I. Definitions

A.     Zen

Looking at the bigger picture. Seeing the forest and not focusing on the trees.  In other words – producing prompt, reasonably priced reports, with the work performed by local transcriptionists.  Working directly for the hospital eliminates sending jobs overseas and  benefits the local economy and community.  Outsourcing minimizes the human component of the process and is more expensive by adding unnecessary middleman profit.

B.     MLS – Medical Language Specialist.

Initially called MTs (medical transcriptionists) by the American Association for Medical Transcription (which is now called the AHDI – Association for Health Documentation Integrity because they are not an organization for American transcribers but are involved in international outsourcing of American transcription).   Neither the AAMT or AHDI are accredited by the American Medical Association or other medical or educational credentialing body.  Since MT represented “medical technologist” many years before the AAMT, medical transcriptionists are better called MLS.    Their competency is best determined by giving a sample report or two to type to determine terminology knowledge and the ability to do transcription.

C.     MTSO – Medical Transcription Service Organization.

Large interstate and even multinational medical transcription services, usually run by corporate executives who have never done medical transcription and are not inherently interested in the working conditions of the MLS or the improvement or cost containment of medical care.  Usually MBAs, they only look at how much profit they can generate. MTSOs often require a hospital send out all of the dictation, preventing local MLS from working directly for local hospitals.  In the process of outsourcing, MTSOs frequently send the dictation overseas to be done in developing countries, transforming former U.S. medical transcriptionists into editors to correct the poor quality, awkward phrases and extensive blanks by non-U.S. transcribers.  MTSOs also try to automate the process (eliminating MLS jobs) by using VERY expensive computer hardware and software to do the transcription with “voice recognition”.  This reduces the remaining MLS to work for approximately half their previous wages, making them “editors” to correct the computer generated text.

D.     QA – Quality Assurance.

Hospitals and doctors insist on at least a 98% standard of accuracy in transcriptions.  To assure this, periodic audits are done by QA staff, who are also used to review transcription done by computer or by reports by foreign MLS, often with bad English and/or grammar.  This position is not essential, as a good MLS quickly can produce a virtually perfect report (when facilitated by keyboarding productivity software and easily accessible online references).  QAs (whose job depends on finding “errors”) are used mostly by MTSOs.

E.     Word expander/computer shorthand

MLS use computer “shorthand” programs or built-in word processing functions similar to Autocompletion (or in the case of Microsoft Word “Autocorrect” or “Autotext”).  These allow the MLS to type only a few characters of a medical or English word or phrase and have the complete word or phrase be suggested and/or instantly inserted.  Virtually any medical and/or English word or phrase that can be automatically inserted with a word expander.  The benefit is elimination of musculoskeletal stress on fingers, wrists, neck, back, etc., by not having to manually type out repetitive words or phrases like “hyperlipidemia” or “straight leg raising”.  Even though it pays off in the long run, it is difficult for MLS to take the time to create and input such a system.

F.     Glossary

The dictionary defines “glossary” as a list of terms, such as in the back of a book or article, defining or explaining words and expressions used.  However, to a MLS glossaries are the data files used by the word expander, usually ASCI text files, consisting of the “short form” (the abbreviation) followed by the “long form” (the complete word or phrase).

G.     InstantText7 (IT7)

InstantText7 is the best word expander/computer shorthand program on the market and is used by Zen Transcription.   Of all the word expansion programs available, Zen finds InstantText7 far superior.  Unlike other program, IT7 does not require typing out every character of an abbreviation to insert that word or phrase into a document.  After typing only a few characters, IT7 can suggest “ballpark” abbreviations and/or completions at the bottom of the screen and then insert that selection by typing that line’s number.

This efficiency means an abbreviation of “tpttpwawtttrr” (the patient tolerated the procedure well and was taken to the recovery room – 83 characters) could be suggested by only typing  “tppwttrr” – 8 characters, or even “tpwtr” – 5 characters, if there is no other abbreviation with that name.

H.     “Smart” transcription

Traditionally medical transcription has been a labor intensive process, because reports were individually typed from scratch.  Hospital accreditation bodies and medical records organizations believed they were protecting patient care by demanding every report be “original” (not a template document).  However, medical transcription has very repetitive headings, words and even phrases, which can be inserted automatically .  MLS using “Smart” transcription methods can generate medical reports more efficiently than MTSOs who outsource to a foreign country or use computer voice recognition.  “Smart” transcription also eliminates an additional MLS to do  review and editing of documents.

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