and risk repetitive motion injuries such as carpal tunnel syndrome. The constant pressure to be accurate and productive also can be stressful.
Many medical transcriptionists work a standard 40-hour week. Self-employed medical transcriptionists are more likely to work irregular hours—including part time, evenings, weekends, or on call at any time.

Nature of the Work

Nature of the Work

Medical transcriptionists listen to dictated recordings made by physicians and other health care professionals and transcribe them into medical reports, correspondence, and other administrative material. They generally listen to recordings on a headset, using a foot pedal to pause the recording when necessary, and key the text into a personal computer or word processor, editing as necessary for grammar and clarity. The documents they produce include discharge summaries, medical history and physical examination reports, operative reports, consultation reports, autopsy reports, diagnostic imaging studies, progress notes, and referral letters. Medical transcriptionists return transcribed documents to the physicians or other health care professionals who dictated them for review and signature or correction. These documents eventually become part of patients’ permanent files.
To understand and accurately transcribe dictated reports, medical transcriptionists must understand medical terminology, anatomy and physiology, diagnostic procedures, pharmacology, and treatment assessments. They also must be able to translate medical jargon and abbreviations into their expanded forms. To help identify terms appropriately, transcriptionists refer to standard medical reference materials—both printed and electronic; some of these are available over the Internet. Medical transcriptionists must comply with specific standards that apply to the style of medical records and to the legal and ethical requirements for keeping patient information confidential.
Experienced transcriptionists spot mistakes or inconsistencies in a medical report and check to correct the information. Their ability to understand and correctly transcribe patient assessments and treatments reduces the chance of patients receiving ineffective or even harmful treatments and ensures high-quality patient care.
Currently, most health care providers transmit dictation to medical transcriptionists using either digital or analog dictating equipment. The Internet has grown to be a popular mode for transmitting documentation. Many transcriptionists receive dictation over the Internet and are able to quickly return transcribed documents to clients for approval. Another increasingly popular method uses speech recognition technology, which electronically translates sound into text and creates drafts of reports. Transcriptionists then format the reports; edit them for mistakes in translation, punctuation, or grammar; and check for consistency and any wording that doesn’t make sense medically. Transcriptionists working in specialties, such as radiology or pathology, with standardized terminology are more likely to use speech recognition technology. However, speech recognition technology will become more widespread in all specialties as the technology becomes more sophisticated, that is, better able to recognize and more accurately transcribe diverse modes of speech. Medical transcriptionists who work in physicians’ offices may have other office duties, such as receiving patients, scheduling appointments, answering the telephone, and handling incoming and outgoing mail. Medical secretaries, discussed in the statement on secretaries and administrative assistants

The future of medical transcription

The future of medical transcriptionThe 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. ''This article is an allied medical field. For other uses, see [[Transcription]] and [[MT]] disambiguation pages''

The future of medical transcription

The future of medical transcriptionThe 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. ''This article is an allied medical field. For other uses, see [[Transcription]] and [[MT]] disambiguation pages''

Outsourcing of medical transcripton

Outsourcing of medical transcription
Due to the increasing demand to document medical records, other countries started to outsource the services of the medical transcriptionist. In the United States, the medical transcription business is estimated to be worth US $10 to $25 billion annually and growing 15 percent each year[citation needed]. The main reason for outsourcing is stated to be the cost advantage due to cheap labor in developing countries, and their currency rates as compared to the U.S. dollar.
It is a volatile controversy on whether work should be outsourced, mainly due to three reasons:
The greater majority of MTs presently work from home offices rather than actually IN Hospitals, working off-site for "National" Transcription services. It is predominantly those Nationals located in the United States who are striving to outsource work to other-than-US-based transcriptionists. In outsourcing work to sometimes lesser-qualified and lower-paid non-US MTs, the Nationals unfortunately can force US transcriptionists to accept lower rates, at risk of losing business altogether to the cheaper outsourcing providers. In addition to the low line rates forced on US transcriptionists, US MTs are often paid as ICs (Independent Contractors); thus, the Nationals save on employee insurance and benefits offered, etc. Unfortunately for the state of healthcare administrative costs in the United States, in outsourcing, the Nationals still charge the hospitals the same rate as they did in the past for highly qualified US transcriptionists, but subcontract the work to non-US MTs, keeping the difference as profit.
There are concerns about patient privacy, with confidential reports going from the country where the patient is located (the US) to a country where the laws about privacy and patient confidentiality may not even exist. Some of the countries that now outsource transcription work are the United States, Britain, and Australia, with work outsourced to Philippines, India, Pakistan, and Canada.
The lack of quality in the finished document is concerning. Many outsourced Transcriptionists simply do not have the requisite basic education to do the job with reasonable accuracy, much less additional, occupation-specific training in Medical Transcription. Many foreign MTs who can speak English are unfamiliar with American expressions and/or the slang doctors often use, are apparently unfamiliar with medical reference books, and are unfamiliar with American names and places. An MT Editor, certainly, is then responsible for all work transcribed from these countries and under these conditions. These outsourced transcriptionists often work for a fraction of what transcriptionists are paid in the United States, even with the US MTs daily accepting lower and lower rates.
The Philippines has recently attracted increased amounts of MT outsourcing from the United States. Due to high literacy in the English language (spoken as a second language and also used in business, education, and government), the Philippines is trying to position itself to become a world leader in this field. Historic connections with the US ensure that the average Filipino is perhaps capable of understanding idioms and slang used in Colloquialism, making them one of the few peoples outside the US to possibly be able to transcribe accurately. This is very concerning to the US MTs. HIPAA (Health Insurance Portability and Accountability Act) governs outsourcing of MT work. Stricter policies in compliance with [HIPAA] are implemented in such companies to enable security and confidentiality of work involved in such practices.AHDI (Association for Healthcare Documentation Integrity) is one of the world’s largest association for medical transcription. AHDI's mission is to lead the evolution of medical transcription, represent and advance the profession and its practitioners. AHDI has a summary of rules in medical transcription that guide companies in facilitating seamless and workable transcription processes.

The medical transcription process

The medical transcription process
transcriptionist accidentally typed a wrong medication or the wrong diagnosis, the patient could be at risk if the doctor (or his designee) did not review the document for accuracy. Both the Doctor and the medical transcriptionist play an important role to make sure the transcribed dictation is correct and accurate. The Doctor should speak slowly and concisely, especially when dictating medications or details of diseases and conditions, and the medical transcriptionist must possess hearing acuity, medical knowledge, and good reading comprehension in addition to checking references when in doubt.However, some doctors do not review their transcribed reports for accuracy, and the computer attaches an electronic signature with the disclaimer that a report is "dictated but not read". This electronic signature is readily acceptable in a legal sense. The Transcriptionist is bound to transcribe verbatim (exactly what is said) and make no changes, but has the option to flag any report inconsistencies. On some occasions, the doctors do not speak clearly, or voice files are garbled. Some doctors are, unfortunately, time-challenged and need to dictate their reports quickly (as in ER Reports). In addition, there are many regional or national accents and (mis)pronunciations of words the MT must contend with. It is imperative and a large part of the job of the Transcriptionist to look up the correct spelling of complex medical terms, medications, obvious dosage or dictation errors, and when in doubt should "flag" a report. A "flag" on a report requires the dictator (or his designee) to fill in a blank on a finished report, which has been returned to him, before it is considered complete. Transcriptionists are never, ever permitted to guess, or 'just put in anything' in a report transcription. Furthermore, medicine is constantly changing. New equipment, new medical devices, and new medications come on the market on a daily basis, and the Medical Transcriptionist needs to be creative and to tenaciously research (quickly) to find these new words. An MT needs to have access to, or keep on hand, an up-to-date library to quickly facilitate the insertion of a correctly spelled device, procedure, or medication dictated

Duties and responsibilities

Duties and responsibilities
Accurately transcribes the patient-identifying information such as name and Medical Record or Social Security Number.
Transcribes accurately, utilizing correct punctuation, grammar and spelling, and edits for inconsistencies.
Maintains/consults references for medical procedures and terminology.
Keeps a transcription log.
Foreign MTs may sort, copy, prepare, assemble, and file records and charts (though in the United States (US) the filing of charts and records are most often assigned to Medical Records Techs in Hospitals or Secretaries in Doctor offices).
Distributes transcribed reports and collects dictation tapes.
Follows up on physicians' missing and/or late dictation, returns printed or electronic report in a timely fashion (in US Hospital, MT Supervisor performs).
Performs quality assurance check.
May maintain disk and disk backup system (in US Hospital, MT Supervisor performs).
May order supplies and report equipment operational problems (In US, this task is most often done by Unit Secretaries, Office Secretaries, or Tech Support personnel). May collect, tabulate, and generate reports on statistical data, as appropriate (in US, generally performed by MT Supervisor

Duties and responsibilities

Duties and responsibilities
Accurately transcribes the patient-identifying information such as name and Medical Record or Social Security Number.
Transcribes accurately, utilizing correct punctuation, grammar and spelling, and edits for inconsistencies.
Maintains/consults references for medical procedures and terminology.
Keeps a transcription log.
Foreign MTs may sort, copy, prepare, assemble, and file records and charts (though in the United States (US) the filing of charts and records are most often assigned to Medical Records Techs in Hospitals or Secretaries in Doctor offices).
Distributes transcribed reports and collects dictation tapes.
Follows up on physicians' missing and/or late dictation, returns printed or electronic report in a timely fashion (in US Hospital, MT Supervisor performs).
Performs quality assurance check.
May maintain disk and disk backup system (in US Hospital, MT Supervisor performs).
May order supplies and report equipment operational problems (In US, this task is most often done by Unit Secretaries, Office Secretaries, or Tech Support personnel). May collect, tabulate, and generate reports on statistical data, as appropriate (in US, generally performed by MT Supervisor

Duties and responsibilities

Duties and responsibilities
Accurately transcribes the patient-identifying information such as name and Medical Record or Social Security Number.
Transcribes accurately, utilizing correct punctuation, grammar and spelling, and edits for inconsistencies.
Maintains/consults references for medical procedures and terminology.
Keeps a transcription log.
Foreign MTs may sort, copy, prepare, assemble, and file records and charts (though in the United States (US) the filing of charts and records are most often assigned to Medical Records Techs in Hospitals or Secretaries in Doctor offices).
Distributes transcribed reports and collects dictation tapes.
Follows up on physicians' missing and/or late dictation, returns printed or electronic report in a timely fashion (in US Hospital, MT Supervisor performs).
Performs quality assurance check.
May maintain disk and disk backup system (in US Hospital, MT Supervisor performs).
May order supplies and report equipment operational problems (In US, this task is most often done by Unit Secretaries, Office Secretaries, or Tech Support personnel). May collect, tabulate, and generate reports on statistical data, as appropriate (in US, generally performed by MT Supervisor

Curricular requirements, skills and abilities

Curricular requirements, skills and abilities
Curricular requirements, skills and abilities
High school diploma or GED, plus range of 1 to 3 years' experience that is directly related to the duties and responsibilities specified, and dependent on the employer (working directly for a physician or in hospital facility).
Knowledge of medical terminology is helpful.
Average to above-average spelling, verbal communication and memory skills.
Ability to sort, check, count, and verify numbers with accuracy.
Skill in the use and operation of basic office equipment/computer; eye/hand/foot coordination.
Ability to follow verbal and written instructions.
Records maintenance skills or ability. Good to above-average typing skills.
As a profession


A medical transcriptionist working in a medical transcription outsourced environment.
An individual who performs medical transcription is known as a medical transcriptionist or an MT, or (less frequently) a medical transcriber. A medical transcriptionist is the person responsible for converting the patient's medical records into typewritten format rather than handwritten, the latter more prone to misinterpretation by other healthcare providers. The term transcriber also describes the electronic equipment used in performing medical transcription, e.g., a cassette player with foot controls operated by the MT for report playback and transcription. In the late 1990s, medical transcriptionists were also given the title of Medical Language Specialist or Health Information Management (HIM) paraprofessional.
There are no "formal" educational requirements to be a medical transcriptionist. Education and training can be obtained through traditional schooling, certificate or diploma programs, distance learning, and/or on-the-job training offered in some hospitals, although there are foreign countries currently employing transcriptionists that require 18 months to 2 years of specialized MT training. Working in medical transcription leads to a mastery in medical terminology and editing, MT ability to listen and type simultaneously, utilization of playback controls on the transcriber (machine), and use of foot pedal to play and adjust dictations - all while maintaining a steady rhythm of execution.
While medical transcription does not mandate registration or certification, individual MTs may seek out registration/certification for personal or professional reasons. Obtaining a certificate from a medical transcription training program does not entitle an MT to use the title of Certified Medical Transcriptionist (CMT). The CMT credential is earned by passing a certification examination conducted solely by the Association for Healthcare Documentation Integrity (AHDI), formerly the American Association for Medical Transcription (AAMT), as the credentialing designation they created. AHDI also offers the credential of Registered Medical Transcriptionist (RMT). According to AHDI, the RMT is an entry-level credential while the CMT is an advanced level. AHDI maintains a list of approved medical transcription schools [1].
There is a great degree of internal debate about which training program best prepares a MT for industry work[2]. Yet, whether one has learned medical transcription from an online course, community college, high school night course, or on-the-job training in a doctor's office or hospital, a knowledgeable MT is highly valued.In lieu of these AHDI certification credentials, MTs who can consistently and accurately transcribe multiple document work-types and return reports within a reasonable turnaround-time (TAT) are sought after. TATs set by the service provider or agreed to by the transcriptionist should be reasonable but consistent with the need to return the document to the patient's record in a timely manner.
As of March 7, 2006, the MT occupation became an eligible U.S. Department of Labor Apprenticeship, a 2-year program focusing on acute care facility (hospital) work. In May 2004, a pilot program for Vermont residents was initiated, with 737 applicants for only 20 classroom pilot-program openings. The objective was to train the applicants as MTs in a shorter time period. (See Vermont HITECH for pilot program established by the Federal Government Health and Human Services Commission).

overview

Overview
Pertinent, up-to-date, confidential patient information is converted to a written text document by a medical transcriptionist. This written text may be printed (and hand placed in the patient's record, archived, and/or retained only as an electronic medical record). Medical transcription can be performed in a hospital, via remote transmission to the hospital, or directly to the actual providers of service (doctors or their group practices) in off-site locations. Hospital facilities often prefer electronic storage of medical records due to the sheer volume of hospital patients and the accompanying paperwork. The electronic storage in their database gives immediate access to subsequent departments or providers regarding the patient's care to date, notation of previous or present medications, notification of allergies, and establishes a history on the patient to facilitate healthcare delivery regardless of geographical distance or location.
The term transcript or "report" as it is more commonly called, is used as the name of the document (electronic or physical hard copy) which results from the medical transcription process, normally in reference to the healthcare professional's specific encounter with a patient on a specific date of service. This report is referred to by many as a "medical record". Each specific transcribed record or report, with its own specific date of service, is then merged and becomes part of the larger patient record commonly known as the patient's medical history.
Medical transcription encompasses the MT, performing document typing and formatting functions according to an established criteria or format, transcribing the spoken word of the patient's care information into a written, easily readable form. MT requires correct spelling of all terms and words, (occasionally) correcting medical terminology or dictation errors. MTs also edit the transcribed documents, print or return the completed documents in a timely fashion. All transcription reports must comply with medico-legal concerns, policies and procedures, and laws under patient confidentiality.
In transcribing directly for a doctor or a group of physicians, there are specific formats and report types used, dependent on that doctor's speciality of practice, although history and physical exams or consults are mainly utilized. In most of the off-hospital sites, independent medical practices perform consultations as a second opinion, pre-surgical exams, and as IMEs (Independent Medical Examinations) for liability insurance or disability claims. Private practice family doctors rarely utilize a medical transcriptionist, preferring to keep their patient's records in a handwritten format.
Currently, a growing number of medical providers send their dictation by digital voice files, utilizing a method of transcription called speech or voice recognition. Speech recognition is still a nascent technology that loses much in translation. For dictators to utilize the software, they must first train the program to recognize their spoken words. Dictation is read into the database and the program continuously "learns" the spoken words and phrases.
Poor speech habits complicate the process for both the MT and the recognition software. An MT can "flag" such a report as unintelligible, but the recognition software will transcribe the unintelligible word(s) from the existing database of "learned" language. The result is often a "word salad" or missing text. Thresholds can be set to reject a bad report and return it for standard dictation, but these settings are arbitrary. Below a set percentage rate, the word salad passes for actual dictation. The MT simultaneously listens, reads and "edits" the correct version. Every word must be confirmed in this process. The downside of the technology is when the time spent in this process cancels out the benefits. The quality of recognition can range from excellent to poor, with whole words and sentences missing from the report. Not infrequently, negative contractions and the word "not" is dropped all together. Voice recognition is similar to the voice prompts one hears on dialing "411", when information provides the wrong number and charges for the "411" call. These flaws trigger concerns that the present technology could have adverse effects on patient care. Control over quality can also be reduced when providers choose a server-based program from a vendor Application Service Provider (ASP).
Downward adjustments in MT pay rates for voice recognition are controversial. Understandably, a client will seek optimum savings to offset any net costs. Yet vendors that overstate the gains in productivity do harm to MTs paid by the line. Despite the new editing skills required of MTs, significant reductions in compensation for voice recognition have been reported. Reputable industry sources put the field average for increased productivity in the range of 30%-50%; yet this is still dependent on several other factors involved in the methodology. Metrics supplied by vendors that can be "used" in compensation decisions should be scientifically supported.
Another unresolved issue is high-maintenance headers that replace simple interfaces to become the "platform" of choice. Pay rates should reflect this lost-opportunity cost for the MT.
Operationally, speech recognition technology (SRT) is an interdependent, collaborative effort. It is a mistake to treat it as compatible with the same organizational paradigm as standard dictation, a largely "standalone" system. The new software supplants an MT's former ability to realize immediate time-savings from programming tools such as macros and other word/format expanders. Requests for client/vendor format corrections delay those savings. If remote MTs cancel each other out with disparate style choices, they and the recognition engine may be trapped in a seesaw battle over control. Voice recognition managers should take care to ensure that the impositions on MT autonomy are not so onerous as to outweigh its benefits.
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.

History

History

The evolution of the transcription dates back to the 1960s. The method was designed to assist in the manufacturing process. The first transcription that was developed in this process was MRP, which is the acronym for Manufacturing Resource Planning, in 1975. This was followed by another advanced version namely MRP2. But none of them yielded the benefit of medical transcription.
However, transcription equipment has changed from manual typewriters to electric typewriters to word processors to computers and from plastic disks and magnetic belts to cassettes and endless loops and digital recordings. Today, voice recognition system (VRS) is increasingly being used, with medical transcriptionists and or "correctionists" providing supplemental editorial services, although there are occasional instances where VRS fully replaces the MT. Natural-language processing takes "automatic" transcription a step further, providing an interpretive function that speech recognition alone does not provide (although MTs do).
In the past, these reportings consisted of very abbreviated handwritten notes that were added in the patient's file for interpretation by the primary physician responsible for the treatment. Ultimately, this mess of handwritten notes and typed reports was consolidated into a single patient file and physically stored along with thousands of other patient records in a wall of filing cabinets in the medical records department. Whenever the need arose to review the records of a specific patient, the patient's file would be retrieved from the filing cabinet and delivered to the requesting physician. To enhance this manual process, many medical record documents were produced in duplicate or triplicate by means of carbon copy.
In recent years, things have changed considerably. Filing cabinets have given way to desktop computers connected to powerful servers where patient records are processed and archived digitally. This digital format allows for immediate remote access by any physician who is authorized to review the patient information. Reports are stored electronically and printed selectively as the need arises. Today, we have very fast computers with many electronic references, and we use the Internet not only for web resources but also as our daily working platform. Technology has gotten so sophisticated that MT services and MT departments work closely with programmers and information systems (IS) staff to stream in voice and accomplish seamless data transfers through network interfaces. In fact, many healthcare providers today are enjoying the benefits of handheld PCs or personal data assistants (PDAs), and are now utilizing software on them for dictation.However, not everything has changed. The conversion of spoken medical language to text is a craft that is difficult to learn and takes time to perfect. Some individuals have a "knack" for it; some will never get it. Technology can and does assist in many ways, but transcription still comes down to people. Even with the transition of MTs to editors for VRS documents, medical-language-interpretation skills will still be imperative for a quality report. MTs welcome this transition as an editor for VRS documents.

Medical transcription

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