VII. The “Abbreviate Everything” system

A.   Medical transcription is more enjoyable with a comprehensive system

This is a subjective concept, but I feel that any abbreviations I can conceptualize and create today will make my job easier tomorrow.  So when a transcriptionist dreads loathes going to a boring job and spending hours typing the same old repetitive type reports, each abbreviation I create makes that report less tedious.  Even doing repetitive reports offers the chance to add more shortcuts, refine the abbreviation names and steadily reduce the manual nature of the keyboarding.

B.   A comprehensive system provides very high quality transcription

A comprehensive system also provides higher quality work, because the MT can go through the report initially at a very high speed by playing back large numbers of abbreviations and has time to go back and listen to a report a second time, speeding up the report and review things like punctuation, gender mistakes, improve grammar, etc.

C.     A Comprehensive Computer Shorthand System Like IT7 Allows a Transcriber to Continuously Reduce Keyboarding

Other word processors have the ability to add abbreviations but not to the extent of an virtually unlimited system like InstantText.  The most common word processor, Microsoft Word,  has a system to play back abbreviations, however, it requires every character of the abbreviation be entered and will not accept shortcuts like ‘tptpwtrr’.  In addition, their system requires that an addition be highlighted in block form and individually added.

However, a transcriptionist using a system like IT7 can create abbreviations for ANY English or medical word or phrase.  It is difficult to remember which words/phrases already have abbreviations and which do not, so a MT just uses a formula for abbreviations and assumes that they already exist.  If  the abbreviation does not play out it is added at that time.  If the term/phrase is used repeated more than once in a report, the time invested creating that abbreviation has already been recovered.  And obviously if it is a medical or English word or phrase it will never have to be manually typed again.  In addition, IT7 allows a MLS to enter large numbers of additions at a time as a group in a text file, not each one manually as with most word processors.

D.    A comprehensive abbreviation system can be easily learned and implemented.

A hospital would benefit by purchasing an already designed system that has abbreviations for most common medical/English terms and is structured to add future entries, so that transcriptionists can instantly begin using the computer shorthand and not have to spend the time manually creating and adding entries.  In addition, IT7 systems can be easily customized by the user.

E.    A comprehensive abbreviation system can easily identify and differentiate duplicate abbreviations

Zen’s comprehensive system utilizes a delimiter at the end of all abbreviations.  This allows us to create a system that may have an unlimited number of abbreviations, even ones that start as duplicates, because the delimiter at the end of the abbreviation differentiates duplicates and allows an unlimited amount of abbreviations.   We are not aware of any other word expanders that have this power other than InstantText.  This feature justifies putting everything into an abbreviation, considering the repetitive nature of medical transcription.

THE ABBREVIATE EVERYTHING SYSTEM

I once had a medical transcription supervisor who said there are two types of transcriptionists, one group who abbreviates everything and the other who say it is faster for them to just type it manually because it takes too long to remember the abbreviations.  And don’t assume that the only repeated text is medical.  I don’t have the articles at my fingers right now,  but I recall reading that 75% of the repetitive typing in medical reports is actually non-medical text.   And of the 25% of medical words and phrases, acute care transcriptionists routinely use the same terminology, almost as frequently, even though the transcribed reports encompasses a wide variety of medical specialties.

Many years ago a system called ABCAA (first 3 letters of the word or,  in the cases of phrases,  the first three letters of the first word of the phrase and then the first letter of each subsequent word).   While working for large agencies as well as hospitals, I have come up with a better method of creating and maintaining abbreviations, which which I call the Abbreviate Everything (AE) system.  It allows a medical transcriptionist to create shortcuts for EVERY DESIRED word or phrase and I don’t believe anyone has a system of more than 600,000 abbreviations which AE cannot handle.  My system allows an unlimited number of abbreviations to be input and recalled.

To implement this system, it requires the use of InstantText7, as that program will maintain a virtually unlimited number of abbreviations.    In case you are not aware of the latest version of InstantText (version 7), it REALLY is a fabulous program and is INCREDIBLY FAST AND FLEXIBLE.   If you look on the internet,  you will see incredible testimony of transcribers regarding their happiness with the program.   My system REQUIRES a transcriptionist use InstantText7.   I have used about a half-dozen auxiliary productivity programs and no other currently sold program has the power, speed, flexibility and unlimited potential of IT7.  IT7 can handle the number of abbreviations that would be required to allow everything to be abbreviated.  I currently have 602,736 entries and am always adding new ones, INCLUDING abbreviations generated from the terminology lists on the internet.  It only takes 2 minutes to load IT7 and the 602K abbreviations.

In addition,  my system does not require that a medical transcriptionist memorize all of the abbreviations; it uses a formula that allows them to be easily recalled.  Initially I thought about trying to sell a system of computer data files with prefabricated abbreviations, but I believe that most transcriptionists have their own systems and it is more efficient for them to add additional abbreviations to their pre-existing system than stop what they have used and learn an entirely new system.

I am willing to give out my formula for free because I feel that the more abbreviations transcriptionists learn to add and use, the more they will find they want to improve their current abbreviations, delete, add, change and enhance them.  There are a large number of occurrences in multi-hundred-thousand abbreviation glossaries and I can revise them much cheaper and in fewer hours than a transcriptionist using IT7.

For example, I have 37 occurrence of “caffeine” and 64 incidents of “hamstring” abbreviated the former as “cf” and the latter as “hs”.  For the average transcriptionist using IT7, changing them to “cfe” and “hsg” must be done individually and is time consuming.  However, with my system of macros I can VERY QUICKLY automatically search and replace terms.   Most transcriptionists need to spend their time generating income/lines of production (although it benefits them to implement a change in abbreviation(s) if as soon as they conceptualize it.  If they can start using the new abbreviation, there is no uncertainty and confusion about whether they have already made the revisions, etc.

The reason my system is superior to ABC is because in solely using the first letter of each word there are WAY TOO MANY identical abbreviations.  For example, ABC uses:

pris        primary surgeon

pris        prior studies

puls        pulmonary sling

puls        pulse shows

pals        palmar sensitivity

pals        palpation shows

 

AE uses the first letter of the word (which could be a prefix), then a letter representing each subsequent major syllable (or root) of that word and then maybe a final letter indicating a suffix, then repeat for the next word.  So my system would represent these phrases as:

pmsxj

pisds

pmrsg

pusw

pmssv

ppjsw

AND IT7 does not require that a transcriptionist enter each letter of each abbreviation,  as long as they enter at least two letters of the first word (an idiosyncrasy—the ONLY shortcoming of IT7–the way that IT7 maintains their abbreviations-a small shortcoming for a program that can load half-a-million entries in 2 minutes,  eh?).   After those 2 first letters, the transcriptionist can leapfrogging and use any letters in the abbreviation.  So, there may be more letters involved in creating an abbreviation with my AE system than ABC, but fewer are require to be typed to call up that abbreviation than the ABC system.

IT7 has an abbreviation generator function, but it uses an “AAA” system.  This is a good (free) start but it doesn’t differentiate the abbreviations enough and has WAY TOO MANY “aa” or “bb” or “cc” abbreviations.  This does not allow a transcriptionist to call up a subsequent word in a phrase by entering one of several significant letters of that word or phrase’s abbreviation.

One could say about AE:   “This would require too many abbreviations.”  However, my system prevents the number of abbreviations from being unwieldy by limiting the number of words in phrases to 5 to 7, does not start phrases with “the” or “and”, use no single letters (“a” or “I”) and uses a delimiter at the end (a number, 0 through 9, or the letters x, y and z), which can be used instead or in addition to a significant letter in an abbreviation to differentiate between identical abbreviations or quickly jump to a desired phrase.

The only part of AE that requires a transcriptionist’s memory is the delimiter, however, someone doing transcriptionist hours per day easily remembers them,  because they were created in a logical and sequential manner.  Those delimiters are:

X         at the end of a series of words indicates a general English phrase

Y         indicates a medical phrase

Z          indicates a “wild card” or “super phrase”.  These allow you to type an acronym or very common phrase just using the first letters of each word, as long as there is a “z” modifier at the end of the abbreviation.

Here are examples:

X         (general) –  hwlnrtx – he will not return

Y         (medical) –  swhnxy – she was HIV negative

Z          (super) –  cadz – coronary artery disease or  abgz – arterial blood gas

Here are the numerical delimiters:

0        Open for use as the transcriptionist prefers

1          Doctor’s names, specialties, addresses, headings, etc.

2          Medication

3          Numerical value

4          Proper name, local geographic names, institutions,  etc.

5          Physical examination words and phrases

6          Anatomy

7          Disease-related

8          Laboratory/diagnostic

9          Surgery

In addition, “q” represents “patient” or “the patient” and “qs” represents “patients” or “the patient’s” or “patient’s”

For single medical words, often the following will be sufficient:

First letter(s):                            prefix

Second, third, etc. letter(s)        significant letter of each syllable

Last letter(s)                             suffix

SINGLE WORDS:  For example,   cardiovascularly

First letter(s):                            cd (prefix for cardio) (remember IT7 wants each entry to be started with TWO  letters of the word or phrase–the ONLY shortcoming for a program that for me loads 600,000 abbreviations in 2 minutes and makes single entry changes instantaneously)

Second, third, etc. letter(s)        vcl (significant letter of each syllable for vascular)

Last letter(s)                             y (suffix for ly)

Just typing 3 letters (cdv)          can produce 14 letters

PHRASES:  For example,  ‘on questioning the patient’  (oqtgqy)

There is a y at the end because this phrase is medical-related

Just typing 4 letters  (oqtq or oqgq) can produce 26 letters

Someone doing transcription all day after a few hours or days quickly recalls this delimiter (a single number at the end of a word or phrase) because they are ordered in a logical sequence:  Think of going from specific or local to general, or chronological order: exam to diagnosis to procedure.

How to implement an AE system:   A transcriptionist begins typing, entering every phrase or word as an abbreviation, assuming they it exists in IT7,  at first using the most significant letters of each word (later adding the prefixes, suffixes and delimiters as they become familiar with them) while watching the advisory at the bottom of the screen and selecting a number for the preferred completion.  If the abbreviation is not present in the advisory,  the transcriptionist adds the abbreviation.

Okay, so you wonder, “Well, I don’t want to have to keep lists of my abbreviations and print, three hole punch and put tons of sheets of paper in binders and then thumb through pages and pages to find out what I am using as an abbreviation for ‘prosthesis’ for example.  That’s way more of a waste of time than typing the repetitive text of medical reports manually”.

AE has a protocol to allow a transcriptionist to look up a term WITHOUT LEAVING THE KEYBOARD.  When a new abbreviation is added (for example:  ‘psts’ for prosthesis–type 4 letters and get 10 on your screen), a second entry is added, which would be a short form starting with a letter z and then the complete word and with a long form which is solely the abbreviation.   So to add “prosthesis” a transcriptionist would enter:

SHORT FORM               LONG FORM

psts                                  prosthesis

zprosthesis                   psts

If after entering prosthesis as a new abbreviation and the typist cannot remember what they named the abbreviation,  all they have to do is type “zprosthesis” (without leaving the keyboard) and they will get an answer.   No printing of lists,  etc.

As you can imagine, the time required to convert these phrases into abbreviations is prohibitive, ESPECIALLY if an MT is so lucky as to have a lot of work and any time spent inputting new abbreviations takes away from productive money-generating transcription.  I can do this for you and the expense is an investment in productivity and increase in future earnings.

My ultimate objective of distributing this system is to allow “standard” transcriptionists (using traditional keyboarding) an unlimited abbreviation system with the ability to do transcription cheaper than voice recognition by computer.  This would allow hospitals to take their work back from services, doing their own work efficiently locally, ending outsourcing to other countries and hopefully ending computer generated transcription,  potentially creating demand for my services.

 

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