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Outsourcing [2008-04-22]
I worked for an imaging center (I was already gone) that laid off the MT's and outsourced the work back in 2002. It lasted about a month. The doctors got mad and insisted to the suits to bring the MT back. They wasted so much time correcting and filling in blanks. They were spoiled with their MT and even stated that they did not read their reports when they signed them because they had that much confidence in the MT. Good news for the MT, she came back and demanded more money...and got it. Lesson learned.
Study on outsourcing -- For Real! [2008-04-08]
Put this under your hats, but there has been a study performed in Ohio regarding the cost effectiveness of outsourcing transcription versus bringing American MTs onboard to handle all of it. Oh, happy day!! The concensus is ..... sit up and read this twice ...... it is more lucrative to hire more people who are skilled and pay them a nice hourly rate with benefits than tooutsource some or all of the work.Hang in there. What goes around, comes around. It's about timethat the true cost effectiveness of inferior work be scrutinized. There are managers and QA's and editors and customer service people up the ying-yang who may have to worry a bit because I truly feelthat doctors across the county (many of whom have invested in outsourcing medical transcription)are beginning to realize that it definitely is a skill/profession that needs to stay here in The States. Woooohooo!
outsourcing [2008-02-12]
BUT as pointed out by Whoopi on the view (who made the mistake of quoting Obama), Hillary said it first (5/2007). So we're good either way (I'm going Hillary). But perhaps happy days will come again for us.
Anyone who is not happy with outsourcing... [2008-02-07]
...might want to consider Barack Obama for president: He says he will ensure that US companies that outsource work to other countries will LOSE the tax breaks.
Something to consider anyway.
This could really be an important issue to all medical transcriptionists.
OUTSOURCING TO INDIA [2007-07-22]
OBVIOUSLY IT DOES MATTER HOW MUCH INDIAN MT'S ARE PAID. IF THE TRANSCRIPTION SERVICES PAY MUCH LESS TO THEM, AND STILL CHARGE HOSPITALS, ETC., SAME AMOUNT PER LINE, THEY ARE OBVIOUSLY MAKING A MUCH LARGER PROFIT.
IN ADDITION, THEY ARE TAKING WORK AWAY FROM U.S. MT'S, WHO ARE MUCH MORE QUALIFIED TO DO U.S. WORK
ALSO, WHY ISN'T THERE BETTER ENFORCEMENT OF THE HIPPA REGULATIONS REQUIRED TO BE MET BY OFFSHORE TRANSCRIPTION REGARDING INFORMATION SECURITY?
Offshore Outsourcing to India by US and EU [2006-05-10]
Posted May 1, 2006, this article analyzes the legal and cross-cultural issues that affect data Privacy Regulation in business. It examines India's lack of law enforcement and scores it workforce regarding the potentiality of selling confidential information and India's lack of faith of its ability to enforce any laws it has declined to adopt to protect personal information.
A long but must read for those concerned about offshoring.
outsourcing [2006-05-10]
This was a great read - I sent it to the senators of my state. Thank you for sharing!
South to become another MT outsourcing destination [2005-10-27]
PART of the developmental strategy in the region is the determination of information and communication technology (ICT) industry niche for Region 12.
Transcription, particularly in the medical field, is one of the priority ICT sub-sectors being pushed.
Its consideration includes the rising global demand for competent yet cost-effective workers.
Foreign MT outsourcing companies continue to seek medical transcriptionists for their familiarity with US medical standards, terminology, and practices.
The region has access to cost-effective telecommunications and business infrastructure.
The 12-hour time difference between the US and Soccsksargen could facilitate speedy delivery of output to US hospitals.
So far, only Garner Global Transcription, Inc. and Transcode One Solutions in General Santos City are the registered MT company based in Region 12.
But there are already a number of sub-contractors that operate home-based.
A group of medical persons received a transcription project from an existing MT companies in Manila for a certain fee.
After a year of industry advocacy lead by RITECC 12 and Department of Trade and Industry (DTI) 12, not only the local business sector together with the medical practitioners are manifesting their investment interest but the growing appreciation by the academe and training institutions to join the developmental bandwagon.
One of the activities during the 2nd e-Business Week Celebration is the conduct of a Forum on Medical Transcription on October 26, 2005 at Family Country Homes and Convention Center in General Santos City.
This aims to prepare professionals to work in MT firms and provide entrepreneurs with information on the MT business, said DTI regional director Ibrahim Guaimadel.
Outsourcing as a crutch to ESL dictators [2005-09-11]
The most probable reason for the boom in outsourcing is that the accent-ridden medical doctors who have the privilege of working in this country and providing a comfortable life for themselves and their families is that the ESL docs simply are unable or unwilling to lose their accent and adjust themselves appropriately to the United States. It's much easier for them to outsource to their home countries because they are more easily understood and/or they can dictate in their native language. The language barrier not something that is worth understanding and/or support. To me, it's a symptom of laziness and very unprofessional. The language barrier is a problem for PATIENTS of ESL doctors as well. Bush should be well advised of yet another source that is stealing US jobs and/or undermining the MT industry.
Years ago, I was a temp for a major publisher of medical books. They had outsourced the duty of scanning in line art for their books at a reduced rate from labor in India. In return, the scanned images were returned, and we were in charge of cleaning up the images using PhotoShop. What's the point in having them do this job for pennies on the dollar when we had to turn around and clean up their work. They didn't even know enough whether to scan it as line art or scan it as a photo = fuzzy images. In all actuality, they didn't save a thing.
Time to introduce a bill [2008-06-27]
This is great news but from my experience, the bottom line is all most companies care about. The company I worked for never paid for enough quality control hours-usually only one hour per day and outsourced it's MT work. Records came back with incorrect names, gender, diagnoses, procedures and labs because the outsourced Transcriptionist could not flag the work for the dictating doctor (boss said doctors were too busy to deal with it) and/or entered anything just to get the chart to clear medical records. They only dealt with issues when lawsuits arose and my guess would be that since most cases are arbitrated, the doctors were the winners yet again. All this is to say, even if the suits know they will get better quality, they do not care because they are only concerned with lining their pockets.
It is not just MT jobs that suffer because of outsourcing. Will you (or anyone else for that matter)be denied work or insurance in the U.S. because an overseas transcriptionist entered erroneous information in your medical record? U.S. citizens would probably be outraged to discover this is happening to their private information despite HIPPA. I believe it is time to get tough and form a coalition to introduce a bill to end outsourcing of medical transcription. Time to take a stand and fight back.
Study on outsourcing -- For Real! [2008-04-08]
Put this under your hats, but there has been a study performed in Ohio regarding the cost effectiveness of outsourcing transcription versus bringing American MTs onboard to handle all of it. Oh, happy day!! The concensus is ..... sit up and read this twice ...... it is more lucrative to hire more people who are skilled and pay them a nice hourly rate with benefits than tooutsource some or all of the work.Hang in there. What goes around, comes around. It's about timethat the true cost effectiveness of inferior work be scrutinized. There are managers and QA's and editors and customer service people up the ying-yang who may have to worry a bit because I truly feelthat doctors across the county (many of whom have invested in outsourcing medical transcription)are beginning to realize that it definitely is a skill/profession that needs to stay here in The States. Woooohooo!
spheris [2007-01-30]
Anyone know the deal with Spheris lately, heard they were bought out by Healthscribe and are going to be outsourcing most. Need to know is I should stay or start looking AGAIN....Have two teenagers at home that need to be fed and we all know the way they eat.
DocQment(TM) Ovation - MedQuist Launches Next-Generation [2006-07-07]
MOUNT LAUREL, N.J., June 29 /PRNewswire-FirstCall/ -- Today's healthcare providers face what appear to be several conflicting challenges in the area of dictation. Pressures to decrease costs and improve productivity must be weighed against the need to demonstrate compliance and increase physician choice and satisfaction. To help its customers meet these challenges, Medquist Inc. (Pink Sheets: MEDQ) has introduced DocQment(TM) Ovation, a Web-based, enterprise digital voice capture and transport solution.
Studies by the Healthcare Information and Management Systems Society (http://www.himss.org/) have shown that when considering the purchase of a new dictation system, providers value HIPAA compliance most highly, followed by Web-based, centralized administration and automatic document routing. Because Ovation is Web-based, it offers easy-to-use tools to manage documents, users and workflow from any computer with Internet access, creating numerous opportunities for productivity improvement. Physicians can select from a variety of options for capturing their dictation, including telephones, PDAs, and desktop computer-based dictation devices.
DocQment Ovation is our newest technology innovation developed in direct response to industry feedback and providers' interest in replacing previous- generation dictation systems, says Scott Bennett, MedQuist senior vice president of Sales and Marketing. An integral component of our growing technology portfolio, Ovation helps to provide an end-to-end solution from dictation to billing, including front-end and back-end speech recognition.
Document Ovation was specifically engineered to be compatible with MedQuist's previous-generation dictation stations, thus facilitating the retention and recruitment of transcriptionists, and making it easy for providers to upgrade with little or no physician retraining required. Deployed at the customer's location, Ovation provides an enterprise view that allows transcription supervisors to easily manage users, documents and voice files from a single dashboard instead of using multiple systems. Ovation's sophisticated configuration options enable administrators to easily track work and share resources in order to get the right document to the right Transcriptionist at the right time.
According to Emmy Weber, MedQuist vice president of Product Management, Breakthrough capabilities engineered into DocQment Ovation, like the ability to define the date that begins the aging process for documents (including admit date and date of discharge), give users better information at the point of dictation to improve workflow, accuracy and report routing.
With MedQuist's help, we configured DocQment Ovation around the way we do business, says Wanda Newton, HIM director at Maury Regional Healthcare System, a three-hospital system located in Tennessee. With Ovation, we are now managing our hospitals and departments more efficiently. We saw a 34 percent increase in productivity in the first two months of use of Ovation, a positive trend that we expect will continue.
Ovation is available for immediate installation. For more information, contact a local MedQuist representative or dial 1-877-489-1500 for sales assistance.
MedQuist, a member of the Philips Group of Companies, is a leading provider of clinical documentation workflow solutions in support of the electronic health record. MedQuist provides electronic medical transcription, health information and document management products and services, including digital dictation, speech recognition, Web-based transcription, electronic signature, medical coding, mobile dictation devices, and outsourcing services.
Mighty, it's not going to 50 years, [2006-07-06]
think it is more like 5 to 10 years.According tothis report,India already has 45% of our jobs, and what about Ireland, and most likely other countries have a finger in the MT pie....and with our government encouraging outsourcing, well, the writing is on the wall, that's for sure. Also I wish someone tell Mr. Dumaguin thatwe aretranscriptionists, nottranscribers....but he's got the money, guess he can say whatever he pleases.
MedQuist Announces Unaudited Financial Results, 6 Million in Operating Loss [2006-05-11]
MT. LAUREL, N.J.--(BUSINESS WIRE)--May 11, 2006--MedQuist Inc. (Pink Sheets: MEDQ.PK) announced today certain preliminary, partial and unaudited financial results, and provided updated information regarding previously-announced litigation and governmental investigations and proceedings. Once the Company completes the financial assessment and review of its billing practices disclosed in the Company's previous filings with the SEC, KPMG LLP, the Company's independent registered public accounting firm, will complete the audit the Company's financial statements. The Company is continuing the process of working toward becoming current in its periodic reports pursuant to the Securities Exchange Act of 1934. The Company's review of its current and prior period unaudited financial statements, as well as KPMG LLP's audits for those periods, may identify adjustments or reclassifications which may be reflected in the periods to which they relate. At this time, the Company cannot estimate the total costs of (i) the billing review, (ii) defense of the class action matters, (iii) the SEC investigation, and (iv) compliance with the Department of Justice investigation, all of which have been previously disclosed in either the Company's filings with the SEC or the Company's press releases. Accordingly, the only costs related to the defense of these matters that have been included in the results below are actual costs incurred through March 31, 2006 by the Company. Because the completion of the billing review and resolution of the litigation and governmental investigatory matters are pending, the Company is not certain whether any changes to the accounting treatment of any component of its consolidated financial statements will be required and, if any changes are necessary, whether any such changes would have a material impact on its current or prior period consolidated financial statements. Accordingly, the financial information set forth below is preliminary, unaudited, and subject to change based on the completion of the financial assessment and review of the Company's billing practices, resolution of the class action matters and governmental investigations and proceedings, and the completion of the review and/or audit of its financial statements, as appropriate.
The financial information and related narrative discussion set forth below is derived from the Company's internal books and records. The Company cautions investors not to place undue reliance on the financial information presented below. As a result of the developments described above and in the Company's previous SEC filings, the Company's financial statements have not been audited or reviewed by KPMG LLP, its independent registered public accounting firm. The financial information contained in this press release also has not been audited or reviewed by an independent registered public accounting firm. Such information is not a substitute for the information required to be reported in the Company's Forms 10-K and Forms 10-Q that have not yet been filed. There can be no assurance that the results of the billing review, and resolution of the litigation and governmental investigatory matters will not have a material adverse effect on the Company's revenue, results of operations and financial condition.
Legal Proceedings
Investigations and Proceedings Commenced by the SEC and the Department of Justice
As previously announced, the Securities and Exchange Commission (the SEC) is currently conducting a formal investigation of the Company. The Company will continue to fully cooperate with the SEC.
As previously announced, the Company received an administrative HIPAA subpoena for documents from the United States Attorney's Office for the District of Massachusetts on December 17, 2004. The subpoena sought information primarily about the Company's provision of medical transcription services to governmental and non-governmental customers. The information was requested in connection with a government investigation into whether Medquist and others violated federal laws in connection with the provision of medical transcription services. MedQuist continues to cooperate fully with the Department of Justice.
Shareholder Securities Litigation
As previously announced, a shareholder putative class action lawsuit was filed against the Company in the United States District Court District of New Jersey on November 8, 2004. The action, entitled William Steiner v. MedQuist, Inc., et al., Case No. 1:04-cv-05487-FLW (the Shareholder Putative Action), was filed against the Company and certain former Company officials, purportedly on behalf of an alleged class of all persons who purchased MedQuist common stock during the period from April 23, 2002 through November 2, 2004, inclusive (the Class Period). The complaint specifically alleged that defendants violated federal securities laws by purportedly issuing a series of false and misleading statements to the market throughout the Class Period, which statements allegedly had the effect of artificially inflating the market price of the Company's securities. The complaint asserts claims under Section 10(b) and 20(a) of the Securities Exchange Act of 1934 and Rule 10b-5, thereunder. Named as defendants, in addition to the Company, were its former president and chief executive officer and its former executive vice president and chief financial officer.
On August 16, 2005, a First Amended Complaint in the Shareholder Putative Class Action was filed against the Company in the United States District Court District of New Jersey. The First Amended Complaint named additional defendants, including certain current and former directors, certain former Company officers, the Company's former and current external auditors and Koninklijke Philips Electronics N.V. (Philips). Like the original complaint, the First Amended Complaint asserted claims under Sections 10b and 20(a) of the Securities and Exchange Act of 1934 (the Act) and Rule 10b5 of the Act. The Class Period of the original complaint was expanded 20 months and now includes the period from March 29, 2000 through June 14, 2004. Pursuant to an October 17, 2005 consent order approved by the Court, Lead Plaintiff Greater Pennsylvania Pension Fund filed a Second Amended Complaint on November 15, 2005. The Second Amended Complaint dropped Philips as a defendant, but alleges the same claims and the same purported class period as the First Amended Complaint. Plaintiffs seek unspecified damages. Pursuant to the provisions of the Private Securities Litigation Reform Act, discovery in the action is stayed pending the filing and resolution of the defendants' motions to dismiss, which were filed on January 17, 2006, and will be fully briefed by May 26, 2006. The Court has not set a hearing date on the motions. The Company believes that the claims asserted in the Second Amended Complaint are without merit, and is vigorously defending the action.
Customer Litigation
As previously announced, a putative class action was filed in the United States District Court Central District of California. The action, entitled South Broward Hospital District, dba Memorial Regional Hospital, et al. v. MedQuist, Inc. et al., Case No. CV-04-7520-TJH-VBKx, was filed on September 9, 2004 against the Company and certain present and former Company officials, purportedly on behalf of an alleged class of non-Federal governmental hospitals and medical centers that the complaint claims were wrongfully and fraudulently overcharged for transcription services by defendants based primarily on the Company's use of the AAMT line billing unit of measure discussed below. The complaint charges fraud, violation of the California Business and Professions Code, unjust enrichment, conversion, negligent supervision and violation of the Racketeer Influenced and Corrupt Organizations Act. Plaintiffs seek damages in an unspecified amount, plus costs and interest, an injunction against alleged continuing illegal activities, an accounting, punitive damages and attorneys' fees. Named as defendants, in addition to the Company, were a senior vice president, its former executive vice president of marketing and new business development, its former executive vice president and chief legal officer, and its former executive vice president and chief financial officer.
On December 20, 2004, the Company and individual defendants filed motions to dismiss for lack of personal jurisdiction and improper venue, or in the alternative, to transfer the putative action to the United States District Court District of New Jersey. On February 2, 2005, plaintiffs filed a Second Amended Complaint both adding and deleting named plaintiffs in an attempt to keep the putative action in the United States District Court Central District of California. On March 30, 2005, the United States District Court Central District of California issued an order transferring the putative action to the United States District Court District of New Jersey.
On August 1, 2005, the Company and the individual defendants filed their respective Answers denying the material allegations contained in the Second Amended Complaint. On August 31, 2005, the Company and individual defendants filed motions to dismiss the Second Amended Complaint for failure to state a claim and a motion to dismiss in favor of arbitration, or in the alternative, to stay pending arbitration. On December 12, 2005, the plaintiffs filed an Amendment to the Second Amended Complaint. On December 13, 2005, the Court issued an order requiring plaintiffs to file a Third Amended Complaint.
Plaintiffs filed the Third Amended Complaint on January 4, 2006. The Third Amended Complaint expands the claims made beyond issues arising from contracts based on AAMT line billing and beyond customers billed based on an AAMT line, alleging that the Company engaged in a scheme to inflate customers' invoices without regard to the terms of individual contracts and even in the absence of any written contract. The Third Amended Complaint also limits plaintiffs' claim for fraud in the inducement of the agreement to arbitrate to the three named plaintiffs whose contracts contain an arbitration provision and a subclass of similarly situated customers. On January 20, 2006 the Company and individual defendants filed motions to dismiss the Third Amended Complaint for failure to state a claim and a motion to compel arbitration of all claims by the arbitration subclass and to stay the case in its entirety pending arbitration. On March 8, 2006 the Court held a hearing on these motions, and took the matter under submission. The Court has not yet ruled on the motions. The Company believes that the claims asserted have no merit and intends to vigorously defend the putative action.
Medical Transcriptionist Litigation
Hoffmann Putative Class Action
As previously announced, a putative class action lawsuit was filed against the Company in the United States District Court Northern District of Georgia. The action, entitled Brigitte Hoffmann, et al. v. MedQuist, Inc., et al., Case No. 1:04-CV-3452, was filed with the Court on November 29, 2004 against the Company and certain current and former Company officials, purportedly on behalf of an alleged class of current and former employees and statutory workers of MedQuist, who are or were compensated on a per line basis for medical transcription services (the Class Members) from January 1, 1998 to the time of the filing of the complaint (the Class Period). The complaint specifically alleged that defendants systematically and wrongfully underpaid the Class Members during the Class Period. The complaint asserted the following causes of action: fraud, breach of contract, demand for accounting, quantum meruit, unjust enrichment, conversion, negligence, negligent supervision, and Racketeer Influenced and Corrupt Organizations Act violations. Plaintiffs sought unspecified compensatory damages, punitive damages, disgorgement and restitution. On December 1, 2005, the Hoffmann matter was transferred to the United States District Court District of New Jersey. As discussed immediately below under the heading Myers Putative Class Action, the Company believes that the claims presently asserted have no merit and intends to vigorously defend the putative action.
Myers Putative Class Action
As previously announced, a putative class action entitled, Myers, et al. v. MedQuist Inc. and MedQuist Transcriptions, Ltd., Case No. 05CV 4608 (JBS), was filed against the Company on September 22, 2005 in the United States District Court District of New Jersey. The action was brought on behalf of a putative class of MedQuist's employee and independent contractor transcriptionists who claim that they contracted with the Company to be paid per AAMT line, but were allegedly underpaid due to intentional miscounting of the number of characters and lines transcribed. The named plaintiffs asserted claims for breach of contract, unjust enrichment, and request an accounting.
The allegations contained in the Myers case are substantially similar to those contained in the Hoffmann putative class action and the two actions have now been consolidated. A consolidated amended complaint was filed on January 31, 2006. The named plaintiffs assert claims for breach of contract, breach of the covenant of good faith and fair dealing, unjust enrichment and demand an accounting. On March 7, 2006 the Company filed a motion to dismiss all claims in the consolidated amended complaint. The motion has now been fully briefed. The Court has not set a hearing date on the motion. The Company believes that the claims asserted in the consolidated actions have no merit and intends to vigorously defend the suit.
Derivative Litigation
On October 4, 2005, the Company announced the dismissal with prejudice of a shareholder derivative action filed in United States District Court District of New Jersey. The suit, Rhoda Kanter (Plaintiff) v. Hans M. Barella et al. (Defendants), was filed on November 12, 2004 against Philips and ten current and former members of MedQuist's Board of Directors. MedQuist was named as a nominal defendant.
In a ruling dated September 21, 2005, the Court found Plaintiff's allegations that MedQuist's Board members breached their fiduciary duties to the Company to be insufficient. The Plaintiff had alleged that for a period from 2001 through 2004, the Defendants violated their fiduciary duties by permitting artificial inflation of billing figures; failing to adequately ensure accurate and lawful billing practices; and failing to accurately report the Company's true financial condition in its published financial statements. To the contrary, the Court concluded: Far from alleging facts supporting a substantial likelihood of liability, Plaintiff here has painted a picture of a board of directors that acted responsively given the circumstances . . . . On October 3, 2005, plaintiffs filed a motion for reconsideration of the Court's order dismissing the action with prejudice. On November 16, 2005, the Court denied Plaintiffs' motion for reconsideration. On December 13, 2005, Plaintiffs filed a Notice of Appeal with the United States Court of Appeals for the Third Circuit.
On March 21, 2006, Plaintiff filed her opening brief on appeal. On April 20, 2006, MedQuist and the other defendants filed their opposition briefs. The appeal will be fully briefed by May 4, 2006. The Court of Appeals has not set a hearing date for the appeal.
Customer Accommodations
As previously disclosed, the primary allegations in a number of the litigation matters relate to how the Company interpreted the AAMT line billing unit of measure. The AAMT line billing unit of measure was developed in 1993 through a collaboration among several industry organizations with the intent of providing standardization in industry billing practices. However, due to inherent ambiguities in the definition of this unit of measure not fully anticipated at the time of its introduction, AAMT line-based billing was applied inconsistently throughout the medical transcription industry and eventually renounced by the groups initially responsible for its development. Despite these issues, a number of companies in the industry have continued to use AAMT line-based billing, and some customers still request proposals and contracts based on the AAMT line.
Like many medical transcription service providers, MedQuist once used the AAMT line unit of measure to calculate invoices for many of its medical transcription clients. It has been widely recognized and well documented throughout the industry, however, that the AAMT definition of a line is inherently ambiguous and subject to a wide variety of interpretations. In fact, no single set of AAMT characters was ever defined for this unit of measure. Accordingly, MedQuist began the process in 2004 of transitioning its AAMT line-based customers off the AAMT line unit of measure and, in April 2005, the Company completely eliminated the use of the AAMT line for billing and called on other industry transcription providers to follow its lead.
Due to these AAMT line unit of measure ambiguities, and the disparity in its interpretation, health care providers have raised concerns regarding charges for transcription services by their respective transcription providers, including the Company. In response to those concerns, and to foster ongoing business relationships with its customers, the Company has approached certain customers and offered to resolve any issues related to their prior AAMT line and other billing related issues.
As previously disclosed, the Company's Board of Directors has authorized Company management to make accommodation offers, up to an aggregate amount of $65.0 million, to certain customers to resolve any concerns over AAMT and other billing related issues. As of March 31, 2006, (i) the Company has entered into agreements with certain customers who have accepted accommodation offers to resolve concerns over AAMT and other billing related issues, and paid or credited an aggregate amount of $31.3 million as an accommodation to those customers and (ii) additional accommodation offers have been made by the Company to certain other customers in the aggregate amount of $11.9 million. From April 1, 2006 through the date of this release, the Company has entered into agreements with additional customers and paid or credited an aggregate amount of $2.9 million and has extended accommodation offers to additional customers in the aggregate amount of $1.1 million. Company management currently intends to make additional accommodation offers in the future, consistent with the Board's authorization described above, although the timing and amount of such offers have not yet been determined and the Company's plans may change in the future. The accommodation offers do not represent an estimate of potential liability, if any, in any of the previously disclosed litigation or investigatory matters pending against the Company.
The Company is unable to predict how many customers, if any, will accept the outstanding accommodation offers on the terms proposed by the Company, nor is the Company able to predict the timing of the acceptance (or rejection) of any of these outstanding accommodation offers. Until such offers are accepted, the Company may withdraw or modify the terms of the accommodation offers at any time. In addition, the Company is unable to predict how many of the future offers, if made, will be accepted on the terms proposed by the Company. The Company believes that its existing cash resources and cash flows from operations are sufficient to fund all of the customer accommodation offers it may make.
By accepting the Company's accommodation offers, the customer must agree, among other things, to release the Company from any and all claims and liability regarding prior AAMT and other billing related issues. The accommodation offers made to date, and those offers which may be made in the future, are not an admission of liability by the Company of any wrongdoing or an admission or acknowledgement that its billing practices with respect to such customers were or are incorrect. MedQuist Inc. -- Preliminary and Unaudited Financial Information
(in millions)
----------------------------------------------------------------------
Three months ended
----------------------------------------
March 31, 2006 March 31, 2005
------------------ ------------------
Revenues $ 97 $ 108
Operating loss $ (8) $ (2)
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As of As of
March 31, 2006 December 31, 2005
------------------ ------------------
Cash $ 164 $ 178
Debt $ - $ -
Three Months Ended March 31, 2006
Revenues:
Preliminary, unaudited results indicate that the Company's revenues decreased $11 million to $97 million for the three months ended March 31, 2006 from approximately $108 million for the comparable 2005 period. This decline in revenues is largely due to decreases in transcription outsourcing services and product sales of $9 million or 10%, and $2 million or 27%, respectively. The decline in transcription outsourcing revenues is largely due to a decrease in the volume of lines transcribed primarily related to clients for whom we no longer provide transcription services. Additionally, pricing pressures continued on the base transcription business during the first quarter 2006, but revenues were impacted far less by pricing pressures than in the comparable 2005 period. Management expects that pricing pressures will continue for the foreseeable future but that the introduction of several new sales initiatives and improved customer service programs should cause transcription volume to stabilize or improve throughout the duration of 2006.
Operating Loss:
Preliminary, unaudited results indicate that our operating loss increased $6 million to a loss of approximately $8 million for the three months ended March 31, 2006 from an operating loss of $2 million for the comparable 2005 period. The operating loss of $8 million was primarily attributable to $9 million of costs associated with the following: (1) costs related to the ongoing billing review including (i) legal fees incurred in connection with governmental investigations and proceedings and defense of the class action matters and (ii) non-legal professional fees; and (2) increased expenses related to prior years' accounting reviews and audit. Operating loss was also impacted by the $11 million decline in revenues over the same period.
Balance Sheet Highlights:
As of March 31, 2006, the Company had $164 million in cash and cash equivalents and no debt. The $14 million decrease in cash as of March 31, 2006 compared with December 31, 2005 was primarily attributable to accommodation payments ($10 million) and capital expenditures ($4 million). There were no issuances of capital stock or other securities for the three months ended March 31, 2006.
The Company expects to incur significant costs and expenses in the future relating to the ongoing billing review, defense of the class action matters and governmental investigations and proceedings, and accommodation agreements. These costs and expenses include (i) legal fees relating to the SEC and Department of Justice investigations and proceedings, (ii) legal fees relating to defense and resolution of the litigation matters described above, (iii) customer accommodation payments and credits, and (iv) non-legal professional fees. The timing and level of these costs and expenses is, in many cases, not within the Company's control. While the Company is unable to predict the timing and level of these costs and expenses, the Company currently believes that it has sufficient resources, including cash on hand and cash flow from operations to fund these costs and expenses. However, there cannot be any assurance that unanticipated changes in the level of these costs will not exceed the Company's available cash resources, nor can there be any assurance that sufficient financing from external sources will be available to the Company on acceptable terms, if at all. In the event that the Company's cash requirements exceed its available cash resources, or if the timing of such costs and expenses requires the Company to divert cash resources away from operations, the Company may not be able to execute its operating plan, which could have a material adverse effect on the Company's business and results of operations.
Other Developments
Restructuring:
As previously disclosed, in conjunction with the Company's movement to a single national service and support organization, a restructuring plan was developed in 2005 to consolidate approximately forty-eight (48) operating facilities and centralize certain components of the business in order to improve operating efficiencies. The Company is expecting to incur total restructuring costs of up to $8.5 million associated with this plan through the end of the fourth quarter of 2006. The Company incurred $1 million of restructuring costs for the three months ended March 31, 2006. This restructuring is expected to generate annualized savings of approximately $18.5 million. The Company realized approximately $1.9 million in savings during the three months ended March 31, 2006. Specifically, the Company has shifted resources to a single national service delivery and support organization for all of the Company's services and products and is in the process of eliminating local service centers.
The plan does not contemplate reductions of, and the Company has no current intentions to reduce, its medical transcription workforce. Rather, the Company will continue in its efforts to hire additional qualified transcriptionists. Further, although the Company is consolidating its local service centers as described above, customer-facing teams, led by account managers, will continue to coordinate customer support on the local level. The customer-facing teams will continue to work with and be supported by the Company's centrally managed customer service organization.
AAMT to start offering its first medical transcription training program in the Philippines. [2006-01-29]
IT education institution Informatics recently signed up with the American Academy of Medical Transcription (AAMT) to start offering its first medical transcription training program in the Philippines.The training modules intend to improve both English communication skills and medical knowledge from basic to intermediate in students hoping to work in the medical transcription business growing in the country.
Among the modules are English grammar and style essentials, foreign accent dictation, human anatomy and physiology, pharmacology, diagnostic procedures, laboratory medicines, medical word building, and medico-legal concepts and ethics.
Participants with medical backgrounds would have 150 hours of lecture and 160 hours of on-the-job training. Those without medical skills would have 220 lecture hours and 160 hours of on-the-job training.
The program intends to train about 2,000 medical transcribers to enter the workforce this year, according to Informatics director for corporate learning Paul Dumaguin.
Statistics from the Medical Transcription Industry Association of the Philippines indicate that over 7,000 medical transcribers are needed to meet the demand of the medical transcription business.
The US is currently the biggest source of medical transcription and 45 percent of the work is being done by India.
Dumaguin said that medical transcribers can work for existing firms, but have an option to work at home as independent transcribers.
“Trainees typically obtain employment with an MT outsourcing firm, but with the growth of the industry, they have other options as well, such as putting up their own MT businesses,” Dumaguin said.
The worldwide medical transcription business is expected to grow to 25 billion US dollars within the next three years.
CBay Awarded Multi-Year Contract [2006-01-19]
ANNAPOLIS, Md., Jan. 18 /PRNewswire/ -- CBay Systems announced today thatit was awarded a contract by Premier Inc. to provide integrated dictationcapture, transcription and web-based document management solutions to itsmember healthcare facilities. Under the terms of the agreement, CBay is theapproved provider to Premier's alliance of approximately 1,500 hospitals andhealthcare systems across the United States. A leading provider of healthcare technology and business processoutsourcing (BPO) services, CBay addresses various issues in the healthcaresector, primarily focusing on transcription process improvement andreceivables management. By leveraging HIPAA-compliant Internet technologiesand highly credentialed global resources, CBay delivers measurableefficiencies and savings to hundreds of hospitals, clinics and physiciangroups. A selection committee at Premier evaluated numerous medical transcriptionservice organizations from across the country and determined that CBay'ssolutions were the right choice for its members. CBay is very excited about this opportunity to provide medicaltranscription services to Premier's member hospitals, said Michael Kimball,CBay's senior vice president of sales and marketing. We offer the ideal blendof service, experience, technology, and value to ensure that Premier's membersreceive timely and accurate medical documentation to help them provide thebest patient care.
TRANSCEND: appointment of Lance Cornell as Chief Financial Officer [2005-11-02]
TRANSCEND SERVICES, INC. today announced the appointment of Lance Cornell as Chief Financial Officer. Mr. Cornell replaces Mr. Mark D. Meersman, who has decided to return to the position of partner-in-charge of inProcess Consulting, a management consulting firm that he left six months ago to join Transcend.
Mr. Cornell is a Certified Public Accountant with over 18 years of experience in accounting, finance and financial management, including controller and chief financial officer positions with publicly traded companies. Prior to joining Transcend, Mr. Cornell was Chief Financial Officer for nearly five years at Facility Resources, Inc., a private consulting firm specializing in facility-related project management, systems implementation and outsourcing for large corporations. Prior to that experience, Mr. Cornell served in chief financial officer and controller positions in two separate publicly traded companies in the healthcare information systems industry. Mr. Cornell received a B.S. degree in Finance with highest honors from the University of Colorado.
Larry Gerdes, the Company's President and Chief Executive Officer, commented on the announcement: We welcome Lance's financial executive experience to our executive management team and thank Mark for his many and varied contributions to our Company. Mark has assisted the company in the automation and analysis of financial data that will prove helpful as we focus on improving our overall profitability. Lance not only understands the challenges facing the Company, but also sees the opportunities for the Company to grow and prosper in the $6 billion market for medical transcription services in the United States. We are particularly excited about his experience in planning and financing growth strategies, including acquisitions.
Mr. Cornell commented: I am excited about the potential effects that the Company's BeyondTXT speech recognition functionality and its strategic acquisition initiative should have upon the Company's financial performance. I look forward to helping the Company achieve its growth and profitability objectives.
About Transcend Services, Inc.
Transcend believes that accurate, reliable and timely transcription creates the foundation for the patient medical record. To this end, the Company has created Internet-based, speech recognition-enabled voice-to-text systems that allow its skilled medical language specialists to securely and quickly produce the highest quality medical documents. The Company's wide range of transcription services encompass everything needed to securely receive, transcribe, edit, format and distribute electronic copies of physician-dictated medical documents, from overflow projects to complete transcription outsourcing.
For more information, visit http://www.transcendservices.com.
South to become another MT outsourcing destination [2005-10-27]
PART of the developmental strategy in the region is the determination of information and communication technology (ICT) industry niche for Region 12.
Transcription, particularly in the medical field, is one of the priority ICT sub-sectors being pushed.
Its consideration includes the rising global demand for competent yet cost-effective workers.
Foreign MT outsourcing companies continue to seek medical transcriptionists for their familiarity with US medical standards, terminology, and practices.
The region has access to cost-effective telecommunications and business infrastructure.
The 12-hour time difference between the US and Soccsksargen could facilitate speedy delivery of output to US hospitals.
So far, only Garner Global Transcription, Inc. and Transcode One Solutions in General Santos City are the registered MT company based in Region 12.
But there are already a number of sub-contractors that operate home-based.
A group of medical persons received a transcription project from an existing MT companies in Manila for a certain fee.
After a year of industry advocacy lead by RITECC 12 and Department of Trade and Industry (DTI) 12, not only the local business sector together with the medical practitioners are manifesting their investment interest but the growing appreciation by the academe and training institutions to join the developmental bandwagon.
One of the activities during the 2nd e-Business Week Celebration is the conduct of a Forum on Medical Transcription on October 26, 2005 at Family Country Homes and Convention Center in General Santos City.
This aims to prepare professionals to work in MT firms and provide entrepreneurs with information on the MT business, said DTI regional director Ibrahim Guaimadel.
CBay Systems Makes Deloitte’s List of 500 Fastest Growing [2005-10-20]
CBay Systems Makes Deloitte’s List of 500 Fastest Growing Technology Companies in North America Maryland Fast 50 Rapid Growth Recognized for the Second Year in a Row
CBay Systems, a leading provider of healthcare business process outsourcing (BPO) services and the largest provider of Indian transcription technology and services to the US healthcare market today announced that it was again named to the Deloitte Technology Fast 500. The ranking measures the 500 fastest growing technology companies in North America, based on percentage revenue growth over the past five years, during which CBay Systems grew 779 percent.
CBay addresses various issues in the healthcare space, primarily focusing on medical transcription. The company’s HIPAA-compliant solutions leverage Internet technologies to provide integrated dictation capture, transcription and web-based document management services to hospitals, clinics and doctors.
Making the Deloitte Technology Fast 500 for the second year in a row is commendable in today’s highly competitive technology industry, said Tony Kern, deputy national managing principal of Deloitte’s Technology, Media Telecommunications industry practice. “Achieving sustained revenue growth of 779 percent over five years is a tremendous achievement. We congratulate CBay Systems on being one of the 500 fastest growing technology companies in North America.
Inclusion on the nation-wide Fast 500 list follows CBay’s recent acknowledgement as a member of the Deloitte Technology Fast 50 in Maryland. This list highlights the 50 fastest growing technology companies in the state of Maryland for 2005.
CBay’s Chairman CEO, Raman Kumar said, “It is an honor for CBay to be recognized for the second year in a row, but we are especially proud of these awards, as they communicate our explosive growth and ever-increasing customer base, providing concrete evidence of our superior product and commitment to customer service.” He also added, “We have 41 centers in our network in India, employing over 5000 people and the number is increasing every month, to cater to our expanding customer base in the US.”
Fast 500 Selection and Qualifications
The Fast 500 list is compiled from Deloitte’s 15 regional North American Fast 50 lists, nominations submitted directly to the Fast 500, and public company database research. Entrants must be headquartered in North America and must be a “technology company,” defined as a company that owns proprietary technology that contributes to a significant portion of the company's operating revenues; or devotes a significant proportion of revenues to the research and development of technology. Using other companies' technology in a unique way does not qualify.
About CBay
CBay Systems is a leading provider of healthcare technology and business process outsourcing (BPO) services and the largest global provider of transcription services to the healthcare industry. CBay’s more than 5,000 highly trained medical language specialists and customer service professionals spread out in 41 production centers situated across 10 states in India serve 650+ health systems, hospitals, clinics and physician practices 24 hours a day, 365 days a year, using HIPAA compliant web-based technologies with a commitment to the highest standards of quality, service and value. CBay is headquartered in Annapolis, Maryland with the Indian corporate office in Mumbai. For more information, visit www.cbaysystems.com.
About Deloitte
Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, its member firms and their respective subsidiaries and affiliates. In the US, services are provided by the subsidiaries of Deloitte Touche USA LLP (Deloitte Touche LLP, Deloitte Consulting LLP, Deloitte Financial Advisory Services LLP, Deloitte Tax LLP and their subsidiaries), and not by Deloitte Touche USA LLP
Integrity [2005-10-11]
You're so right!! outsourcing is really a dangerous business because it isn't about quality of patient care; it's all about money. I have been a medical Transcriptionist for 29 years and I have seen this profession devolve to that of a factory worker on a production line. Not that there's anything wrong with working in a factory, but we have a much more grave responsibility upon us because what we put in a report, if incorrect, can potentially cause harm or even death to a patient. This fact alone motivates me to give meticulous attention to make sure I get it right, even if it takes long periods of listening and re-listening and lots of research to do so. We need to stop and think, if this were my mother, my father, my loved one, or myself, would I want someone to be racing through the process of transcribing a history and physical, consultation, operative report, or any other medical report to see how many lines can be produced for the day?? If this is what we've devolved into, then it's time for me to get out of this profession because I refuse to be driven by how many lines per hour I can transcribe versus the quality and accuracy of what I transcribe.
There are so few who really understand, especially in management, what being a really good medical transcriptionist entails. Transcribing medical dictation and doing it accurately requires a tremendous amount of knowledge, skill, and research, as well as paying attention to the smallest of details in order to prevent harm to patients. I fear we're headed in a very dangerous direction. The fact that an organization like AAMT ascribes to this line-count/productivity mentality baffles me. Patients' health and lives should be our top priority and we should be so very careful not to misinterpret what a doctor is dictating. This often involves a lot of painstaking effort, but it's worth the time it takes to get it right.
MedQuist Moving to Centralized, National Service Delivery Model [2005-10-11]
MedQuist Moving to Centralized, National Service Delivery Model
10/10/2005 9:00:00 AM EST
Shift Will Streamline Operations, Drive Improved Service Standards and Technology
MedQuist Inc. (Pink Sheets: MEDQ.PK) today announced that management, in accordance with direction received from the company's board of directors, adopted a plan on October 6, 2005 to centralize and streamline the company's organizational and operational structure to better serve its customers. The plan is expected to improve operating performance and increase customer satisfaction.
The move toward a new structure and delivery model will be supported by the following actions:
-- Medquist will shift resources to a single national service delivery and support organization for all of the company's services and products, eliminating local service centers. This new centrally managed structure will enhance workflow management, with the result being dramatically improved levels of service and quality for our customers. The company expects this transition to result in the consolidation of approximately forty facilities over the next twelve months.
-- In conjunction with the shift to centralized customer service delivery, the company's national service delivery and support organization will, in the fourth quarter of this year, begin to implement its Qtinuum of Care initiative. The Qtinuum of Care initiative is focused specifically on driving increased levels of customer satisfaction through a new centralized and integrated customer service and support model.
-- To drive greater customer focus, the company's product management group will be moving under the direction of the Chief Technology Officer. Additionally, new products in the area of voice capture, speech recognition and on-premise transcription solutions will be introduced within the next twelve months.
-- The company's Sales and Marketing organizations will be combined, which will improve communication between MedQuist's direct sales group and its marketing support organization. As a result of this combination, the Senior Vice President - Marketing and Business Development and the Senior Vice President - Sales have separated from the company. MedQuist is currently engaged in the process of selecting the combined organization's leadership.
The company anticipates that all of the foregoing actions will be complete by the end of the third quarter of 2006, and that it will record restructuring charges in the range of $6.5 million to $8.5 million pre-tax, largely representing facility exit costs and employee severance payments. As a result of the plan, the company also expects to realize annualized savings of approximately $18.5 million.
About MedQuist:
MedQuist, a member of the Philips Group of Companies, is a leading provider of electronic medical transcription, health information and document management products and services. MedQuist provides document workflow management, digital dictation, speech recognition, mobile dictation devices, Web-based transcription, electronic signature, medical coding products and outsourcing services.
Safe Harbor Statement under the U.S. Private Securities Litigation Reform Act of 1995: Some of the statements in this Press Release constitute forward-looking statements within the meaning of the U.S. Private Securities Litigation Reform Act of 1995 including, but not limited to, statements relating to the Company's expected results of operations and financial condition, scheduled actions under plan to improve the company's organizational and operational structure, restructuring charges expected to be recorded in connection with the plan, expected cost benefits resulting from the plan, expected reductions in location, and consolidation and reorganization of technologies and business units. These statements are not historical facts but rather are based on the Company's current expectations, estimates and projections regarding the Company's business, operations and other factors relating thereto. Words such as may, will, could, would, should, anticipate, predict, potential, continue, expects, intends, plans, projects, believes, estimates and similar expressions are used to identify these forward-looking statements. These statements are only predictions and as such are not guarantees of future performance and involve risks, uncertainties and assumptions that are difficult to predict. As a result, these statements speak only as of the date they were made, and the Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise. The Company's actual results may differ from the forward-looking statements for many reasons, including unanticipated expenditures in connection with the effectuation of the plan to improve the company's organizational and operational structure; unanticipated difficulties in connection with reductions in location, or the consolidation and reorganization of technologies and business units; customer reaction to the plan; any direct or indirect impact of the matters disclosed in the Form 12b-25 filed by the Company on August 19, 2005 on the Company's operating results or financial condition; any continuation of pricing pressures and declining billing rates; difficulties relating to the implementation of management changes throughout the Company; and the outcome of pending and future legal and regulatory proceedings and investigations.
Spheris Hiring more workers in India [2005-10-11]
Spheris says it is hiring more workers in India Media Release Oct. 6, 2005
An American company that transcribes doctors notes said Wednesday it is setting up a transcription center in the southern Indian city of Coimbatore, making it the latest U.S. company to expand outside India's traditional outsourcing hubs.
Spheris Inc. of Franklin, Tennessee, has already hired 300 people for its new center in Coimbatore, in India's southern Tamil Nadu state, and plans to add another 700 workers in the next year, the company's president and chief executive, Steven E. Simpson, told reporters.
Workers at the Coimbatore office transcribe taped dictation of U.S. doctors'' diagnosis and advice for patients, saving the physicians time and allowing them to treat more people.
Spheris already employs 2,000 people doing the same work in the southern city of Bangalore _ one of the hubs of India's outsourcing business _ but decided to expand to Coimbatore because of the city's large untapped pool of skilled workers, he said.
The city has a strong foundation in education and is inexpensive, he said of Coimbatore, a city of one million people 360 kilometers (224 miles) south of Bangalore.
Western firms have sought to cut costs by farming out software development, engineering design and routine office work to India.
But the influx of Western firms has led to labor shortages and rising wages in larger cities that have become centers for the outsourcing business, such as Bangalore and Hyderabad.
In contrast, wages in smaller cities have not risen nearly as fast and are now about 30 percent lower than in traditional outsourcing hubs.
Among the companies that have chosen to set up operations lesser-known Indian cities are Honeywell International Inc., which has an office in the southern city of Madurai, and IBM Corp., which has built a facility in the western city of Calcutta.
MedQuist Shareholder Derivative Suit Dismissed [2005-10-05]
MedQuist Shareholder Derivative Suit Dismissed
10/4/2005 8:44:00 AM EST
MedQuist Inc. (Pink Sheets: MEDQ.PK) today announced the dismissal with prejudice of a shareholder derivative action filed in U.S. District Court in New Jersey. The suit, Rhoda Kanter (Plaintiff) v. Hans M. Barella et al. (Defendants), was filed November 12, 2004 against Koninklijke Philips Electronic N.V. (Philips) and ten current and former members of MedQuist's Board of Directors. Medquist was named as a nominal defendant.
In a ruling dated September 21, 2005, the Court, the Honorable Jerome B. Simandle presiding, found Plaintiff's allegations that MedQuist's Board members breached their fiduciary duties to the Company to be insufficient. The Plaintiff had alleged that for a period from 2001 through 2004, the Defendants violated their fiduciary duties by permitting artificial inflation of billing figures; failing to adequately ensure accurate and lawful billing practices; and failing to accurately report the Company's true financial condition in its published financial statements. To the contrary, the Court concluded: Far from alleging facts supporting a substantial likelihood of liability, Plaintiff here has painted a picture of a board of directors that acted responsively given the circumstances....
Howard S. Hoffmann, MedQuist CEO, was confident of the outcome. It is the right decision, and certainly supports the actions of MedQuist's Directors in fulfilling their responsibilities to the Company.
About MedQuist:
MedQuist, a member of the Philips Group of Companies, is a leading provider of electronic medical transcription, health information and document management products and services. MedQuist provides document workflow management, digital dictation, speech recognition, mobile dictation devices, Web-based transcription, electronic signature, medical coding products and outsourcing services.
Safe Harbor Statement under the U.S. Private Securities Litigation Reform Act of 1995: Statements in this press release regarding MedQuist's business which are not historical facts are forward-looking statements that involve risks and uncertainties. Such risks and uncertainties, which could cause actual results to differ from those contained in forward-looking statements include, but are not limited to: (1) our ability to recruit and retain qualified transcriptionists and other employees; (2) the impact of new services or products on the demand for our existing services; (3) our current dependence on medical transcription for substantially all of our business; (4) our ability to expand our customer base; (5) changes in law, including, without limitation, the impact the Health Information Portability and Accountability Act (HIPAA) will have on our business; (6) infringement on the proprietary rights of others; (7) risks inherent in diversifying into other businesses; (8) any continuation of pricing pressures and declining billing rates; (9) difficulties relating to the implementation of management changes throughout the Company; (10) the outcome of pending and future legal and regulatory proceedings and investigations; and (11) any direct or indirect impact of the matters disclosed in the Form 12b-25 filed by the Company on August 19, 2005. Actual outcomes and results may differ materially from what is expressed or forecasted in forward-looking statements. As a result, forward-looking statements speak only as of the date they were made, and the Company undertakes no obligation to publicly update or revise any forward-looking statements, whether as a result of new information, future events or otherwise.
in-house transcriptionist [2005-09-26]
I am a tranacriptionist with 30+ years experience in almost all areas of acute, care, oncology/hematology, neurology/neuropsychology/neurodiagnostics/ pediatrics, etc.
I wish there were more doctors like you with your feelings toward outsourcing, perhaps then I wouldn't be unemployed!! Thank you!!!
MedQuist Relief for Katrina Victims [2005-09-15]
MOUNT LAUREL, N.J., Sept. 14 /PRNewswire-FirstCall/ -- Today, MedQuistInc. (Pink Sheets: MEDQ), with nearly 10,000 people spread across the UnitedStates, announced the immediate actions that the company took in response tothe aftermath of Hurricane Katrina, including aid from the company to itspeople in the areas hardest hit by the hurricane. The Company's firstpriority in the days after the storm was to identify the Medquist employeesand statutory workers who were in Katrina's path, determine their status andset aside funds to provide financial assistance to those who lost their homes.We have been concentrating first on finding our people - many of whom workfrom home - to provide them with personal financial assistance if they havelost their home, and, if necessary, with new computers to help them return towork from wherever they are staying, says Frank W. Lavelle, MedQuist'spresident. Company employees and statutory workers who have been affected byHurricane Katrina are encouraged to contact MedQuist's toll-free technicalsupport line, 1-800-DICTATE. We're encouraging everyone in the MedQuist family who has been affectedby Katrina to call in, even if they have already been in touch with someonefrom the company, says Lavelle. And we want them to keep us updated ontheir location if they move again in the next few weeks. In addition,MedQuist's clients who need any kind of assistance due to damage from Katrinashould call MedQuist's toll-free technical support line for clients,1-888-DICTATE. Ensuring that our clients have the ability to continue toprovide medical care is of the highest priority to everyone at MedQuist, addsLavelle. In addition to providing personal financial assistance to MedQuist'semployees and statutory workers who have lost their homes to the storm,MedQuist has also made a donation of $20,000 to the American Red Cross forHurricane Katrina disaster relief. The company is committed to matching thedonations of its employees and statutory workers as well, up to an additional$30,000. Since the storm, MedQuist people have been calling and asking what theycan do to help, says Lavelle. They have offered everything from places forpeople to stay to giving some of their paid time off to our employees who areout of work because of Katrina. In response to that generosity, MedQuist hasset up a bank for paid time off hours so that employees can donate time thatwill be used for other employees who have been victims of the storm. Theoutpouring of offers doesn't surprise me a bit, adds Lavelle. We arefortunate at MedQuist that we have such wonderful caring people affiliatedwith the company who have been looking for ways to help each other and othersin the region affected by Hurricane Katrina. MedQuist, a member of the Philips Group of Companies, is a leadingprovider of electronic medical transcription, health information and documentmanagement products and services. MedQuist provides document workflowmanagement, digital dictation, speech recognition, mobile dictation devices,Web-based transcription, electronic signature, medical coding products andoutsourcing services. Safe Harbor Statement under the Private Securities Litigation Reform Actof 1995: Statements in this press release regarding MedQuist's business whichare not historical facts are forward-looking statements that involve risksand uncertainties. For a discussion of such risks and uncertainties, whichcould cause actual results to differ from those contained in the forward-looking statements, see Risk Factors in the Company's Annual Report or Form10-K for the fiscal year ending December 31, 2002.
Outsourcing as a crutch to ESL dictators [2005-09-11]
The most probable reason for the boom in outsourcing is that the accent-ridden medical doctors who have the privilege of working in this country and providing a comfortable life for themselves and their families is that the ESL docs simply are unable or unwilling to lose their accent and adjust themselves appropriately to the United States. It's much easier for them to outsource to their home countries because they are more easily understood and/or they can dictate in their native language. The language barrier not something that is worth understanding and/or support. To me, it's a symptom of laziness and very unprofessional. The language barrier is a problem for PATIENTS of ESL doctors as well. Bush should be well advised of yet another source that is stealing US jobs and/or undermining the MT industry.
Years ago, I was a temp for a major publisher of medical books. They had outsourced the duty of scanning in line art for their books at a reduced rate from labor in India. In return, the scanned images were returned, and we were in charge of cleaning up the images using PhotoShop. What's the point in having them do this job for pennies on the dollar when we had to turn around and clean up their work. They didn't even know enough whether to scan it as line art or scan it as a photo = fuzzy images. In all actuality, they didn't save a thing.
Dictaphone Expands ichart Speech-Certified [2005-09-09]
Dictaphone Expands ichart Speech-Certified Transcription Network; Responds to Increasing Demand with Certification Program and Call for Additional Transcription Partners
American Association for Medical Transcription (AAMT)
Annual Convention and ExpoHONOLULU--(BUSINESS WIRE)--Sept. 6, 2005--Today at the American Association for Medical Transcription (AAMT) Annual Convention and Expo, Dictaphone announced the creation of the healthcare industry's first Speech-Certified Transcription Network in response to the substantial growing demand for its ichart(R) Managed Services solutions. ichart Managed Services combines Dictaphone's industry-leading speech recognition technology with transcription services performed by Dictaphone's Speech-Certified Transcription Network, which has been trained to edit on the company's speech recognition platform. This combination of labor and technology delivers lower-cost, high-quality medical transcription with rapid turnaround. All Dictaphone transcription service partners are required to pass its rigorous certification program to ensure even higher levels of service excellence and proficiency in speech recognition editing.
ichart Managed Services is quickly proving what we suspected when we introduced the product less then one year ago: that using speech recognition to drive down the enormous costs and improve the quality of transcription is the future of medical documentation outsourcing, said Don Fallati, senior vice president of marketing for Dictaphone. The overwhelming response we've had from the market is driving us to create the first Speech-Certified Transcription Network, offering our clients the most talented and best-equipped group of 'speech recognition-enabled' transcription service providers.
Speech-Certified Transcription Providers are thoroughly trained, evaluated and benchmarked against specific industry-standard quality, speed and customer service metrics. Those that meet the strict criteria will receive certification and will be reevaluated quarterly to ensure continued adherence.
Tamara Brown, president and CEO of Encompass Medical Transcription, Inc., a member of Dictaphone's Speech-Certified Transcription Network, said, ichart has allowed us to increase the volume of work Encompass can do with our existing staff and enabled us to train new medical transcriptionists to generate high-quality reports at a higher level of productivity. Headquartered in Wisconsin, Encompass is a U.S. medical transcription company that employs only U.S.-based medical transcriptionists.
We welcome and encourage other medical transcription companies to join the Speech-Certified Transcription Network, Fallati said. The interest we've seen from potential partners wanting to participate in the program has been significant and reflects the broad momentum in our industry for acquiring the skills associated with speech recognition.
About Dictaphone's ichart Managed Services
Dictaphone's ichart Managed Services offering aims to meet the needs of organizations currently relying heavily on outsourced transcription but who are attracted to the savings that can be generated by speech recognition. The program blends Dictaphone technology with transcription services performed by Dictaphone's Speech Certified Transcription Network who have been trained to edit on the company's speech recognition platform. Customers receive a blended line rate covering work that is transcribed traditionally as well as documents edited from speech recognition. Frequently, significant savings can be achieved by healthcare organizations over current line charges.
About Dictaphone Healthcare Solutions Group
Dictaphone is the world's largest supplier of dictation, transcription and speech recognition systems and services that simplify and enhance the production and management of paperless electronic patient information. Through the integration of speech recognition and natural language processing within existing health information management workflow, Dictaphone systems are helping healthcare organizations save money and improve patient care by increasing the speed, accuracy and usability of their medical documentation. For more information, please visit www.dictaphone.com or call 1-888-350-4836.
Evergreen+Spheris=India [2005-09-07]
I'm sure everyone noticed in sm's submitted article about India's opportunities for housewives in medical transcription, that one of their work sources is Spheris. Another submit states that Evergreen Hospital is outsourcing to Spheris ---- does Evergreen know their medical records are going to India? Doubt it!!!!
PS. The article about India said Stheris -- it's an error -- wonder how many of these errors show up in transcribed reports. Hmmmm
Court records sent abroad [2005-08-25]
Trial and hearing tapes were farmed out to Hong Kong for transcription, in violation of rule
Marion County judicial officials are investigating what appears to be an unprecedented security breach in which workers in Hong Kong prepared hearing and trial transcripts in a yet-to-be-determined number of cases.
The outsourcing of what is supposed to be an in-house court function has alarmed Indianapolis judges because these records often contain sensitive information and are critical for appellate judges to understand what transpired in courtrooms months or years before.
Local officials have informed the Indiana Supreme Court of the breach, and the court, which enforces rules on the handling of court records, is awaiting information from Marion County.
This is prompting a thorough investigation, said Marion Superior Court Judge Jane Magnus-Stinson, a member of the court's three-person executive committee. We're talking about the record that goes up on appeal. If it's wrong, that's big stuff.
She said no judge is believed to have authorized a court employee or court employees to send official trial tapes offshore.
A spokesman for the Virginia-based National Association of Court Reporters said he was unaware of any U.S. court sending transcription work overseas and that the group has tried to determine whether it's going on.
The best-quality transcript is prepared by someone who was present at the proceeding, said Marshall Jorpeland, the national group's communications director. The best-educated English speaker in Hong Kong isn't going to know street slang unless they've moved there from here.
Other concerns include Social Security numbers appearing in transcripts, as well as the names and addresses of crime victims or their family members and sensitive information about employment or income, Jorpeland said.
Marion County's judicial leaders are trying to figure out how much work was sent overseas in violation of a local court requirement that transcriptions be done in-house by county employees to protect against privacy violations -- including identity theft -- and to ensure accuracy.
At least one court reporter has acknowledged some work on major felony cases was sent to a private firm, said Mark Renner, the Marion Superior Court administrator.
Renner declined to release the name of the court reporter or the judge for whom the reporter works. The employee has not been reprimanded but could face disciplinary action, including a possible dismissal.
Renner said the breach occurred after an experienced court reporter hired an Indianapolis transcription firm, Baynes Shirey, which does business as ClearPoint Legal, to prepare transcripts. That work was then outsourced to Scriptero, a Hong Kong company that has more than 50 clients from all over the world that demand at least 4,000 transcripts a year, according to court officials and the company's Web site.
Neither company responded Tuesday to requests for comment.
No one is accusing either firm of wrongdoing. Renner said he intends to send a letter today to Baynes Shirey asking for a complete list of proceedings the firm has transcribed for Marion County's court system.
On its Internet site, Scriptero says it is often hired to transcribe depositions, which usually are closely reviewed for accuracy by participants, and that it uses only native-language transcriptionists. The Hong Kong firm boasts a 99.75 percent accuracy rate, but that's been of little consolation to local officials.
This assignment of transcripts to anyone other than another Superior Court reporter shall cease immediately unless the Judge of your Court gives you express permission to so assign the responsibility of transcription to some outside entity, Renner wrote in an e-mail sent Friday to court officials.
Renner said a Porter County judge notified Marion County officials of the breach last week after hearing about it from a member of the Indiana Shorthand Reporters Association
An e-mail that was ultimately received by the Judge in Porter County from the company in Hong Kong confirmed that they had in fact been doing work from Marion County, including full transcripts from jury trials, Renner told court officials.
Tina DeBone, president of the Indiana reporters association, said she blew the whistle to court officials but did not name any of the firms involved. She said no Porter County judges were involved.
DeBone said she heard about the violation from a court reporter in Arizona who had been approached by the Hong Kong company. DeBone, a victim of identity theft, said she was worried about sensitive information falling into the hands of terrorists who might use it to enter the United States.
Farming out transcription work is in complete violation of the reporter's contract that each reporter signed, Renner said in his e-mail. These contracts, signed with Marion Superior Court, do not provide for hiring private companies to do transcription work.
MedQuist Announces Preliminary, Partial and Unaudited [2005-08-20]
MT. LAUREL, N.J., Aug. 19 /PRNewswire-FirstCall/ -- Medquist Inc.(Pink Sheets: MEDQ) announced today certain preliminary, partial and unauditedfinancial results. Once the Company completes the financial assessment andreview of its billing practices disclosed in the Company's previous filingswith the SEC, the Company expects that an independent registered publicaccounting firm will review and/or audit the Company's financial statements,as appropriate. While, at this time, the Company cannot estimate the totalcosts of (i) the billing review, (ii) defense of the class action matters,(iii) the SEC investigation, and (iv) compliance with the Department ofJustice investigation, all of which have been previously disclosed in eitherthe Company's filings with the SEC or the Company's press releases, the costsincurred to date by the Company in connection with the foregoing have beenincluded in the results set forth below. Because the completion of thebilling review and resolution of the litigation and governmental investigatorymatters are pending, the Company is not certain whether any changes to theaccounting treatment of any component of its consolidated financial statementswill be required and, if any changes are necessary, whether any such changeswould have a material impact on its consolidated financial statements.Accordingly, the financial information set forth below is preliminary,unaudited, and subject to change based on the completion of the financialassessment and review of the Company's billing practices and the completion ofthe review and/or audit of its financial statements, as appropriate. The information set forth below is derived from the Company's internalbooks and records. The Company cautions investors not to place undue relianceon the information presented below. As a result of the developments describedabove and in the Company's previous SEC filings, the Company's financialstatements have not been audited or reviewed by an independent registeredaccounting firm. The information contained in this press release also has notbeen audited or reviewed by an independent registered accounting firm. Suchinformation is not a substitute for the information required to be reported inthe Company's Forms 10-K and Forms 10-Q that have not yet been filed. Therecan be no assurance that the results of the billing review, and resolution ofthe litigation and governmental investigatory matters will not have a materialadverse effect on the Company's revenue, results of operations and financialcondition. MedQuist Inc. - Preliminary and Unaudited Financial Information (inmillions) Years Ended 12/31/2002 12/31/2003 12/31/2004 Revenue (1) $486 $490 $456 Operating income (1) 71 61 23 Cash (3) 103 162 196 Debt (3) 0.1 0.1 0.1 Quarters Ended 12/31/03 3/31/04 6/30/04 9/30/04 12/31/04 3/31/05 6/30/05 Revenue (2) $121 $118 $114 $113 $112 $108 $106 Operating income (2) 13 13 7 6 (3) (2) (6) Cash (3) 162 180 183 192 196 199 198 Debt (3) 0.1 0.1 0.1 0.1 0.1 0.1 - Notes: (1) Information presented for the twelve months ended (2) Information presented for the three months ended (3) Information presented as of the date Twelve months ended December 31, 2003 Revenues: Preliminary, unaudited results indicate that the Company's revenueincreased from approximately $486 million for the twelve months endedDecember 31, 2002 to approximately $490 million for the comparable 2003period. The increase was largely the result of twelve months of Lanieroperations being reflected in 2003 results as compared to six months of Lanieroperations being reflected in 2002 results, as the acquisition of LanierHealthcare LLC took place on July 1, 2002, largely offset by transcriptionservice volume declines as well as declining pricing from both new andexisting transcription clients. Operating Income: Preliminary, unaudited results indicate that operating income declinedfrom approximately $71 million, for the twelve months ended December 31, 2002to approximately $61 million for the comparable 2003 period. The decline inoperating income is largely the result of transcription service volume andrate declines, partially offset by the result of twelve months of Lanieroperations being reflected in 2003 results as compared to six months of Lanieroperations being reflected in 2002 results, as the acquisition of LanierHealthcare LLC took place on July 1, 2002. Balance Sheet Highlights: At December 31, 2003 the Company had $162 million in cash and cashequivalents. At December 31, 2003, the Company had less than $100 thousand intotal debt. Other than minimal exercises of stock options, there were noadditional issuances of capital stock or other securities for the twelve monthperiod ended December 31, 2003. Twelve months ended December 31, 2004 Revenues: Preliminary, unaudited results indicate that the Company's revenuedecreased from approximately $490 million for the twelve months ended December31, 2003 to approximately $456 million for the comparable 2004 period. Thedecline in revenues includes the impact of decreasing transcription servicevolume from existing and lost clients, partially offset by new clients, aswell as the impact of pricing declines attributable to a competitive pricingenvironment. Additionally, the Company has recognized declines in revenue fromits front-end speech recognition products as it transitioned from TalkStationto SpeechQ for Radiology. Operating Income: Preliminary, unaudited results indicate that operating income declinedfrom approximately $61 million, for the twelve months ended December 31, 2003to approximately $23 million for the comparable 2004 period. The decline inoperating income includes: 1) the impact of approximately $11 million in costsincurred in 2004 related to the ongoing billing investigation and associatedlitigation, 2) approximately $4 million in costs associated with separationand replacement of the Company's management team, including members at theexecutive level and 3) approximately $3 million associated with the write-offof intangible assets associated with products no longer being offered. Inaddition, the base business, as described above in the Revenues section,experienced a decline in transcription service volume from existing and lostclients and a decline in transcription service rates charged to customers.The impact of the revenue decline was partially offset by several cost savinginitiatives including reductions in telecommunications costs, officeconsolidations and associated staff reductions. Balance Sheet Highlights: At December 31, 2004 the Company had $196 million in cash and cashequivalents. At December 31, 2004, the Company had less than $100 thousand intotal debt. Other than minimal exercises of stock options, there were noadditional issuances of capital stock or other securities for the twelve monthperiod ended December 31, 2004. Six Months ended June 30, 2005 Revenues: Preliminary, unaudited results indicate that the Company's revenuedecreased from approximately $232 million for the six months ended June 30,2004 to approximately $213 million for the comparable 2005 period. Thedecline in revenues includes the impact of the result of reductions incontracted transcription service rates from existing clients, further affectedby new transcription business service volume replacing lost transcriptionservice volume at a lower average price. Management expects these pricingpressures to continue and for revenue in the second half of 2005 to declinefrom first half levels. Operating Income: Preliminary, unaudited results indicate that operating income declinedfrom approximately $20 million for the six months ended June 30, 2004 to anoperating loss of approximately $8 million for the comparable 2005 period.Operating income includes 1) approximately $16 million in costs incurred in2005 related to the ongoing billing investigation and associated litigation,which represents an increase of approximately $11 million over similar costsincurred for the comparable time period in 2004 and 2) approximately $3million in costs associated with separation and replacement of the Company'smanagement team, including members at the executive level, which representsand increase of approximately $2 million over similar costs incurred for thecomparable time period in 2004. In addition, the base business, as describedabove in the Revenues section experienced a decline in transcription servicerates charged to customers. The impact of the revenue decline was partiallyoffset by several cost saving initiatives including reductions intelecommunications costs, office consolidations and associated staffreductions. The Company continues to strive for improved profitabilitythrough service and technology enhancement initiatives, along with other costreductions. Three months ended June 30, 2005 Revenues: Preliminary, unaudited results indicate that the Company's revenuedecreased from approximately $114 million for the three months ended June 30,2004 to approximately $106 million for the comparable 2005 period. The declinein revenues includes the impact of the result of reductions in contractedtranscription service rates from existing clients, further affected by newtranscription business service volume replacing lost transcription servicevolume at a lower average price. As noted above, management expects thesepricing pressures to continue and for revenue in the second half of 2005 todecline from first half levels. Operating Income: Preliminary results indicate that operating income declined fromapproximately $7 million for the three months ended June 30, 2004 to anoperating loss of approximately $6 million for the comparable 2005 period.Operating income includes 1) approximately $9.5 million in costs incurred in2005 related to the ongoing billing investigation and associated litigation,which represents an increase of approximately $5.5 million over similar costsincurred for the comparable time period in 2004 and 2) $1 million in costsassociated with separation and replacement of the Company's management team,including members at the executive level. In addition, the base business, asdescribed above in the Revenues section experienced a decline in transcriptionservice rates charged to customers. The impact of the revenue decline waspartially offset by several cost saving initiatives including reductions intelecommunications costs, office consolidations and associated staffreductions. The Company continues to strive for improved profitabilitythrough service and technology enhancement initiatives, along with other costreductions. Balance Sheet Highlights: At June 30, 2005, the Company had $198 million in cash and cashequivalents and no debt. There were no additional issuances of capital stockor other securities for the six month period ended June 30, 2005. About MedQuist: MedQuist, a member of the Philips Group of Companies, is a leadingprovider of electronic medical transcription, health information and documentmanagement products and services. MedQuist provides document workflowmanagement, digital dictation, speech recognition, mobile dictation devices,Web-based transcription, electronic signature, medical coding products andoutsourcing services. Disclosure Regarding Forward-Looking Statements: Some of the statements in this Press Release constitute forward-lookingstatements within the meaning of the U.S. Private Securities LitigationReform Act of 1995. These statements are not historical facts but rather arebased on the Company's current expectations, estimates and projectionsregarding the Company's business, operations and other factors relatingthereto. Words such as may, will, could, would, should,anticipate, predict, potential, continue, expects, intends,plans, projects, believes, estimates and similar expressions are usedto identify these forward-looking statements. The forward-looking statementscontained in this Press Release include, without limitation, statements aboutthe Company's results of operations and financial condition. These statementsare only predictions and as such are not guarantees of future performance andinvolve risks, uncertainties and assumptions that are difficult to predict.Forward-looking statements are based upon assumptions as to future events ofthe Company's future financial performance that may not prove to be accurate.Actual outcomes and results may differ materially from what is expressed orforecast in these forward-looking statements. As a result, these statementsspeak only as of the date they were made, and the Company undertakes noobligation to publicly update or revise any forward-looking statements,whether as a result of new information, future events or otherwise. TheCompany's actual results may differ from the forward-looking statements formany reasons, including any direct or indirect impact of the matters disclosedin the Form 12b-25 filed by the Company on August 19, 2005 on the Company'soperating results or financial condition; any continuation of pricingpressures and declining billing rates; difficulties relating to theimplementation of management changes throughout the Company; and the outcomeof pending and future legal and regulatory proceedings and investigations.
Seventeen employees will lose their jobs [2005-08-17]
2005-08-16by Lori VaroshJournal Reporter
KIRKLAND -- Seventeen employees of Evergreen Hospital Medical Center in Kirkland will lose their jobs, most by Aug. 31, victims of a trend toward outsourcing the work of medical transcriptionists.
Spheris, a Franklin, Tenn.-based contract medical transcription company, will begin today to take over the work of typing doctors' dictation into Eastside patients' records, hospital spokeswoman Amy Gepner confirmed Monday.
The practice is increasingly common among area hospitals. It provides benefits in expertise and cost savings, supporters say. But critics warn that, without careful safeguards, the practice can put patients at risk.
outsourcing has become the area standard, said Caitlin Hillary, spokeswoman for Overlake Hospital Medical Center in Bellevue, which outsourced its transcriptionists in 1999. Such companies have the expertise and the employee base to handle the peaks and valleys of patient loads, she said.
Overlake had been having trouble recruiting transcriptionists before it outsourced those jobs, and the solution has worked well, Hillary said.
Job quality is `inferior'
But others find outsourcing generally ``is inferior to having long-term, loyal staff,'' said Diane Clark, supervisor of transcription services for the UW Medical Center, which outsources about half of its transcription work.
Because they offer lower pay, transcription companies attract people with less experience, Clark said. Those workers have no particular loyalty to the medical center, and no personal investment in the work.
And, because they often work on a per-line basis, ``the faster they type, the more money they make,'' which can result in mistakes, Clark said.
Nor do physicians always review the transcriptions as they should, she added.
If the doctors' notes are not transcribed accurately, ``it could result in patient care issues,'' Clark said. outsourcing can work if the companies routinely sample the work for accuracy and have a second pair of eyes proof-reading the transcription.
Spheris was chosen because of its quality, said Evergreen's Gepner. Physicians at the Kirkland hospital read and sign off on all transcriptions before they go into a patient's medical record, she said.
In an April memo to physicians obtained by the Journal, however, medical staff warned that problems are possible during a transition period to the new system.
``There will be a period of time in which the new dictation service will need to adapt to the phraseology and individual traits of our Evergreen physicians; during that time there will be more blanks and errors, so please pay close attention to your dictation for accuracy,'' the memo said.
The taxpayer-supported hospital expects to save $400,000 a year over its current costs for transcription services, including salaries and benefits, Gepner said. But the move is also being made because existing transcriptionists cannot keep up with the workload without a $500,000 to $750,000 investment in equipment as well as personnel.
``It doesn't make business sense to be significantly increasing the cost,'' Gepner said.
The hospital's administration proposed outsourcing and the hospital district's commissioners approved because it was ``best for patient safety,'' Gepner said.
``What we need to do is get (the information) as fast as we can in the patient record,'' she said. Spheris already is capable of working with the new patient records system Evergreen added two years ago, she said.
The contract with Spheris also requires that no work be sent out of the country and that all 17 Evergreen transcriptionists be offered jobs, Gepner said. ``Three have chosen to go with Spheris,'' she said.
The company has taken out ads in local newspapers seeking more transcriptionists.
Some employees complain, however, that the contractor is simply not offering a living wage. Spheris offered 7.5 cents per line, said one transcriptionist, who asked for anonymity for fear that a ``measly'' severance package would be withdrawn.
An average Spheris worker would make less than two-thirds that of an Evergreen employee, according to the figures the Transcriptionist provided.
Evergreen transcriptionists earn $13.50 to $19.62 per hour, plus a 7-cent per line bonus for more than 938 lines a day. At a consistent day's work of 1,200 lines, the midrange Evergreen employee would earn $150 a day, compared to $90 for the Spheris worker.
``I have to pay a mortgage, pay bills,'' the transcriptionist said. ``I can't live on that kind of wage. ... I'd just be giving my expertise away.''
In a letter to the hospital district's Board of Commissioners in June, transcriptionists complained that they learned by e-mail that their jobs would vanish and that the severance package offered is ``insulting.''
Evergreen didn't want to provide as long a period of extended health care for laid-off workers as the standard set by Overlake and Group Health hospitals, explained Carter Wright, spokesman for SEIU, the health-care workers union.
``Evergreen is not only getting rid of jobs, they're trying to do it on the cheap,'' Wright said.
``There's concern about cutting down errors in hospitals and streamlining medical records,'' he said, ``but it's really important to make sure the information is accurate. Accuracy can literally be a matter of life and death.''
In the June letter, transcriptionists urged commissioners ``to look at the human cost of your actions. We are not only employees of this hospital, we are members of this community, a community that you have sworn to represent.''
The hospital that touts its role as the biggest employer in Kirkland is sending Kirkland jobs elsewhere and dumping employees into the pool of 600,000 state residents without health insurance, a transcriptionist complained.
outsourcing is best for patient safety, Gepner said. ``We're putting patient safety concerns over public relations concerns.''
Lori Varosh can be reached at lori.varosh@kingcountyjournal.com or 425-453-4234.
Losing medical integrity [2005-08-05]
Losing medical integrity
By Pius KamauDenver Post Columnist
Not too long ago, all my local transcriptionist had to do was call me when she couldn't understand something in my medical dictation. Now, I no longer know who transcribes reports of my surgical procedures and physical exams or where they are. I only know that most hospital transcriptions have been outsourced. At times, the resulting inaccuracies are incredible or enormously amusing.
Transcription is only one of many medical fields facing outsourcing, which is rapidly making inroads into American health care. The stability of medicine is being chipped away to satisfy America's Wal-Mart belief that cheaper is better.
While the public prefers not to know how fundamental changes in health-care delivery may be adversely affecting it, real harm to patients has resulted from outsourcing. Recently a lab that processed specimens from across the nation was found to have misinterpreted Pap smear results. In some cases, a pathologist hadn't actually read some slides.
Such labs aren't chosen because they do a better job than local pathologists. Simply put, they're cheaper. Cost-cutting is the new mantra, and shoring up profits the prevailing credo in a world where the quick fix trumps the long-term, universal good.
The net result has been to throw many competent lab techs out of work. Valuable, highly qualified people have forever been lost to the medical world. My former medical transcriptionists were used to my accent, and offered occasional advice on how Americans pronounce certain words. They were replaced by others who find American speech heavily accented and sometimes indecipherable.
Hospitals are not factories; they don't manufacture screwdrivers or light bulbs. Hospitals are small communities, where sundry departments and personnel form a mosaic that fulfills the essential function of the institution: to heal the sick. It's a cohesion that has slowly been dismantled to squeeze out more profits for investors and HMO moguls.
The practice of medicine is unique in that each person in the system plays a vital role. Frequently, we discuss puzzling radiologic images, weird pathological presentations, and brainstorm difficult surgical cases in corridors and lunchrooms.
Unfortunately, there's now a move to outsource imaging technology as well as other forms of testing and therapeutic modalities. Without casting aspersions, I believe many of us wouldn't like to discover that our scans are read in Beijing, Bombay or Manila.
Hospital staff collegiality has suffered irrevocable damage. X-ray, lab technicians and other medical colleagues have been let go or moved away because their expertise was deemed useless.
Change is inevitable. But it should always be geared toward making patient care better and safer, not jeopardized by profit- taking.
It's conceivable that future insurance policies will offer several options: Pay more if you want care in local facilities or pay nothing if your treatment is provided in Mexico, South America or Africa. If you could save a few dollars, would you do the latter?
Looking at this as well as other aspects of our failing system, it's easy to see that the businessmen we have entrusted our health care to will do anything they can to shortchange the public, as long as we let them. The question is: What will it take before we all say enough?
I want my transcriptionist down in my medical records office. I don't want to talk to a radiologist in Bombay or Nairobi about a patient in Denver. I want a pathologist I can interact with on a regular basis. Surely you don't want your surgeon to be located in Guadalajara?
Pius Kamau of Aurora is a thoracic and general surgeon. He was born and raised in Kenya and immigrated to the U.S. in 1971. His column appears on alternate Wednesdays.
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