Petition Letter to Legislators
United States Senate and House of Representatives
Washington, DC 20510
Dear Senator OR Representative:
We thank you for considering the critical role the healthcare documentation sector continues to play with the adoption of the Electronic Health Record (EHR). We are constituents from a wide variety of congressional districts across the nation, members of the healthcare documentation community, represented by the Association for Healthcare Documentation Integrity (AHDI) and/or the Clinical Documentation Industry Association (CDIA) (formerly known as MTIA).
Regardless of the method used to capture healthcare information, medical transcriptionists serve as an “essential set of eyes” to ensure the quality, accuracy, and consistency of patient records. As EHRs become more common, error rates could put patients at greater risk. By employing more documentation professionals more jobs will be created while, at the same time, reducing medical errors in the healthcare record.
Our Value Proposition:
Medical transcription service organizations (MTSOs) and medical transcriptionists (MTs) are valuable resources to health care providers and the use of electronic health records (EHRs) in four key areas:
I. Efficiency: We enable dictation, which is the most efficient way for healthcare providers to document patient care.
II. Clarity: We produce narrative notes that tell a patient’s full story and enhance clinical decision making.
III. Usability: We enable meaningful use of EHRs in two key areas: interoperability and quality measures.
IV. Accuracy: We find and correct documentation errors at the genesis of the documentation process, providing 98%+ accuracy of clinical information
Benefits of Medical Transcription within the Patient-Care Cycle:
- Our services make efficient use of physician time. (We keep doctors from becoming data entry clerks.)
- We preserve face-to-face interactions between physician and patient. (Physicians can focus on the patient, not the computer screen.)
- We ensure the quality and validity of clinical data going into an EHR. (Providing clinical documentation authentication support.)
- We promote information sharing among caregivers in a secure environment. (Every day we route readable patient notes among physicians and hospitals.)
We petition your continued support in these urgent times by communicating with the Centers for Medicare and Medicaid Services and the Office of the National Coordinator for Health IT, seeking acknowledgment in regulations that the dictation-transcription process and structured narrative reports are recognized as vital elements of electronic health records (EHR), are included in the definition of “meaningful use”, and recognized as essential for ensuring patient safety.
If you or your staff has any questions or need additional information, please contact Andrew Wolf, AHDI staff liaison to the Legislative Issues Group at 800-982-2182 ext. 2452 or by email: awolf@ahdionline.org. Your consideration, time, and support are appreciated by us all.
Sincerely,
Please lend your support to this matter. It is greatly appreciated
I agree 100% ~
It is imperative that we have your support in this endeavor to aid patient safety.
[...] Take a look at Jay’s latest post on AHDI Lounge. He draws attention to ADHI West’s online petition to consider transcription as a valued part of Meaningful [...]
I Agree!!
I worked for a long time at a large hospital, and in the past year lost my job to global outsourcing. I was kept on at the hospital as an editor, and can attest to the importance of accurately dictated and transcribed reports. Not only is it a required part of the medical record, but coders (responsible for the money) use the reports to code charts. The transcriptionist is vital to the patient record process, and frankly, the record process cannot do without them, even by those seeking to trim the bottom line (like outsourcing to India)
I have seen too many errors with voice recognition software for medications, etc. There is no replacing the human mind that can profread and transcribe with great quality. Errors will create lawsuits which in the end will make healthcare costs increase as physicians have to pay more and more for malpractice insurance or even lawsuit settlements.
Please continue to lend your support. We appreciate what you are doing for the health care industry.
Now is the time to focus on patient safety through the EHR. We ask your support in this AHDI/MTIA endeavor.
Please support this – it is very very important that this be addressed sooner rather than later.
I would sign the petition if it included a paragraph about not off-shoring work. I don’t see anything there regarding that. We need to keep the jobs in America.
I feel that now more than ever is the time to focus on patient safety through the EHR. The transcriptionist is vital to the patient record process, and frankly, the record process cannot do without them, even by those seeking to trim the bottom line (like outsourcing to India). Please support in this AHDI/MTIA endeavor.
We appreciate your comment, Janet. The petition letter specifically addresses the need to have the narrative report (dictation/transcription) included in the next stage of the meaningful use definition for the electronic health record (EHR) certification. Without this specification, the act of transcription as we know it will continue to decline. Off-shoring is a separate concern. We encourage you to view the impact AHDI has made regarding this issue and join that discussion on the AHDI Lounge. http://ahdilounge.blogspot.com/2010/11/president-obama-offshoring-fears.html
I agree with Valarie Rogers and Janet, outsourcing medical transcription costs jobs in this country and is detrimental to accuracy. This comes from my personal experience in dictating mental health notes that were being outsourced to a company in India, and the finished product was unbelievable. I would support AHDI if they promoted healthcare documentation integrity through MTs here at home. Outsourcing is the MT, it is just an MT in another country, and I agree the MT is vital to EHR and patient safety. So I believe off-shoring is vital to this petition.
The accuracy of documents produced at the county hospital I transcribe for is only 86 percent, and the doctors are required to correct their own dictation. The tax payers are paying for this hospital, and the doctors are correcting dictation rather than seeing patients.
From a financial perspective, all patients to the ER who are admitted and on Medicare or subsidized healthcare (ACCESS) are paid from our taxes directly from our paychecks. I understand the cost of doing business, but not when my paycheck is supporting a facility to employ off-shore(non-tax paying)individuals doing the very work we all have educated ourselves, RMT/CMT, etc. to do. Is there a requirement for the educational background for off-shore workers? If not, it is time to bring the work back to America where the educated can and do a much better job. We need legislation to protect the medical record in its entirety including transcription based outsourcing. Transcribed reports are part of any legal actions, accuracy is prudent.
Medical transcription and medical editing are vital to the care of the patient. I believe that the people trained to do this position should be doing the job. The mentality has become that ANYBODY can step in and do this. Physicians are not trained as to what is correct and accurate. Spelling, grammar is not their expertise. I want my doctor focusing on me, my needs, not his computer. Physicians are trained to diagnosis and treat patients, not do transcription or editing. Do they even know what to edit? The voice recognition basically “puts words in their mouth” and neglects to put in what they do say. I have been doing this for 10+ years now and I say we are going backwards. We are losing the ground we have gained to become professional. The goal is to save time and money. Instant gratification loses its meaning and its true goal. It takes twice as long to edit as it did to type. Let the people who know what they are doing do their job.
Sharon and Lisa, we appreciate your comments. As posted previously off-shoring is a separate concern. This particular petition letter is focusing on the concern that dictation/transcription has been completely left out of the current meaningful use definition as this nation begins to certify electronic health records, regardless if that is done within our borders or off-shore. Without this specification, EHR vendors will not be required to include that “feature” in their systems. There will be another stage of definitions and we are focused on being included at that time. We also recognize the impact speech recognition technology has had on our profession. The value we bring to the healthcare delivery system and patient safety is multifaceted and paramount. We are starting with this petition letter so the decision makers in our country recognize this and we appreciate your support in signing this letter. This is our first effort of this kind. We cannot legally change a petition letter’s content once it has been signed. We have already received hundreds of signatures. We need THOUSANDS of signatures, so help us to promote this effort far and wide. In regards to off-shoring, comments are being captured in the AHDI Lounge. We encourage you, or anyone else, to be part of that discussion by posting your comments and concerns at http://ahdilounge.blogspot.com/2010/11/president-obama-offshoring-fears.html
Please provide more explanation on how transcription supports meaningful use for EHR’s in the areas of interoperability and quality. Thank you.
I agree 100%, medical transcription is detrimental to patient care.
I have been an MT for almost 20 years now and I know that the doctors really appreciate having a “human being” transcribe their dictation.
I would prefer that medical reports dictated in the United States be transcribed by an MT in the United States rather than be sent to an offshore transcription service.
I totally agree with everyone on the outsourcing of transcription. I also have seen what the outsourcing has done to some of the hospitals in my area. We have one hospital that has made all of their doctors use the computer system instead of having any transcriptionists in the facility. I cannot blame doctors for being upset. First they became paper pushers and now they have to use the computer on top of being a doctor and taking care of patients. After 23 years of working in this field, I never thought I would see such a mess.
Sandy L, thanks for the interesting question about meaningful use, interoperability and quality. AHDI and MTIA and their members support EHR adoption under meaningful use criteria by
(1) Promoting uniformly structured and coded document formats for healthcare practice based on HL7 Clinical Documentation Architecture, allowing sharing of rich narratives among facilities for purposes of patient care and reimbursement.
(2) Developing with business partners a digital platform (Medical Data Exchange) to facilitate secure transfer of healthcare information among EHR systems.
(3) Promoting the preservation of the healthcare narrative within the EHR, a form of data entry proven to increase quality and accuracy of health information for increased patient safety and coordination of care.
(4) Studying, evaluating and promoting, as appropriate, technologies (such as natural language processing) that will enable the use of structured data without sacrificing the richness of the patient-care narrative, thus enhancing quality and supporting meaningful use criteria for structured data content.
Your professional organizations are fully supportive of a high-quality, exchangeable EHR that will enhance our nation’s health care system. The petition letter created by AHDI-West is an important initiative in that effort!
I agreed!
I feel this is a very important matter, but the subject of offshore transcription should be addressed and that is not mentioned at all. I would be very interested in coming to Washington to participate if the matter of offshore transcription is included. Sending transcritpion overseas compromises patient confidentiality and I cannot see how that is HIPAA compliant.
Please support this vital instrument for ensuring patient safety.
MTs are a necessary part of the total health care package.
Thank you for your consideration in this matter.
I agree 100% , we need medical Transcriptionist , as this is a way for our economy to provide jobs for people, this is how we are ing to build back up our economy which is such a huge mess, if there are no jobs for these people then there goes the rise of unemployment which eventually we will run out of funds, and then what will we do.
Hello,
I am a firm believer in personalized patient care. Technology is great but it doesn’t mean that its always efficient. What will happen if the system ever malfunctions??? I am for transcriptionists, keeping jobs “in house” with real people instead of a “EHR” Electronic system that could possibly generate errors on a daily basis. If society was focused more on keeping jobs instead of cutting corners for lower cost,the world of healthcare would be a lot better. Please consider and recognize those who have worked so very hard to provide excellent patient care.
Sincerely,
Kristina Paige
I agree that technology has its place in healthcare, however when it comes to patient care, safety is of foremost importance. Transcriptionists have the trained knowledge and skill to apply that safety factor along with technology.
Please strongly consider supporting this necessary effort.
Please support this necessary instrument for ensuring patient safety. MTs are a vital part of the total health care package.
Thank you for your consideration in this matter.
Agree.
Please support this necessary effort
Could not express it any better than those previously.
Agree!
Agree with all preceding comments. Please support this.
Please support this.
I agree with above comments.
There is no way I will sign or support what AHDI is trying to pull. They started all this offshoring years ago when they decided to open up schools in India and teach transcription in that country. That was “Our” voice as MT’s and they sold us down the river for the almighty dollar. If transcripition was excluded from this current legislation, maybe it is because it is being done in other countries and has fallen off the radar as a viable skill in the U.S. I can’t support anything AHDI does anymore and I was one of the founding members who grandfathered in when it first started.
I agree with the posters here about the need for outsourcing to be mentioned and a part of this petition; not separate. I say either amend it or rewrite it and then ask for signatures. EHR vendors are a step ahead already and they are in the offices of physicians training the offices on its use and undermining our jobs. I have seen this in several offices I go to well for well over 1-2 years. All info is entered at POS (point of service)hence, they feel not need for transcription. The forms are modified per each office and their needs for documentation. So, there is more to it than outsourcing, but that also has a huge impact on our defunct profession, which has been in question for years now and we are just seeing a huge impact these days. Its hard to justify a “job” as a profession when unqualified transcriptionists have perpetuated the market along with that niche being the one offices (doctors) seem most likely to trim from their budget as they feel its an uncessary position to have to pay for. The government is also offering courses in community colleges for EHR with a subsidy to pay back about 1/2 to those that pass and offering placement with EHR. On face, this is tantalizing, however, once they are installed and operating by 2014 per government mandate, then what happens to those jobs? Another field we get elminated from when offices are all compliant? So many questions, too few answers and unfortunately, no one really in transcription’s corner. While we sit and watch how many being put out of not a job, but a career and we are boxed into a corner now having spent so many years at home in front of our computers. Now, try going out to an office to get a job. They says, what have you done lately? As no one considers working at home a job, much less office experience. If we only had a crystal ball years ago, we might have chosen another profession or one that is translatable later. We have just been forced out of getting our “own” accounts as unable to compete with the big companies in price/delivery technicalities and are reduced to applying to the big companies who pay slave wages, treat us substandard and condescending policies; forgetting how important our job really is to the patient’s bottom line. Its a shame having watched this evolution over the past 20+ years.
I too believe that medical transcription of patient information is a very important part of health-care documentation. Medical transcriptionists should be considered as part of the health-care-documentation team and not a disposable commodity. Medical transcriptionists are educated in many of the same aspects as other allied healthcare professionals; however, medical transcriptionists have been only considered to be typists by many and these assumptions are getting much worse causing experienced, trained medical transcriptionists to leave the profession out of financial necessity.
I have been an MT for over 20 years…Sometimes I don’t know what a dictator is saying so I don’t understand how a machine could…I don’t feel MTS have EVER been given the respect and credit we deserve, especially in acute care. Doctors have specialties but we have to know EVERYTHING…From head to toe, not to mention meds, dosages, pathology, radiology, labs and their correct values, account specifics for various hospitals, not to mention giving special attention to some doctors who just want it their way. We have to be consistent in everything so why not make a standard throught the US as to how an H and P will look…I know technology is a thing of the future but it doesn’t belong in such critical documentation as that of a patient’s medical record. There are so many people out of work now and technology is only making that worse except for those at the top who benefit from it. One company I worked for would not allow me to have a wireless PC, so how does that work when work is off-shored and where is the HIPAA compliance there? I know this is very long and it could be longer. I take pride in the work I do, catching dictators’ error, sentence structure to make sense, etc. Voice recognition, in my opinion, has no place in recording crucial information for a patient’s medical record. You don’t see voice recognition in court rooms, why in hospitals. My employer is going to VR very soon and I am dreading it. At what MTSOs pay, there is no time to produce a “perfect” report. Grammar goes right out the window as we are told…”Don’t over-edit.” Not my style…sorry, especially for minimal wage.
There is one common thread through all of these posts and that is a resonating concern for our jobs as this future unfolds. This is precisely why it is so incredibly important to support this letter. AHDI did not invent or initiate offshoring. Business people saw a need and a fit and opened their doors. We have the option of taking 3rd shift positions while the demand for faster TATs increase, but few want those and that’s when India works.
We can’t change what has taken place out of supply and demand, so let’s focus on what we can impact. We can get credentialed, not for AHDI, but for ourselves as a professional workforce to identify and register our expertise that will set us apart from fly-by-nights.
We can’t stop technology like speech recognition – and again, AHDI didn’t invent or initiate that. Let’s put our energies where we can still have a voice – and that’s in this letter bringing recognition to the value that we as an integral part of the healthcare delivery team – because healthcare is far and away better off with us than without us. We are the #1 physician efficiency option! United we stand, folks! (and you know the rest of that verse)
I truly hear and sympathize with the frustration many have voiced here over transcription jobs being outsourced overseas. It does hurt, just as communities of 1500 citizens are hurt when 200+ jobs at a call center are outsourced. I think we can all realize, too, that it’s not just our jobs. Called a credit card company lately? In many instances, you can pretty much tell if the person trying to answer your questions is in your city or state or not. Seriously, what can we do about it? Cancel the credit card? Some parts for computer systems are produced in foreign countries with the resulting American manufacturing facilities shut down and hurting those previously employed there. Should we throw out our computers? I figure that transcription service companies are at the bottom of the food chain when it comes to who is almost last in line to get money in healthcare delivery, and everyone higher up is being pressured to reduce costs. That is why jobs are outsourced: someone figured out a way to produce more for less.
I believe in picking my battles. I cannot make any headway on the outsourcing debate. I think we can and should continue to make the case for backend speech recognition documents with an MT editor for the sake of quality. I think we have an opportunity to make a difference as we campaign for the narrative to stay in healthcare documentation. Here is the hard line: If there is no preservation of the narrative (aka dictation) that can be inserted into the documentation, it won’t matter who is available to do it or where they live: there will be NO dictation to transcribe or to edit. Thanks to Dewey Square Group, AHDI and CDIA have been able to connect with the people who are crafting the definition of meaningful use of the EHR and have helped us understand and participate in the process for creating that definition. On the first release of the definition, we were told that transcription wasn’t purposefully omitted; we were just never intentionally included. AHDI through lobbying efforts such as this petition aims to try to keep the dictated narrative intentionally included and thus the MT skill set included as part of the medical record. Without the patient’s “story” being part of the documentation, much is lost of the whys and hows of the patient history and treatment decisions. That is the purpose of this letter. Of course off-shoring has had a huge impact on our sector, but I’d like to suggest that we concentrate our efforts where we have a chance of succeeding and making a difference.
Barb Marques, CMT, AHDI-F, AHDI President
Please add my name to the list. As an American transcriptionist that takes patient safety, continuity of care, and the cost of healthcare very seriously, I would appreciate our representatives taking the time to restore and magnify our importance in the healthcare industry by recognizing our value and putting an end to the outsourcing to offshore workers. This is a travesty. Not only are we losing American jobs, but our pay does not and cannot under these circumstances reflect the value that we as transcriptionists are to the patient, the physicians, and the entire healthcare industry.
I agree with the clear intent of the proposed letter. However, I should mention I worked with a firm who lost a court action based on shaving medical transcriptionist wages; in that case, the employer settled by arbitration, an agreement among lawyers and judges to not make the falsified wages good. Instead, the company donated a million dollars to AHDI for advancing AHDI’s training programs. Further, the company was purchased by a Mumbai outfit, and laid off most of the onshore MTs in the US.
All that said, I support offshoring, even though it cost me a job after 20+ years in the MT trade.
What I would like to see in the electronic health records process is involvement of medical ethicists in the proofreading phase. Further, I would like to see MT employers engage in weighted payscales based on difficulty of many sorts, including doctors whose words and thoughts are expressed inaccurately.
I became much more productive with speech recognition output than in the prior world of linear transcription.
However, my company enforced grammarian rules which were way below the education level of most physicians dictating, as well as much less education than I had achieved personally, as I actually studied many disciplines in the technical fields which help us, the transcribers, understand the doctors’ wordstream and thoughtstream. I was ashamed of my dumbed-down reports which the company produced. Many doctors were quite brilliant, the company proofers were less so.
So, there is a quality and excellence of personnel issue here. I would like to see the letter scintillate with references to quality assurance, as well as reflecting appreciation of the wonderful intellects which a very considerable corpus of medical transcriptionists show.
Keep up the good work, AHDI; but, this time, no signature from me.
I especially agree with the need for face-to-face interaction between physician and patient. There is nothing worse than having your doctor staring at a computer screen and entering data instead of focusing on and listening to you.
Please support this cause.
Amen!
Medical transcription and medical editing are vital to the care of the patient. I have caught numerous mistakes that could have potentially severely harmed patients. It is a liability for a hospital not to have qualified medical transcriptionists creating and editing these reports.
I agree that technology has its place in healthcare, however when it comes to patient care, safety is of foremost importance. Transcriptionists have the trained knowledge and skill to apply that safety factor along with technology. MTs are a necessary part of the total health care package.
Please strongly consider supporting this necessary effort.
Please realize transcriptionists play a vital role in medical record accuracy!
Please support us in this matter.
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