VIII. Outsourcing is Expensive or Watson is not cheaper

Remember how the Rocky & Bullwinkle had alternate titles for each episode?

When a hospital outsources their medical transcription, considering ALL of the costs, not just to the hospital, but to the community, such as reduced income (and loss of multiplier effect) for local businesses, fewer jobs for local residents, more uninsured, etc., outsourcing is more expensive than the hospital having the transcription done by local transcribers.

Sending the dictation to large medical transcription services in Dallas, Oklahoma City, Florida and New Jersey adds an unnecessary  “middleman.”  Those services use computer generated/voice recognition transcription, which requires incredibly expensive hardware and software AS WELL AS editing by a human because of inadvertent and unforeseeable mistakes in the transcript.  These editors are paid half of what they used to earn doing traditional transcription).

Large services do not pay their transcriptionists on an hourly basis but instead pay for productivity (per line of reports generated).  As a result, the medical transcriptionists develop their own systems of shortcuts,  such as “shell” reports for each doctor, specialty, report type, etc., as well as using word/phrase expansion/”Autotext”  software (with lists of terms called glossaries) to reduce repetitive keyboarding.   These shortcuts increase the transcriptionists’ income, as they produce more lines per hour and this efficiency allows large services to charge less per line than the hospital has to pay for transcription done manually.

With improvements in this productivity software, the best of which is InstantText7 (see below), transcriptionists now can have a virtually unlimited number of abbreviations in glossaries (hundreds of thousands and even millions).   A hospital that has the foresight to develop and share glossaries with new transcriptionists eliminates the time required to individually create it, resulting in a synergy of productivity among transcriptionists, more productivity/income as well as happier workers. has worked for numerous large nationwide medical transcription services and used these types of shortcuts while doing transcription.   For its keyboard abbreviations Zen uses the FABULOUS and POWERFUL state-of-the-art word expander/AutoText software program InstantText7.  Zen currently has 618,000 abbreviations, on a Pentium 4 computer with only 1.5 Meg RAM, which only require 2-3 minutes to load and adds/revises entries instantaneously.
There are only two demands to using such a system.
1.   Remembering the abbreviations – Memorizing them is not necessary, as Zen has developed and posted in the Appendix to its website an easy-to-use formula and details on creating entries.   It is very flexible, allows the transcriptionist to customize it and provides horizontal choices shown at the bottom of the screen to prevent potential duplicates or differences.
2.  Time required to revise entries.   When a transcriptionist has hundreds and thousands of occurrences of common words (in phrases, headings, etc.), it is time consuming to revise each of them.  However, it helps to learn new/revised entries by using them immediately, rather than keeping a list of intended changes, to edit when one has time and then wondering whether which changes have already been instituted.
Zen has developed macros to revise HUNDRED AND THOUSANDS OF entries instantaneously and and offers this inexpensive and time-saving service to hospitals and transcriptionists.

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