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Serving Over 20,000 US Medical Transcriptionists

point-of-care mobile devices - that is a bigger threat...

Posted By: MTthink on 2005-09-09
In Reply to: A must read for our profession...any thoughts? - MTthink

another excerpt: 

It is no longer a question of whether medical transcription will survive. The move away from traditional, free-text medical transcription is inevitable, given the improvements in speech recognition technology and natural language processing; the development of standardized templates through HL7’s CDA (clinical document architecture), ASTM schema, and other similar efforts; XML-based communication; and point-of-care mobile devices that will ultimately facilitate real-time documentation. And it is very clear that real-time, point-of-care documentation by the practitioner will replace transcription! This can already be seen in countries outside the United States that are developing direct entry, interactive, structured text documentation without going through all the evolutionary steps from traditional, free text transcription.

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actually, they are boasting better quality care with point-of-service mobile devices...
as they (service providers) will have immediate access to all information on a patient throught a "MedChip" rather than have to wait for, you know, "people" (heaven forbid) to get old records, records which have too much information, etc. The system will eventually be world-wide as well, which that will take years and years, I am sure.

This is also to be used not only by doctors, but nurses, physical therapists, anyone who performs a service on a patient. They will have hand-held devices that do everything, document, code, bill.

I realize that will take years, but you can already see the 'growing pains.' Look at all the complaints about MQ. They are losing work because of the speech recognition. All the good, easy, clear dictation is being switched over. This alone seems to be 'weeding' out quite a few MTs.

There are supposedly over 400,000 MTs in the US.

I understand there is no going back, and technology is moving forward and eliminating jobs just as automation did; but excuse me for having some passion. I love this job.
...and regarding the mobile devices (more information)

Ladies:  Looks like we should be investing in some of these companies...Intel/McKesson on cutting edge, and VOIP companies (we currently use a VOIP phone)...

If we can not make money in transcription, maybe we should invest in its future?

Quote:  "Medical Transcription will change more in the next few years than it has in the last 100."

It is an odd thing, but I actually like typing and will not like it when it is gone. 
In a perfect world, the mobile devices will work perfectly..
It will only take a few big money malpractive suits and lawsuits against hospitals for this standardized text and free text to be proven to be inadequate documentation. Do you honestly believe Joint Commission and insurance companies will relax their standards for health care documentation? I could be very wrong, but I'm not throwing in the towel yet.
I use Verizon mobile and the rule of thumb with mobile broadband is...
Basically, it will work whereever your cell phone will work.  If your too remote, it may not work, but I do know a lot of campgrounds like KOA offer Wifi, which means you should be able to pick up that signal too. You can always call ahead to the campground etc. I use mine going down the road for the most part but every great while going through the mountains I lose reception.  
Point of Care systems

Anyone here had experience with doctors going to Point of Care systems (Pulse)? My doctors are trying this now and I'm wondering if it will be too difficult and time consuming for them. Sure is cutting way back on my work. Thanks. Teri.

Point of Care Systems
It's my own account. They use the Pulse EHR.
Point of Care Program
Hi: I worked for a clinic as the only Transcriptionist with eight full time providers. My clinic opted to go to Point of Care program and I lost my job. I could have stayed working but not as an MT. The "point" of these Point of Care programs is to eliminate the MT job. That was about four years ago. I still hear from friends at the clinic who tell me the docs are not happy with the program, some of them are continually two weeks behind on dictation. It is a lot of extra work for the doctors but they are now stuck with it because of the high cost of investment!! Beware of Point of Care programs. I would go immediately to your supervisor and ask exactly what the plans are and how you as an MT will fit into those plans. It is your job on the line and you have a right to know. Good luck!! Chris
I have children, and paid child care so what is your point?
I am saying this is talked about time after time after time. Now a post saying MTs unskilled, first nonprofessional and now unskilled workers. Talking about wanting to work from home because you want to be a stay at home mother lousy reason to start this job. The post above says it well, you need to concentrate to learn, you have a small baby you need to take care of, something suffers.
Bud of mine is an almost-blind MT. She uses devices, huge print, magnifcation
Always the same threat

I have kept up with all the gossip on MQ on this board.  I have to say that for over a year or so, all I have seen are posts that say basically "just wait until MQ falls, just wait until this or that", when is this gonna happen?  So there are some lawsuits against them.  They are a huge company, many companies actually.  You guys are so funny.  Anytime someone has something good to say about them, you guys get on here and bash, bash, bash.  Not just the company but the MT.  It's old and tired ladies.  Let it go.  MQ isn't going anywhere.  And neither are the whiners that complain about them.  They are gonna stay and work for MQ and continue to complain.  Why?  That's is the kind of people they are.  It doesn't matter who they work for, they will never be happy.  There are other issues out there that really are important, can we talk about them for a change?


EMR threat
I'm interested in hearing anything and everything on this subject, too. Just found out last Friday my office is going to this. Not sure what my position will be when all the dust settles, but I am the sole support for 2 teenagers looking at college, and I am SCARED! My job up until now has been the dream job - work at home, paid nice hourly wage and full benefits. Pretty sure if I am able to stay with the same office it will NOT be at home and I will have to take a wage cut. Bummer, bummer, bummer!!!
VR real threat
It is my opinion that VR is a huge threat. More and more accounts are being added to VR, as well as more and more MTs are picking up VR either by choice or by force (as in no other account available). It is my experience that the MDs who are good for straight transcribing are also good on VR, but of course the flip side is those who are bad for straight are also bad on VR. VR is a killer for fast keyboarders who are pulling in good hourly wages doing straight transcription. VR does go a little faster, but there is really a lot to correct. Also, you are pretty much losing the advantage of your word Expander as well as any macros you might be able to create for use in straight transcription. If it paid more, it might be more readily accepted by MTs, but the pay is only half or less per line, and it is really hard to double your productive line count with VR and still pass QA requirements (which are the same regardless). I do not see there being less VR in the future as it is the same bottom line. Money. Same amout of work for half or less the money. The hospitals probably get some break in cost to be competitive, the MTSO makes a huge profit, and the MTs make less. If it were not for my age, I would definitely be trying to get into some other line of work. I like what I do and have over the years felt it was important and worthwhile, but it is getting harder and harder to justify the time, skill, study, intelligence, and personal financial overhead of working from home it takes to do this job.
VR a real threat?
I keep noticing people posting that they were laid off or changed jobs because their company switched to VR. Does anyone think this a real threat in the future or is it so under-developed that it isn't really a threat? Opinions?
Not a threat. VR is idiocy, and a way to cut MTs pay.
Every time I do VR, I see how awful it is, and I am supposedly on one of the most intelligent platforms. Every time I edit this stuff, I laugh how awful it is. Being OCD as well I can't help but get annoyed at even the smallest things it cannot do with style, grammar, formatting, aside from the poor mistakes it makes in very important medical matters.
I performed a calculation which I am sure you already know. If you edit 1:2 which is about how fast a fast person can type, then you edit as fast as you type. That is what I do. However, you get paid a little more than half per line editing or less than half. Do the math. It is a way to cut the fastest MT's pay 40 percent. This calculates to the old way of not paying for spaces. This calculates to the old way of not paying for expanders, etc. So, in the end VR is JOB SECURITY for the MT because it cannot do our job. VR NEEDS US. It always will. And of course VR cannot do the difficult ESLs so those like me who do straight typing 2:1 on the ESLs get paid what they should. Top dollar, if paid the correct line rate with benefits.
What do I project? People who are the fastest and best with lots of years' experience will get paid 40% less the most doing VR at 500 lines an hour. And those who are normal doing 4:1, or 3:1 or those learning will be poverty-stricken. But that is a large amount of people. If you REFUSE to take that kind of pay, supply and demand, India or no India, either companies will abandon VR because they NEED US or they will go back to straight typing. I tell you. If my day were more than 25% VR and 75% editing, I could do better at 7.5 c a line straight typing (and I can do prn work for that anywhere) than being fast on VR.
Remember. THEY NEED US. If we take it and take the cut in pay and do great at VR it is still a 40% pay cut for the fastest out there. If you fall into that bunch or less, then it won't work. The hospitals will go back to higher pay for those who can do straight MT. They will come back from India for poor quality, they will come back to straight typing or pay editors the same or MORE and either way we will win. It may take some time but every time you do your VR remember it is JOB SECURITY because it cannot fail. Thanks for reading this long post. I am in the biz over 28 years and I have thought about it a loong loong time. The sick people won't go away and the lawsuits won't either. So, things will turn around. Just be patient and watch.
Yes, and also what did HE do about the growing threat of islamofascism?
It also reduces threat of a virus infecting
For the person who thinks Codex is no threat. I advise you read

July 11, 2005

Henry Lamb- A Great Freedom Fighter Documents how your Dietary Supplements are Under Attack

Mr. Speaker, I urge my colleagues to read "Your dietary supplements: Under attack again" by Henry Lamb, which I am inserting into the record. Mr. Lamb explains the threat to American consumers of dietary supplements and American sovereignty by the Codex Alimentarius commission, commonly referred to simply as Codex. The United Nations created Codex to establish international standards for foods and medicines. Just last week, representatives of the United States government agreed to a final version of Codex's standards on dietary supplements which, if implemented in the United States, could drastically reduce Americans' ability to obtain the supplements of their choice. Members of the American bureaucracy may be hoping to achieve via international fiat what they cannot achieve through the domestic law-making process--the power to restrict consumers' access to dietary supplements. American bureaucrats may gain this power if the World Trade Organization, which considers Codex "guidelines" the standard by which all other regulations are judged, decides that our failure to "harmonize" our regulations of dietary supplements to meet Codex's recommendations violates international trading standards! This could occur despite the fact that American consumers do not want to be subjected to the restrictive regulations common in other parts of the world, such as the European Union.

This article is typical of Henry Lamb's work. For almost twenty years, beginning at an age when most Americans are contemplating retirement, Mr. Lamb has worked to expose and stop threats to American liberty, sovereignty, and prosperity. Mr. Lamb became involved in the battle for liberty when, as the CEO of a Tennessee construction company, he founded a state association of contractors to work against excessive regulations. In 1988, Henry Lamb founded the Environmental Conservation Organization to defend true environmentalism, which is rooted in the truth that there is no better steward of the environment than a private property owner, from those who used the environment as a cover for their radical statist agendas. Since 1992, Mr. Lamb and ECO have focused on the threat to economic liberty and self-government posed by the radical global environmental agenda.

Henry Lamb works to further the cause of liberty by giving speeches around the country, editing an on-line magazine, making numerous television and radio appearances, and writing a weekly column to inform his fellow Americans of the latest scheme to undermine their freedoms. Mr. Lamb is the model of a citizen-activist, and all who wish to become involved in the battle for freedom can learn from his example. In conclusion, I once again urge my colleagues to read Mr. Lamb's article to learn about the need to protect American consumers from Codex, and I thank Mr. Lamb for his tireless devotion to the cause of freedom.


(By Henry Lamb)

The Codex Alimentarius Commission sounds like one of those shadowy, sinister organizations conjured up by one-world-government nuts to scare people.

Truth: It is!

The Food and Agriculture Organization and the World Health Organization created this commission in the early 1960s to set standards for food safety and to ``harmonize'' the laws of member nations. The commission was endorsed by U.N. Resolution 39/248, which says:

``When formulating national policies and plans with regard to food, governments should take into account the need of all consumers for food security and should support and, as far as possible, adopt standards from the ..... Codex Alimentarius. .....''

The Codex Alimentarius Commission consists of delegates from 163 member nations representing 97 percent of the world's population. It meets every two years, either in Rome or Geneva. Between meetings, the commission is governed by an executive committee that directs the activities of its many committees.

Of immediate concern is the ongoing effort to bring dietary supplements in America under the control of standards set by this commission. Dietary supplements generate a $17 billion industry in the United States, which affects more than 150 million consumers, according to Congressional findings (H.R. 2485). Proposed procedures and standards could virtually destroy this market and deprive millions of Americans of the supplements they want to use.

The European Union Directive on Dietary Supplements, which becomes law in August, severely restricts the types and quantities of supplements that may be legally sold. Most forms of vitamins C and E, for example, are not available, or are available only in extremely small doses. If current plans proceed on course, American consumers are in for a shock.

How can this little-known international commission control what consumers buy in the United States?

An even less-known agency, deep within the bowels of the U.S. Department of Agriculture is responsible for U.S. participation in the Codex Commission and designates delegates to each of the commission's committees. Barbara O. Schneeman is the delegate to the Codex Committee on Nutrition and Food for Special Dietary Uses.

The effort to regulate dietary supplements has been under way for more than a decade. In 1994, Congress adopted the Dietary Supplement Health and Education Act, which kept supplements beyond the reach of the drug police. In the past, Codex recommendations have been non-binding. Now, however, the Codex Alimentarius Commission is teaming up with the World Trade Organization to bring international enforcement to the dietary-supplement battle.

Ironically, it was primarily the U.S. that brought the WTO into existence in 1994, as the successor to GATT, the General Agreement on Tarriffs and Trade. The WTO agreement specifically requires that the member nations--including the U.S.--conform its laws to meet the requirements of WTO decisions. Failure to conform results in stiff financial penalties. The Codex Commission and the European Union want the WTO to enforce Codex standards, which fly directly in the face of the Dietary Supplement Health and Education Act.

Pascal Lamy of France was just selected as director general of the WTO. Lamy served as a member of the French Socialist Party's steering committee and was chief of staff and representative of the European Commission for President Jacques Delors. Since 1995, he has served as a member of the Central Office of the Mouvement Européen (France) and as a member of the European Commission, responsible for trade.

The Codex Commission will be meeting in Rome July 4-9 to adopt the final rules on dietary supplement use. Dr. Carolyn Dean, president of Friends of Freedom International, will attend this meeting and return to the U.S. just in time to present her report to the Sixth Annual Freedom 21 Conference in Reno, July 14-16.

The Codex Alimentarius Commission's reach is much broader than dietary supplements. Its committees are also working on standards for pesticide residue, labeling of all kinds of foods, food additives and nutrients, veterinary medicine and drugs, as well as standards and methods for analysis. The function of this organization is to establish standards for all food worldwide and to enforce those standards through the power of the World Trade Organization.

Few people know that there is such a thing as the Codex Alimentarius Commission. It was created to promote food safety in international trade. It is on the brink of becoming an Orwellian bureaucracy--far worse than the worst fantasies of the one-world conspiracy theories.

The Codex Alimentarius Commission is neither fantasy nor theory; it is real.



Bigger isn't always better!
I know that one small private online service does nothing but the Mayo Clinic. It's a very nice little company who does quality work.
10-15% seems low, they like bigger
At Acusis, competitive pay means competitive with third world countries.  Company is for all intents and purposes an India company.  Start looking before the mass exodus.
I just want to be mobile

I just want to be able to move around the house with a laptop, which I am still looking for a good deal on.  I am looking for a 17 inch screen.  What is your laptop?  Give me the specs please.



I have used ATT and with the $60 package you have unlimited use...It worked good for me.
I didn't apply, so that's a moot point. The point I was making is that
she's ranting here about something that doesn't even pertain to most of us. You can't come to a MT message board railing at MTs without getting a response. That's why it's not called MTSOstars. Also, it's unprofessional of a business owner to let her emotions overrule her common sense. As for the newbies, they'll learn. We were all newbies at one time or another. None of us was born perfect, not even the MTSO.
You missed my point. My point wasn't perks but prestige...nm
The point wasn't that it was copyrighted. The point the poster tried to make
Oh, boy, yep, you got bigger problems than me...
Isn't life grand? Sorry I can't offer any advice but to hang in there and do what's best for you. I don't know you, of course, but *hugs*.
Bigger puzzles?
Have you seen the books with the huge grafts? I have not tried these yet.
I see a bigger picture there than you do - sm
I see the state of US healthcare as a whole, which is going steadily downhill. It's a complicated mess and will take a lot of scrutinizing and picking apart to have any hope of cleaning up some of its dirtier secrets. Taking surveys in various sectors of that industry (especially in MT, a sector that for the most part is totally swept under the rug and ignored) is at least a step in the right direction. Not being interested in taking a survey is a personal decision, and if you feel threatened by it, then by all means steer clear if it makes you feel better. But your all-out attack on the idea, which seems to center around a PayPal button, seems skewed somehow, and makes me think you are MORE threatened by the thought that our profession's dirty laundry just might get aired.
Mobile Infirmary sm
Beth, where would you be moving from?  I did hear today that Mobile Infirmary bought Knollwood which is also a hospital in the Mobile area.  I don't know anything about working there, though.  I just accepted a position at Providence Hospital in Mobile and started today.
Mobile transcription
I am really just fishing here. I don't start this itinerate life until February, so I am hoping to here from more people who are out there on the road earning a living.
Mobile Transcription

Interesting question!  I own a small MTSO that is essentially a family business.  My Dad is retired, but does sales and bookkeeping for me.  My Mom is retiring August 1st, and she is planning on getting back into transcription, working for me.  They own a big RV and are planning on being "snowbirds" - living in Arizona for at least 3 months of the year.  The place they are going to is a big RV community which has WiFi internet, so they can both work remotely. I am also an avid camper, so we've been looking into remote internet options.

We explored the different satellite options, but it was very expensive initially for the equipment and the setup at each stop seemed kind of complicated.  The other problem was the upload/download speed - I can see why many services won't hire someone with satellite service.  We ended up going with Verizon Broadband access - anywhere I can get a cell phone signal I can get internet.  The speed isn't the greatest, but it works for us.

What I've found is if you work for a company that requires you to be logged on to the internet the whole time you are working, this option won't really work because of the connection speed.  However, we use a product called DocShuttle by Bytescribe that allows my staff to download the audio and disconnect, type the reports, and then connect and upload the documents.  It works great for that - I even have an employee who lives in the country where there is only dial-up available, and she works just fine like this.

It can be done - I've worked while camping several times this way.....

Mobile transcription
I have just heard from one person so far, and she just did this for about 6 months. I will keep in touch.

Mobile transcription
I'm a fairly new MT, and my husband and I are going to start living in our RV and traveling around the country moving about every 3 months. Is there anyone out there doing something similar? I'd love to hear from you.
Mobile homes are many here in NC, and
they are not a good deal, IMO. Every tornado heads straight for them like they are magnetized, and they seem to burn down a lot. Now I had a townhouse that I lived in for 11 years, and I made quite a nice profit due to the fact they were attractive, had a bit of land and nice landscaping, and were in a good location. I think I paid $85,000, and sold it for $119,000 11 years later. Not bad for a townhouse.
I am mobile with a laptop and use a....sm
Microsoft Elite keyboard. Many years ago I started transcribing with my keyboard in my lap. This has served me very well and is the only way I work now, even at home at my desk. Ergononically, it is great with no stress on arms, neck etc. Just be sure you have the computer at the right height. Sometimes I have to put a few books under my laptop depending on the height of the chair I am sitting in. I love being mobile!
Mobile internet
I need to go mobile with my laptop so I can work away from home.  Anybody else out there who does this?  Any suggestions.  Good carriers?  Any advice greatly appreciated.  Thanks. 
Okay, I decided to try mobile

wireless internet through Verizon.  I currently have a Verizon cell and have no problem with reception in my home, so I'm hoping this is a go.  I also have a 30-day trial period, so I'll know for sure if I have any glitches. 

What I don't understand is this lingo about voice files, etc.  I'm on the Bayscribe platform, so any info would be greatly appreciated.  Please "dumb it down" for me, as I am not a PC person.  The lady that signed me up told me that the limit is 5 GB and that that generally means about 35,000 web pages a month.  How does this correlate to voice files?  Do I even use voice files on Bayscribe?  I'm assuming so since I have an audio player. 

At least I know if this doesn't work out, I can cancel and not lose anything.  Then I'll have to sign up for satellite, which is about $300 upfront and $60 to $90 per month for service.  I'm keeping my fingers crossed that Verizon will work for me.

Thanks for any info.

That's nice, but they have a bigger problem SM
with the fact that their own employees take the information home on laptops....per the letter I received last week from the VA notifying me that my information had been stolen from someone's car...
Bigger concern is your husband!!
Aside from the fact that your husband's friend is a jerk, what is your husband saying about the fact that he will not give you this female's phone # so you can call her back and let her hear a piece of reality here!! It's as if your hubby is saying this is a game here and it's "okay". Does the fact that this lady called him give him some kind of a charge, a little excitement for him? I would question his ethics first, after all, if he's willing to keep this number from you, what else would he think is none of your business? Sorry, but that's the bigger problem.
the Az Humane Socity said 2 lbs or bigger
BTW, the bigger issue made of my...sm
smoking....   the more I smoke.  That happens to be true of lots of smokers.  So, don't bug her about it.  She's more likely to do it on her own if you drop it.
Women now are into the bigger crimes
so a woman does not gain entrance into my house. Your daughters are really old enough to know better. I had 2 women come here 1 day, raining outside and they were shivering and wanted entrance and I said NO. I know anyone can get in if they want but no sense in making it easier for them. I saw a police chase yesterday (thought coming from Calif as ones that happen here usually when it is over) but live and the people got out and ran- husband is saying is that not a female? It was and she along with a male trying to escape. I had someone in uniform (who most people trust) show up 1 day asking to use my phone- no way Jose, told them give me a # and I will call for you. I am very, very aware of all around me and no one enters my house through the garage or front door (while I am home, of course) without my letting them in. Rural versus city no different. Crime happens everywhere.
LOL! I've already had to buy a bigger monitor
my problem is that my keyboard shelf only allows space for the keyboard and I love this desk -  is a corner desk - now with more constant use of mouse my shoulder aches because it is higher- I have to figure out how to make space for the mouse - any suggestions?  Need a man to jigsaw me an extension, I guess.
You will have bigger worries than us sitting in
The bigger the better. Flat screen.
If you are wanting to make it bigger, but
not affect the final report, look on your tool bar and there should be a box that has a number/percentage in it. Mine says 100%. You can increase it there so it is bigger on the screen, but does not change the "font" of the report. This is in MS Word.
MS Word....anyone know how to get the text to appear bigger
Help if you can! Thanks!
That's not my point. My point is previous owner hired
Mobile Infirmary Medical Ctr
Have applied for a full-time MT job at Mobile (AL) Infirmary Medical Center.  Has anyone experience working for them?  I would appreciate any information, as this would involve a move for me.  Thanks in advance--
Mobile Infirmary Hospital
I don't know much about Medical Records except that they have a BIG turnover. Always hiring. Say a little a prayer before you except, it may be that it works out great for you.
Mobile home buying

Shop around for repossessed homes. I have a double-wide Palm Harbor that we picked up for about 60% of book. Yes, they do depreciate like cars, and some brands hold value better than others. Palm Harbor and Patriot seem to have the slowest depreciation rate, and do have pretty good records for storm survival (always remember, they have earned the term Tornado Bait honestly!)  Our home was barely lived in, with very little evidence of wear, and a great price.  Try to look for a repo-only lot - they are usually run directly by the mortgage company and if you have good credit, a good deal can be made, especially if they have had the home back for a while. They can also show you homes alreay set up in parks, or on lots of 1/2 to 1 acre or even more, and if you like the location, won't even have to wait for moving and set-up. Make sure they are able to demonstrate that the heat and air work properly, even if they are lot-set in a temporary sales lot. Don't know about AZ, but in Texas they do have to have certain warranties for roofs, appliances, etc. for at least 90 days.  New home dealerships often have some repos, but they are usually dogs to make you want the new ones.  Shop around, take as much time as possible (we stayed in contact with the repo dealer we brought from for about a year, and he called when he got in what he knew we were looking for) and you can find a deal, especially if you have great credit. We are way more happy with the mobile home we bought when we remember how little we gave for it. Stay away from Fleetwood, Shulte and SOUTHERN ENERGY (run-don't walk-away), unless they just give you one, then be prepared for problems anyway.  I am running on, aren't I? I just wish someone had steered me this direction in the first place.   21st Century Mortgage Company is a good lender for mobile homes. There are not many companies out there who still do trailers, but you can find them if you look. Hope this helps. Contact me if you want more info. 

My advice if you do buy your own is to get a laptop so you can be mobile. nm