It Doesn’t Take a Harvard MBA to See The Value Of Today’s Medical Scribes

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In a recent article by Patricia Kirk, published on Wednesday, November 13th, 2013 by the enews/management briefing service Dark Daily, the article makes reference to a claim made by EHR vendors who “contend that the need for medical scribes is temporary because eventually EHR use will evolve in ways that will make scribes obsolete.”

I hope not for a number of reasons.

First off, with a well-documented shortage of well-trained physicians I cannot imagine a scenario where we as a country would want to burden our scarce resource of physicians with the responsibility of doing data entry.  As I have said before this would be analogous to having the CEO of Macy’s operate a cash register or having Tom Brady work the concession stand at half-time.  Unless I was doing some type of wacky marketing thing, if I owned stock in Macy’s (which I do not) or the owner of the New England Patriots (which I am not) I would certainly want to make sure I was getting the most value from my investment and having doctors doing data entry is clearly not the solution. I bet getting the most value from an investment is taught on a regular basis at Harvard!

Secondly, and this one might get a chuckle from many readers, if Obamacare truly increases the number of people with health insurance (40M more people) and those newly enrolled seek additional healthcare services what physician is going to have time to provide these additional services and do the increased level of administrative tasks associated here? This is simply a question of supply and demand…another topic I am sure is taught at Harvard.

And finally, one of the biggest reasons it doesn’t take an MBA from Harvard to see the value of today’s medical scribes is simply this…you do not lower the cost of healthcare by replacing a $12 – $20 per hour resource (a medical scribe or a medical transcriptionist) with a $200 – $500 per hour resource (the physician).  That’s madness and begs the question, why aren’t more hospital CEOs, CFOs, CIOs and physicians themselves seeing this?

To effectively lower the cost of healthcare we need to have the right people, with the right tools (technology), in the right roles, doing the most cost effective work possible.  This includes Healthcare Documentation Specialists of all types, including Medical Scribes and Medical Transcriptionists.  This is why it doesn’t take a Harvard MBA to see the value of today’s medical scribes!

Read more: Medical Scribes Move Outside the ER to Help Clinicians in Other Healthcare Settings Make the Switch From Paper Charts to EHRs

The Military Spouse Career Advancement Accounts (MyCAA) Program

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With the government shut down, The Military Spouse Career Advancement Accounts (MyCAA) Program, was also at a standstill. Since the government shut down is now over, you can begin to apply for your benefits again. It make take several days for MyCAA to receive full funding again but hang in there and keep checking the MyCAA website for full updates.

Does Turmoil at the Top of the Medical Transcription Industry Signal a Decrease in Patient Care on the Front Lines?

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The recent news coming out of the largest providers of medical transcription services to U.S. hospitals paints a clear picture of the turmoil going on behind the scenes at these organizations.

M*Modal Shakes Up Leadership, Names New CEO

Moody’s Downgrades M*Modal; Outlook Negative

Carl Icahn Increases Nuance Stake, May Seek Board Seat

But what does this mean to the individual healthcare provider or the 5,500 hospitals scattered across the U.S and most importantly, the patients they serve? If these two organizations are responsible for creating a significant portion of the healthcare documentation created today, could turmoil at the top be a precursor to:

  • An increase in poor quality healthcare documentation on the front lines?
  • Non-compliance with desired/needed turnaround times?
  • Reduced customer service and responsiveness to client inquiries?
  • Increased physician re-work at a time physicians are already being pulled in multiple directions?
  • Decrease in physician productivity and satisfaction?
  • And ultimately, increased legal exposure for physicians and hospitals?

How could this not ultimately impact the level of patient care being provided in our hospitals nationwide?

At a time when the healthcare industry is spending billions of dollars to implement electronic medical records, move to a new coding system (transitioning from ICD-9 to ICD-10) and otherwise position themselves for the launch of ObamaCare (the Patient Protection and Affordable Care Act), maybe, just maybe, it’s time to get back to basics?

In the not too distant past many healthcare entities leveraged the services of a contingent of medium sized medical transcription services organizations who pride themselves on providing:

  • Premium level clinical documentation services;
  • Leveraging well-trained U.S. based labor resources;
  • With flexible, scalable solutions and/or the flexibility to use the hospitals internal systems;
  • Functioning on a variety of platforms including 3M, MModal, Nuance/Dictaphone/eScription, Dolbey, Infraware, Arrendale, McKesson, Meditech, Epic, etc.
  • With a single point of contact between the client and those able to effectively respond to client inquiries/needs without having to navigate multiple layers of an organization;
  • A well-defined and documented Quality Assurance program;
  • A proven proved track record with reference-able client sites; and
  • A commitment to pricing transparency and pricing competitiveness.

With turmoil at the top and patient care hanging in the balance…maybe it’s time to consider moving your business back to a medium-sized provider of medical transcription services.

For a list of medium-sized service providers leveraging strictly U.S.based labor resources, please feel free to contact us at 1.800.407.1186, extension 803 or email us at [email protected].

Windows XP End of Life and HITECH/HIPAA Compliance

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Windows XP was released August 24, 2001 (yeah a long, long time ago) and has been widely adopted by both home users and corporate users alike. On April 8, 2014, Microsoft will discontinue support and not release any security patches for Windows XP, which will effectively make it non-compliant with HIPAA / HITECH. After April 8, 2014, users running Windows XP Service Pack (SP) 3  or earlier will become vulnerable to attacks as hackers work to reverse engineer the last security patches. This includes both security and “non-security” hot fixes, free or paid support options and online technical content updates.

I am sure there are a lot of users in our industry who still run the old trusted and familiar OS but the time for its replacement is now. The biggest issue will be the vendor support of the various transcription applications and their ability to work with the newer versions of Windows. The majority should now will work with Windows 7 but as most of you know by now Windows 8 is the current version of Windows available. (I wrote about this some time ago so feel free to read that post as well). Application vendors should be hard at work updating their applications to work properly with newer versions of Windows and the included web browsers.

The upgrade process is typically painless and Windows will update itself with the new version when you purchase the upgrade version of the OS.  It  will update itself and keep your applications and data intact. Of course this could be a great excuse to finally get that fast new PC you have been wanting for a while too!

I would recommend any Windows XP users out there start looking to upgrade now and get with the appropriate application vendors or your company IT departments to inquire about the availability of application updates that will work with the new Windows (7 or 8) and get ahead of the curve before it happens. IT departments will be busy in the coming months getting this issue addressed within their organizations to maintain compliance. So the sooner you are ready for this coming change the better.

 

Rebranding the AHDI Credentialing Exams

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If you have not heard, there are going to be some changes for the RMT and CMT certifications.    New credentials will be  RHDS or CHDS.  Below is the article from AHDI –
In late 2013, the current Medical Transcriptionist (RMT) and Certified Medical Transcriptionist (CMT) exams will be rebranded and renamed to Registered Healthcare Documentation Specialist (RHDS) and Certified Healthcare Documentation Specialist (CHDS). Please visit this webpage for updates and the most current information on the changes.

All new candidates taking and passing the credentialing exam offered through our current testing provider Kryterion, will receive their RHDS and CHDS upon the official release.

The transition for individuals who currently hold the RMT and CMT will vary based on when the credential was earned and personal preference. The options are detailed below

  • RMTs and CMTs who credentialed under the current exams (this includes those who passed the 2010 beta test) will automatically be changed to an RHDS or CHDS. A new certificate will be sent to reflect this designation when the rebrand takes place. You can begin using that designation upon receipt of their new certificate.
  • CMTs who earned their credential before the release of the current exam blue prints (before January 2011, with the exception of those who took the beta exam in fall of 2010), will have two options:
    • CMTs may choose to keep their transcription-specific credentials. AHDI will continue to service the CMT through the established recredentialing program. The CMT exam will no longer be offered to new candidates.
    • CMTs may choose to bridge over to the CHDS by taking an online continuing education course and quiz. The online course will cover the new areas introduced in the current exam blue prints. The online bridge course will be available only to current CMTs and will be optional. If the course is not successfully completed, the individual will retain their CMT and may take the online bridge course again after a 6 month waiting period. The pricing and details for the bridge course are not available yet.
  • RMTs who earned their credential before the release of the current exam blue prints (before January 2011, with the exception of those who took the beta exam in fall of 2010), will transition automatically to the RHDS designation through a revised recredentialing course.  The current RMT recredentialing course is being updated to include the additional blue print domains not previously covered as part of the course. Two options will be available:
    • RMTs can opt to take the recredentialing course as soon as it is released or at any time during their credentialing cycle. Successful completion of that updated recredentialing course will earn the RMT their new RHDS designation and trigger a new 3-year cycle.
    • RMTs can choose to wait until end of cycle to take the recredentialing course to recertify and earn their new RHDS credential.  Successful completion of that updated recredentialing course will earn the RMT their new RHDS designation and their new 3-year cycle will begin.

AHDI’s recredentialing program and policies will apply to all four credentials: RMT, RHDS, CMT, and CHDS. The information, policies, and guidelines will be updated and posted online when the rebranding is implemented.

As a Medical Scribe You Can Launch a New Career in Healthcare

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It’s well known that, in the vast majority of cases, Electronic Medical Records (EMRs) make doctors far less efficient when seeing patients.

Why? Because it’s rather difficult to tend to the computer when you’re supposed to be focusing on the patient. It’s relatively easy to write with pen and paper while listening and explaining. It’s far harder to keep two hands on a keyboard, a third hand on the mouse, one eye on the screen and another eye on the patient and any family members that may be in the room with you. And the fact that most EMRs and user interfaces are designed by computer geeks with no knowledge of clinical care or workflow certainly doesn’t help matters. As soon as EMRs are deployed, physician productivity typically goes down by about 40% and it rarely ever gets back to where it was prior to installation.

Employing “scribes” is an increasingly common way physician’s and healthcare organization’s use to get around this mess. Since physician time is scarce and expensive, the thinking goes, why not hire a somewhat less expensive person to handle all the new busywork generated by computers? As a result, an entirely new industry has arisen whose main function is to type patient information directly into electronic medical records.

A medical scribe or clinical information manager is a person trained in medical documentation who assists a physician throughout his or her work day. They serve as a personal assistant to doctors to help make them more efficient and productive. The primary function of a scribe is the creation and maintenance of the patient’s medical record, which is created under the supervision of the attending physician. The scribe will document the patient’s story, the physician’s interaction with the patient, the procedures performed, the results of laboratory studies, and other pertinent information. Additional functions of a scribe may include ordering laboratory/radiology studies, assisting with the patient’s disposition, documenting consultations, and notifying the physician when important studies are completed.

Here is a list of characteristics that contribute to the success of a medical scribe.

  • Strong English grammar skills
  • A compelling interest in healthcare
  • Outgoing and friendly personality
  • Strong desire to work onsite in a clinical setting
  • Superior analytical and resource skills
  • Strong computer and keyboarding skills
  • Keen listening skills
  • Self-starter
  • Strong hand-eye coordination
  • High level of concentration
  • Attention to detail
  • A commitment to lifelong learning
  • Looking for a career that has an excellent future

If you are interested in pursuing a career as a Certified Medical Scribe, visit our online Medical Scribe training program information  page!

Windows 8 in the Transcription Industry. Tips and Information

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As it goes with technology, Microsoft and others continually update their operating systems to add new features and security.  From time to time they change the whole user interface (UI) to a new look and feel but typically the changes are minor. This is not the case with Windows 8. Microsoft has totally revamped the UI with this build to get in line with their tablets and phones.  In the transcription environment the “Modern interface” (previously called “Metro” ) is not optimal for getting work done nor are the transcription applications  available in the Modern versions. Luckily  Microsoft kept the old Desktop functionality but made it an application (app) . Once you open the Desktop app, you will find yourself in the old familiar screen where you used to ‘live’. While this mode is almost the exact same as Windows 7, there are a few differences.

The missing Start Menu is the most notable change you will notice. Now if you hover your mouse in the lower left corner you will have an option to go back to the start screen  (Modern view), where you can simply start typing the name of whatever app or document you need and Windows search will find it for you. Secondly, some older applications especially transcription applications may refuse to install or run citing an “invalid or wrong version of Windows”. A lot of the time you can simply right click the application, select  properties, then the compatibility tab. From there you have an option to run the application in compatibility mode. When this option is checked you will see in the dropdown options from Windows 95 to Windows 7.  I would recommend using the most current version  you can and work backwards.  Doing this will most times allow the application to run in Windows 8 without issue. There are certainly times when this wont work and you have no choice but to get the most current version that is certified for Windows 8 from the vendor. Some vendors may not have a Windows 8 version as of yet and in that case you may have to use another PC with an older version of Windows until they do.

Lastly  while I would recommend users to learn the new ways to navigate each version of Windows in its native format, this time since its such a drastic change I have a few recommendations that may help. Since all the applications that are used for medical transcription will be running in the desktop anyway, there are 3rd party options to put the start menu back!  Most of these will allow you to boot directly to the desktop and skip the Modern start screen altogether. They also add back your programs to the menu so you can access them like you are used to. There are a few different versions but the most popular I have run across are Start Menu 8 and Classic Shell. Both are easy to install and configure.

So while Windows 8 is becoming more and more popular and about all you can get when you purchase a new pc, all is not 100% lost. I hope this information helps you remain productive and less frustrated in the new Windows 8 world!

Clinical Medical Assistant, is it for you?

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Certified Clinical Medical Assistant

Maybe it is time to give your career that much needed BOOST, but how?  Think about becoming a Clinical Medical Assistant. The clinical medical assistant is an important healthcare expert who performs tasks related to basic patient care. They are a crucial component to any doctor’s office, clinic, or hospital.  Starting here can open the door to many opportunities for you.

So what are some of the duties of a Clinical Medical Assistant?

Some of the common duties of clinical medical assistants include taking vital signs of patients, conducting in-office screening tests, collecting and preparing specimens to send to diagnostic laboratories, and recording medical histories. Below is a list of some of the other duties a Clinical Medical Assistant may do.

  • Welcoming patients.
  • Answering patient phone calls.
  • Prepare patients for the visit by taking them to the exam room
  • Helping during examinations.
  • Preparing laboratory specimens/basic lab tests.
  • Telephoning prescriptions to pharmacies.
  • Drawing blood.
  • Preparing patients for x-rays.
  • Removing sutures and changing dressings.
  • Explain/Educated patients on treatment procedures, medications, diets, or physicians’ instructions.
  • Applying bandages.
  • Administering medications.
  • Keeping supplies ready and in stock for the office/clinic.
  • Cleaning and sterilizing instruments.
  • Disposing of contaminated material.
  • Maintaining confidential patient information.

So now that we know some of the duties of a Clinical Medical Assistant, what are some of the qualities I should have before deciding on this particular field?

The first thing that comes to mind is compassion and concern for others well being. This job requires you to be understanding to others in their time of need. The ability to listen and give each patient your undivided attention is critical.  You will have to accurately chart patient details and convey that information to the doctor.  Speaking clearly is also an important ability so others can easily understand you. Reading and writing comprehension along with critical thinking skills are preferred in this profession. Clinical Medical Assistants need to have several skills because their general duty is to ensure the office/clinic is running smoothly.

As you can see, a Clinical Medical Assistant is crucial component to any hospital, clinic or doctors office. You can get trained to become a Clinical Medical Assistant is less than a year and the job opportunities are limitless. This is a profession you can be proud of. To learn more about becoming a Clinical Medical Assistant, please visit our Program Overview- Clinical Medical Assistant.

Speech Recognition Editing – Do You Have the Skills?

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Speech recognition is the process by which specialized software, often called a “speech engine,” transforms the spoken word into written text.  Speech recognition is being used more and more in the healthcare documentation industry as a complement to what we think of as “traditional” medical transcription.

Speech recognition technology (SRT) does not eliminate the need for the human element – not by a long shot.  Although SRT can reduce overall turnaround times, making a patient’s documentation available more quickly, the technology is not capable of the critical thinking skills required of accurate documentation and possessed by the MT.

Enter the speech recognition editor.  While “traditional” transcription is still very much in use, speech recognition is being used in a percentage of our work.  Healthcare documentation specialists are often called on to switch hats from transcriptionist to editor in the course of the day when encountering providers who use SRT for their dictations.

The editor role is NO LESS IMPORTANT and NO LESS CHALLENGING than the transcriptionist role we are accustomed to.  Editing requires additional skills that must be honed in order to catch errors made by a “hand” other than our own, examine the context of the report, and correct any errors made by the speech engine.  Whether a report is transcribed or edited, critical thinking skills are of upmost importance.

While with time speech engines can “learn” dictators and produce somewhat more accurate initial results, there will always be a need for that human element that the technology doesn’t possess.  Errors will range from small errors in wording or punctuation to more…interesting translations of the dictated word.

As healthcare documentation specialists, we possess skills and experience that are in high demand.  No matter what hat we wear in a given day, our skills are absolutely essential in order to ensure accurate documentation for patients.  As SRT use has increased in the industry, so has the demand for speech editors.  If you have not already experienced speech recognition editing, now is the time to expand your education and learn techniques to complement your skills.

Enroll now in the Speech Recognition Editing course offered by AHDPGTM.  This independent-study, online course was created in conjunction with AHDI and is the first of its kind, offering hands-on editing experience.  More course information is available at American Healthcare Documentation Professionals Group (AHDPGTM) .

Electronic Encoders: Friend or Foe?

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In today’s day and age, everything seems to be about technology, instant gratification, quicker turn around as well as more for less.  I can say that I have seen and worked within the concept of “more for less” for many years and it just seems to be the nature of our society today, or so it would seem.  So as we look at the transition of health care and the migration of medical records to electronic health records, this has actually managed to create a new vein of career paths in the health care field within our environment, which is great.  Along these same lines now emerges electronic encoders.  It is the opinion of this blog writer that encoders are positive and negative in a few different ways in the coding world for the profession coder and I am going to share why.

Encoders are great tools to help increase production standards because you can save time searching for your codes by having the system do the work for you.  They have built in references that are wonderful to have at your fingertips and not have to leave your work station to locate or search the all mighty web.  Not all working environments give their employees access to the internet so the fact that the encoder programs could possibly provide medical dictionaries, CPT Assistants, drug listings, Coding Clinics, anatomy diagrams, ICD-9 guidelines, and GEM guidelines would be invaluable to the work flow for a coder.  Not to mention the space it would safe from having all of these references in the work space.  Some encoders also come with other administrative functions that assist us to conduct research on specific procedures as well as individual payer information.  So there are some real great benefits that come with an encoder software package, depending on what is purchased and implemented in the working environment.

So you probably are wondering then, why would I even be asking why an encoding product would be a Foe in the world of a coder?  Here is my reason why.  Coding is a skill that we work extremely hard to learn and perfect.  Hours, months and years of time go into learning what we know and how we do what we do in our line of work.  Encoders are a great tool but can also spoil and ruin us as coders, if we allow them to.  If a coder becomes too reliant on an encoder, this is a bad thing.  If a coder becomes to “comfortable” coding with an encoder, this is a bad thing.  A coder needs to use their skills that they have built or they lose these skills over time.  They may not lose them completely but they can become very rusty for sure.  It is good practice to still manually code from time to time.  It is good for the brain to keep your fingers in your coding references so you remember how your books work, where to find everything, keeping your skills fresh on crosswalks and modifiers.

Things to keep in mind is that even if your working environment is using an encoding product, not everything in the coding world is and remember that to maintain your coding certification, you have tom complete continuing education credits.  Many of these continuing education credits are manual coding exercises.  If you look to gain any additional certifications above the certifications you already carry, these will be manual coding exams.  Not to mention, it is really difficult to put your personal coding notes in an encoder program but you have the luxury to place them anywhere you would like in your personal coding reference.