AHDI Lounge

Call For AHDI National Leadership Board Candidates

2012-02-10T16:14:00.000-05:00

The AHDI National Leadership Board will have three At-Large Director positions open for 2012, with term of office beginning September 1, 2012. Here's your chance to make a difference! Outlined below is the timeline for nominations and elections (dates may be subject to change):

Mid-February - Friday, April 6, 2012: Call for candidates
Monday, April 9, 2012: Candidacy packets DUE
April 9 - April 13, 2012: Candidate interviews and selection process
Week of April 16, 2012: Final ballot announced/campaigning begins
May 2012 (date TBD): Candidate debate webinars
Monday, June 4, 2012: POLLS OPEN
Monday, June 18, 2012: POLLS CLOSE
End of June 2012: New directors announced

For more information on the requirements for National Leadership Board candidates, please visit http://www.ahdionline.org/GetConnected/Leadership/AHDIBoardofDirectors/NationalLeadershipBoardCandidacy/tabid/197/Default.aspx.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Director, District 1
AHDI National Leadership Board
jay.ahdi.district1@gmail.com

Stay Informed With AHDI National Leadership Board Meeting Summaries

2012-02-10T10:58:00.004-05:00

The AHDI National Leadership Board has made a commitment to keeping our members informed about the issues discussed and decisions made at our meetings. Now there's a handy place where you can download summaries of past NLB meetings:

http://www.ahdionline.org/GetConnected/Leadership/AHDIBoardofDirectors/NationalLeadershipBoardCandidacy/AHDIBoardofDirectorsMeetingHighlights/tabid/296/Default.aspx

This page is only available to AHDI members, so you will be asked for your member ID and password.

I hope you'll take a few moments to look over these summaries to stay up to date on the activities of your elected AHDI representatives.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Director, District 1
AHDI National Leadership Board
jay.ahdi.district1@gmail.com

Creating The Future

2012-02-02T07:57:00.002-05:00

I recently ran across the following quote by futurist John Schaar: "The future is not some place we are going to, but one we are creating. The paths are not to be found, but made, and the activity of making them changes both the maker and the destination." This statement caused me to stop and think about people who weren't content with waiting to see what the future would look like, but instead took it upon themselves to actually shape the future. As an unrepentant techie, my mind quickly focused on folks like Steve Jobs of Apple, Mark Zuckerberg of Facebook, and Bill Gates of Microsoft as examples of individuals whose willingness to challenge the status quo literally changed the future for billions of people. Traveling further back in time, I also think of the likes of Henry Ford, Thomas Edison, and the Wright brothers, who clearly changed the world forever as the result of their tenacious ingenuity.

Of course, the vast majority of us will likely never reach such heights of achievement, but every one of us has the ability to change our own future if we're willing to make the effort and take the risk. Certainly there will always be factors beyond our control which will exert some degree of influence on our lives. But the people who have made the greatest impact on their own future, not to mention that of others, tend to be those individuals who are simply unwilling to sit passively by and allow their lives to be totally controlled by external circumstances. Stephen Hawking is a man whose physical limitations would seem totally insurmountable to many of us, yet he has made an indelible mark on the world of science and scientific thought. How many other examples could we find of people who have been dealt a losing hand in life, yet have risen above their circumstances to make the world a better place for themselves and others?

"The future is not some place we are going to, but one we are creating." Even by doing nothing we are shaping our future. Every choice I make today will change the course of my future to one degree or another, even if I don't realize it. The easy option, of course, is the path of least resistance, what the Bible would call "the broad way." There is something seductive in allowing ourselves to fulfill the role of victim, because it makes it easier to let ourselves off the hook for "the road not taken." How tempting it is to blame our situation on what other people have done, or on circumstances beyond our control!

But we don't have to live that way. We can choose not to play the victim. I'll be the first to acknowledge that these are challenging times for those of us in the medical transcription field, and there are plenty of things to complain about if that's what we want to do. But while we bemoan our current situation and fret about what lies ahead, we're missing opportunities to shape both our present and our future for the better. For some of us those opportunities might include changing jobs, or acquiring additional training, or pursuing credentialing in our current field of endeavor. For others it may mean a change of direction into a different profession entirely. The one thing all such opportunities will have in common is the necessity of taking action rather than simply maintaining the status quo. Is change often scary, or inconvenient, or costly? Yes! If you're anything like me, you like things "a certain way" and don't like it much when your familiar routine is jeopardized. But the harsh reality is that as long as we keep doing what we've always done, we will forever get what we've always gotten. The good news is that it's never too late to decide that enough is enough.

What will your future look like, and what will you look like in the future? Choose to answer those questions yourself rather than waiting for someone else to answer them for you.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Director, District 1
AHDI National Leadership Board
jay.ahdi.district1@gmail.com

The Hurrier I Go, The Behinder I Get

2012-01-31T11:52:00.000-05:00

I can remember hearing adult family members use this saying as I was growing up, not knowing it was a quote from "Alice In Wonderland" by Lewis Carroll. As a child I couldn't fully appreciate the truth in that pithy nugget, but as an adult I've come to understand it all too well. At some point going faster only puts me further behind because, as another old saying goes, I don't have time to do the job right the first time but somehow I find time to go back and do it again!

I've been thinking along these lines lately because of what I consider to be a very disturbing and dangerous push in the healthcare documentation field to demand more work in less time. The demand for near-real time documentation of patient encounters seems to be ever increasing, with no letup in sight. One of the driving factors behind the move to electronic medical record (EMR) systems is the notion that this technology will allow medical caregivers to provide higher quality care by speeding up the documentation process.

What I find interesting--and concerning--about that point of view is that the medical profession has already been forced to confront the reality that speed doesn't necessarily equate to better care. In 1999 the Institute of Medicine published a watershed study entitled, "To Err Is Human: Building A Safer Health System." The IOM concluded that between 40,000 and 98,000 lives were lost every year in the U.S. healthcare delivery system due to avoidable errors. Due in large part to that study, many hospitals have since instituted measures designed to decrease errors and improve outcomes. Interestingly, a number of those measures have required caregivers to take more time, not less, in order to ensure patient safety. A couple of examples that come to mind are surgery timeouts before operations and sponge and instrument counts afterwards. Without question these procedures slow down the pace of delivering healthcare. But clearly the cost of NOT slowing down became too high, whether that cost was measured by political pressure or multimillion-dollar malpractice lawsuits.

I have to wonder how long it's going to take before the demand for more documentation in less time--be it via transcription, speech recognition editing, or EMR--reaches a similar tipping point. I'm not sure which is going to happen first: healthcare documentation professionals finally say enough is enough, or somebody dies because of inaccurate documentation caused by trying to do too much in too short a time. I suspect the latter has already happened, we just don't have an Institute of Medicine-style white paper to prove it.

Make no mistake, I'm a capitalist through and through, and I love working for my employer, but there is a downside to the corporatization of medicine in general and the medical transcription field in particular. In America today, conventional wisdom seems to be that the job of corporate management is to wring the most productivity out of labor for the least amount of money in the shortest period of time. But if the history of our nation since the Industrial Revolution has taught us anything, it is that the quest for profitability sometimes exacts a cost in human resources that is simply too high.

Or, to quote one more old saying, "You can't squeeze blood out of a turnip." At some point we simply won't have anything more to give.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator
Director, District 1
AHDI National Leadershp Board

2012 AHDI Rising Star Award Submissions Now Being Accepted

2012-01-06T17:56:00.000-05:00

In honor of educator Marilyn Craddock, this award serves to recognize an outstanding industry student for a contemplative and informed response to the Association's annual essay contest. Each year, staff and leadership will determine an essay topic which is relevant and timely to the state of the industry. Students actively enrolled in a healthcare documentation (or related field) program will have an opportunity to submit an essay for consideration by the awards committee. Judging is based on clarity of content, organization, creativity, spelling, grammar, punctuation, and capitalization. There will be no more than one winner.

2012 Essay Topic: "Driving Your Healthcare Documentation Future”

2012 Rising Star Application

Deadline to submit your essay is April 30, 2012

Tina Wilson
Senior Programs Specialist
Association for Healthcare Documentation Integrity (AHDI)

Clinical Documentation Industry Association (CDIA)
4230 Kiernan Ave., Suite 130
Modesto, CA 95356
Phone: (209) 341-2456
Fax: (209) 527-9633
twilson@ahdionline.org

2012 AHDI Integrity Awards Nominations Now Being Accepted

2012-01-06T17:52:00.001-05:00

2012 AHDI Integrity Awards—Nominations Close April 30, 2012

With the demands and challenges facing our sector, we hear so much about recognition of our workforce and the need to acknowledge the outstanding work being done by so many across the industry and within the association. AHDI's Integrity Awards program is designed to shine a spotlight on those individuals, organizations, and volunteer groups who are truly making a difference in our industry. Not only does this recognition program impact the individuals who are nominated and chosen for these awards, but it generates visibility around best practices and drives recognition of our industry in a public way. Do you know a CMT who has a passion for credentialing and helping others get credentialed? What about an MT educator who really made a difference to you as a student? Do you belong to an AHDI component that has done something innovative and engaging this year? Is your employer creating a corporate culture that has inspired you to excel? Every one of us knows someone who has made a professional impact over the last year. Be a proactive colleague. Take the time to nominate that person or organization for one of these awards:

Nominations should be submitted electronically and are due no later than Friday, April 30, 2012. Nominees will be notified of nomination after committee vote and winners will be announced at the Integrity Awards Luncheon at AHDI Annual Convention and Expo in Indianapolis, IN. Visit the AHDI Integrity Awards page for more information.

Tina Wilson
Senior Programs Specialist
Association for Healthcare Documentation Integrity (AHDI)

Clinical Documentation Industry Association (CDIA)
4230 Kiernan Ave., Suite 130
Modesto, CA 95356
Phone: (209) 341-2456
Fax: (209) 527-9633
twilson@ahdionline.org

Recipe for Success

2012-01-02T09:05:00.019-05:00

What is our recipe for success?

I’ve spent hours upon hours chewing on this question. At first blush, it’s appears to be a relatively simple question but frankly, for each of us, it’s a pretty complicated one.

There are the recipes handed down from generation to generation that have proven themselves through the test of time. But we cannot rely on those alone. Our environment is changing too quickly to be firmly stuck in the past. Some recipes may no longer be relevant based on our busy lives. So we continuously develop and test new recipes. You probably know these well through your own culinary experiences. Some quickly become a new family staple, making it to the dinner table on a weekly basis. Then there are the “special occasion” recipes. They’re more complex and require special preparation techniques and ingredients. The anticipation is exciting and they are worth the wait. We need recipes for various courses: appetizers, main dishes, side items, and dessert (maybe the most important?). All of these should complement each other in taste and nutrition when serving such a meal.

What about AHDI’s recipe for success? Our association exists to promote the integrity of healthcare documentation through development of an educated, prepared workforce in clinical documentation, and our recipe box needs to be diverse to meet the needs of our membership. As YOUR professional association, we constantly look for the common threads by talking to members and others within the sector, listening to the challenges being faced from the rapid changes occurring in healthcare documentation workflow and technology, scanning the landscape to identify trends and opportunities, and ultimately developing solutions.

There are already a lot of recipes in our box, e.g., the Book of Style, RMT and CMT credentials, education approval program, and Benchmark KB. There are more recipes being developed by our members and staff particularly focused on workforce development, continuing education, credentialing exam preparation, and advocacy and alliance building.

From your perspective, what other recipes can AHDI prepare for our members and are there critical ingredients we’re currently missing?

Linda G. Brady, CAE
Interim CEO
AHDI

* Photo by Simon Howden

Survey Says: Widespread Conversion To EMR Systems May Take 15+ Years

2011-12-27T08:16:00.000-05:00

A new survey commissioned by Nuance Corporation suggests that U.S. healthcare providers are taking their own sweet time converting to electronic medical record (EMR) systems, and that the process could easily take 15-20 years. This conclusion would seem to correlate well with a 2009 Centers for Disease Control and Prevention study which revealed that only 6.3% of physician practices had a "fully capable" EMR with only 20.5% of respondents having a "basic system."

The Nuance study consisted of an online survey of forty physician practices with five or more full time physicians plus follow-up telephone interviews with six of them. Quoting from the survey's executive summary, "The objective of the study was to understand how practices handle paper within their practices, the challenges that arise in a paper-based or hybrid medical record system and their satisfaction with their current practices. The results of the study provide interesting insight not only into the progress the United States healthcare system has made in adopting electronic health records but also just how far it has to go before patient care documentation processes are predominantly electronic."

The study's authors concluded that "complete implementation of EHR systems by ambulatory physician practices with meaningful use of those tools and elimination of the vast majority of paper in these practices will take at a minimum of 10-15 years and potentially many years longer."

I believe this type of research has important implications for those of us within the medical transcription field. The demand for what I would call "traditional" healthcare documentation methods continues to be strong in spite of the hype surrounding the push for EMR implementation. Don't misunderstand me, big changes in the way we do what we do are coming, no doubt about that. But the sky is not falling, and the need for medical transcription as we know it today isn't going away any time soon.

The real question in my mind is whether or not our profession has found the bottom of the compensation freefall. Unless the industry figures out a way to fairly compensate healthcare documentation professionals as knowledge workers instead of widget makers, it won't matter how strong the demand is because there'll be nobody left to do the work.

Am I over-dramatizing? Yes...but not by much.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Director, District 1

AHDI National Leadership Board

Ramp-up Productivity by Taking a Break?

2011-12-19T08:21:00.013-05:00

This month the AHDI staff rolled up our sleeves to prepare our work plans for 2012. There were literally dozens of action items assigned and ideas generated. Like Santa’s elves, draft budgets are now being prepared, timelines are getting posted in our project management software Basecamp, and ideas are being analyzed and vetted. Although the tangible work product was our primary reason for pulling all staff together for four days of face-to-face meetings, there were many other positive outcomes in doing so. Spending time as an entire staff team not only super-charged our enthusiasm for AHDI and our members, it reminded us that it’s important to take short breaks from the hectic pace to enjoy the camaraderie of each other. Ultimately, it makes for a healthier work environment, we gain a better understanding of communication and work styles, and it helps us come closer together as a team. All of these benefits directly help increase our productivity in the long run!

We built in a variety of short breaks, but the most memorable was adopting a family with five children for the holidays. The entire staff pitched in to shop for their gifts and wrap them. (Yes, that’s an ironing board you’re seeing in the picture to the left from our “Minute to Win It” challenge the previous day!) At the same time, we had the pleasure of visiting with a few AHDI members from California who joined us Thursday afternoon: Carrie Boatman, Gail Sutphin, Genny Smith, and Mike Grady. They’re a great group of volunteers who have made significant contributions to AHDI over the years. It was wonderful for the entire staff to have an opportunity to spend time with them—and Carrie, Gail, Genny, and Mike also got to witness a bit of our zaniness!

As you go through all of your lists this holiday season, don’t forget to take short breaks now and again to savor your friendships, family, and colleagues. From us to you, we wish you a happy, healthy, and abundant new year. Happy holidays!

Cheers,

Linda Brady, Interim CEO & the entire AHDI Staff

Front (left to right): Wendy Carriegan, Linda Brady, Jason Hatchell, Tina Wilson

Middle (left to right): Danielle Shelton, Treva Perez, Miranda Chalabi, Rebecca McSwain, Tom Kewley

Top (left to right): Kristin Wall, Terri White, Andrew Wolf

Technology Adds To Physician Distraction: Who Will Catch The Resulting Errors?

2011-12-19T08:18:00.001-05:00

A recent New York Times article confirms something we in the medical transcription profession have known for a long time: not only does technology in the medical field NOT cure all healthcare documentation ills, it can actually ADD to the problem. The article highlights some of the ways technology can and does interfere with quality medical care, with particular emphasis on cell phone, tablet, and computer use. Although the article doesn't specifically make the connection between physician distraction and the need for human review of healthcare documentation, there's no doubt that such a correlation exists. We simply must continue to make the case for the need for skilled human review of physician-generated documentation, regardless of the methodology used to create the patient encounter record.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Director, District 1

AHDI National Leadership Board

Medical Transcription's Uncertain Future

2011-12-12T10:25:00.004-05:00

A recent article in For The Record magazine highlights the challenges facing the medical transcription profession as the U.S. moves slowly but inexorably toward an electronic medical record environment. The article, by freelance journalist Selena Chavis, doesn't cover much new ground in terms of what MT professionals already know: technologies such as speech recognition and EMRs are having a negative impact on transcription volume, but nobody knows for sure what the future holds for the profession.

From my perspective, there are a number of trends in motion which will impact the medical transcription industry in the coming years, some positively and some negatively. On the downside, more and more hospitals with in-house transcription departments will look at outsourcing as a cost-cutting measure. There's no doubt in my mind that in-house MT positions will become much scarcer in the next few years due to outsourcing. At the same time, some of those MTs may decide to pursue other career opportunities within their institutions, perhaps in coding, abstracting, quality improvement, or EHR support roles. Speech recognition technology will continue to negatively impact the volume of traditional transcription, but again, the increased use of SRT will create an accompanying demand for more MT editors. Finally, I think it's safe to say that EMRs will generally decrease the demand for transcription, some more than others. For instance, our local hospital is implementing the Epic EMR, and their plan is to eliminate transcription altogether (we'll see how that works out). But not all EMR implementations are created equal in that respect; some customers include a dictation/transcription option in their workflow because the doctors demand it.

Overshadowing everything in this discussion is the fact that the demand for healthcare documentation is going to explode over the next 20 years as we Baby Boomers reach retirement age. I strongly believe that over the next couple of decades, even with EMRs, speech recognition, natural language processing and who knows what else, our healthcare delivery system is going to need plenty of skilled healthcare documentation professionals in a variety of roles. Yes, we will have to adapt to new technologies and new ways of doing things, but what else is new? Adapt is what MTs do, and I have no doubt we will continue to do so for the foreseeable future.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Director, District 1

AHDI National Leadership Board

Communicating Effectively: "Who Needs To Know This?"

2011-12-07T10:50:00.003-05:00

The longer I live and do business and deal with people, the more I'm convinced that the vast majority of the problems we encounter in those contexts are the result of poor communication. One of the greatest movie quotes of all time, from "Cool Hand Luke" with Paul Newman, is uttered by the warden character played by Strother Martin:

Countless numbers of books have been written on the subject of effective communication, in a wide variety of contexts including business, relationships, families, organizations, etc. A number of folks make their living by traveling the world giving seminars on how to communicate effectively. But here in the little corner of the world where I live, given my short attention span and finite bucket of energy and motivation, I need something short, sweet, and to the point to help me stay focused on the need for good communication. Thus, my contribution to the pantheon of effective communication techniques boils down to asking one key question:

"Who needs to know this?"

Every day that I live I'm inundated with all kinds of information, a great deal of which would be of value to someone else. I find that I'm a much more effective husband, father, manager, leader, and all the other roles I fill, when I can identify what "this" is and who needs to know it.

I think one of the great challenges we all face in the area of communication is our tendency to assume that other people know what we know. Yet haven't we all discovered the hard way--over and over and over--what a costly assumption that can be? If I could develop just one effective communication technique--and I readily admit I haven't accomplished this yet--it would be the ability to mentally evaluate everything I think someone else should know, and take the time to find out if it's actually true. Just think of how many problems in your job, marriage, relationships, etc., could be avoided by simply ensuring that other people really do know what you assume they know?

I could assume that after 20 years of marriage, my wife Carol knows by now that I love her. But as a wise husband (I hope), I make sure she knows, by what I say and by what I do, on an ongoing basis. In my job I interact with folks from a variety of areas of experience and expertise, from clients to upper management, sales, marketing, technology, and operations. I have learned, and am still learning, that I can't assume that all those people in different niches know everything they need to know to do their jobs well. The same is true with my interaction with AHDI members and leaders.

It's easy to make assumptions about what others should know, but a truly effective communicator takes the time to confirm what others actually do know. A couple of minutes spent touching base with someone today can save countless hours of frustration down the road.

Jay Vance, CMT

AHDI Administrator/Moderator

Director, District 1

AHDI National Leadership Board

Canadian Health Systems Proposing To Outsource Medical Transcription Services

2011-12-05T10:39:00.005-05:00

Over the past several months I've had the opportunity to present my "Top 10 Trends In Medical Transcription" presentation at a number of AHDI venues, including the 2011 ACE conference in Phoenix. One of those trends is the outsourcing (both domestic and offshore) of medical transcription services by institutions which have thus far maintained in-house transcription departments. From Vancouver, Canada comes word of a major outsourcing initiative by four health systems, including Fraser Health, Providence Health Care, Provincial Health Services Authority and Vancouver Coastal Health. The proposed shift to outsourced transcription services is estimated to save over $3 million annually.

Expect to see this trend continue across North America as CFOs and HIM directors realize that in-house transcription departments are significantly more expensive than outsourced transcription services.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

NIST Releases Free HIPAA Security Rule Toolkit

2011-11-29T09:09:00.003-05:00

The National Institute of Standards and Technology (NIST) has released a free HIPAA Security Rule Toolkit to "help organizations better understand the requirements of the HIPAA Security Rule, implement those requirements, and assess those implementations in their operational environment." The toolkit is a standalone application compatible with Microsoft Windows, Apple Mac OS, and Linux operating systems. The application presents a series of questions in groups related to each of the Health Insurance Portability and Accountability Act's Security Rule standards and implementations specifications. It follows the established HIPAA structure of administrative, physical and technical safeguards; organizational requirements; and policies, procedures and documentation requirements.

A user guide is also available to assist users in implementing the toolkit.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

"Have You Read Your Medical Record?" Revisited

2011-11-10T11:15:00.003-05:00

AHDI Director-at-large Linda Giles has written a great article in ADVANCE for Health Information Professionals online magazine revisiting AHDI's 2005 "Have You Read Your Medical Record?" public awareness campaign. As Linda points out, that question and that message is even more relevant today than it was back then. With the advent of healthcare reform, the rise of electronic health records, and a push to grant patients access to their own medical records, the need for accuracy in healthcare documentation is only going to increase in the coming years. Linda makes a great comparison between errors in financial records and inaccuracies in one's medical documentation; both can be devastating but the latter could be deadly.

I hope you'll take a few moments to read Linda's article and then post your thoughts here on the Lounge.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Dare We Say The Emperor Has No Clothes (Or At The Very Least Is WAY Underdressed)?

2011-11-01T17:42:00.003-04:00

As I was reading through the Oct. 10, 2011 edition of For The Record magazine I was intrigued by the guest editorial entitled, "A Dissenting Voice" by New England Medical Transcription CEO Linda Sullivan. In her article, Linda makes the assertion that "We are all employing [speech recognition technology] because we have to, but in my opinion, it just isn't delivering the results it should." She goes on to note some of the factors that negatively affect the quality of SRT output, and finishes up with this zinger:

"However, SRT’s most significant drawback may be its effect on our workforce. During times like these, when economic realities are brutal, history has shown that entire industries can be wiped out by the evolution of technologies. That’s very well what may be occurring in the medical transcription industry and it’s tough to watch.

I believe one of the reasons the transcription industry is evolving is that we’re trying to use a technology that just isn’t there yet but we’re requiring our workers to use it anyway—and to make a lower salary in the process."

I would love to hear your thoughts on Linda's comments. Do you think she's on target? What, if anything, can working MTs do about the situation?

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Interview With Vern Davenport, MedQuist CEO

2011-10-27T09:11:00.003-04:00

In August of this year, in conjunction with AHDI's Annual Convention & Expo (ACE) in Phoenix, I had the opportunity to interview MedQuist's new CEO and Chairman of the Board, Vern Davenport. Our conversation touched on a number of issues impacting the medical transcription industry, including the electronic health record, consolidation, technology, and downward pressure on compensation. The video of the interview can be found here:

Vern Davenport Interview

Please feel free to share your thoughts about the conversation here on the Lounge.

Jay Vance, CMT

Lounge Administrator/Moderator

Pen To Paper

2011-10-24T17:03:00.004-04:00

The following is a guest post by Cherise Tasker, MD, Chief Medical Officer for Transcend Services, Inc.

As I put pen to paper, I think…

Pen to paper?

In the medical transcription world, our fingertips have been flying across keyboards for decades. We formalize the thoughts of those who rely on us to document what they can’t. Whether because their notes must be automated or they speak more articulately than they write or because dictation is more efficient or because they know our spelling, grammar, punctuation and formatting is better than theirs, clinicians rely on us to preserve their patient encounters.

In clinical settings, however, Paper Mate, Bic, Pilot and Uni-ball, not to mention the generic pens emblazoned with medication names, still circulate next to the paper clips, phones, lab order sheets and prescription pads in a clutter at the nurses’ station. (By the way, what happens when your sixth grader grabs a pen for his backpack and ends up advertising Cialis or Tri-Cyclen Lo while completing his social studies question of the day?) Even as electronic health records and computerized provider order entry seem to take over the clinical documentation world as we know it, physicians continue to put pen to paper to document a patients’ daily progress, assess their lab results and summarize their progress on a low sodium diet at home.

Do those who continue to handwrite their notes savor their technology-free moments? Do they find their thoughts have the room to flow and develop? Or, do they wish they could document more quickly, having the option to dictate or point-and-click? Do they feel guilty that they prefer the pen when they have an electronic alternative?

I suspect that for each clinician, the answers are different. As I think about “pen to paper,” I go to my keyboard to preserve my thoughts. I don’t have a problem with my pen; it is simply the reality of how we share our ideas with others today. I think about how this reality impacts how we share information and preserve our unique inscription in a QWERTY world.

Cherise Tasker, MD

Chief Medical Officer

Transcend Services, Inc.

AHDI & CDIA Announce Change In Executive Staff Positions

2011-10-19T14:36:00.002-04:00

Dear AHDI and CDIA Members,

On behalf of the AHDI and CDIA Boards of Directors, we wish to share with you important news on the association's executive staff. Dr. Nancy Brighindi, who recently served as chief executive officer, is no longer with the organization. We extend best wishes to her for a bright and successful future. AHDI and CDIA have named a strong interim executive staff team to continue to lead the organizations. As AHDI and CDIA's chief volunteer officers, we will work in close partnership with the executive staff to ensure a smooth transition and continuity in leadership succession.

Linda G. Brady, CAE, will serve as our interim Chief Executive Officer. Linda joined AHDI/CDIA in September 2009 as Director of Member Relations, and she has more than 15 years' experience in both professional and trade associations. Wendy Carriegan has been appointed interim Chief Operating Officer. Since 2002, Wendy has expertly managed the finances, operations, and infrastructure for the associations. We are confident in their executive leadership skills to lead and grow both organizations during this change.

A steering committee of both Boards is assessing the needs of the associations to develop a long-term plan for the association's executive staff leadership. As details become available on these important decisions, we will keep you informed.

Like our own lives, associations experience change and this year is no exception. As challenging as change can sometimes be, we stand unified and strong to continue to serve our members.


Sherry Doggett		Noel Bambrough
AHDI President		CDIA Chairman

"People Don't Buy What You Do, They Buy Why You Do It"

2011-10-10T07:59:00.005-04:00

In the days following the announcement of the death of Apple co-founder Steve Jobs, a great deal of discussion has taken place in our society regarding Apple's--and Jobs'--extraordinary success. In that vein, I'd like to share a video clip of a presentation given at TED in 2010 by Simon Sinek on "How Great Leaders Inspire Action."

The main theme of Simon's presentation is the importance of selling the why instead of merely the what, and he uses Apple as an example of the validity of this principle. Interestingly, I read just this morning that pre-orders for Apple's newest iPhone, the 4S, have completely sold out. This in spite of the fact that there really isn't a whole lot new about the iPhone 4S compared to the previous model. But Apple has done such a great job of marketing the why that the what is seemingly a secondary consideration.

Another point Simon makes that resonated with me is the difference between leaders and those who lead. I loved his comment that in his most famous speech, Dr. Martin Luther King, Jr. proclaimed "I have a dream," not "I have a plan." I think we're all getting weary of hearing folks who claim the title of "leaders" assuring us that they have a plan, be it for fixing the economy, creating jobs, bringing peace to the world, or whatever. What we really need, for our country, for our industry, for our professional association, and even in our own families and social circles, are people who are willing and able to lead, who can clearly articulate the why but also make the what happen.

I'd love to hear your thoughts on this topic.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Identifying Errors, Protecting Patients

2011-10-07T21:04:00.002-04:00

The past several months medical transcriptionists have been contributing to the project identified as “Identifying Errors, Protecting Patients.” In a post today at the MT Inner Circle, the findings of the data that has been collected have been released and are being discussed.

These findings, while no surprise to MTs, provide us with some data that we can now share with others outside of our profession. The intention isn’t to say that we don’t want technology (because we do see value in technology), but to call for a process that requires quality checks in clinical documentation. Without that process, we run the right of patient’s records having serious errors that could impact patient care and safety.

I invite you to read the report and join in the discussion.

Identifying Errors, Protecting Patients

Kathy Nicholls, CMT, AHDI-F

AHIMA 2011 Wrap-Up

2011-10-05T21:32:00.011-04:00

The 83rd annual conference of the American Health Information Management Association (AHIMA) has come to a close here in Salt Lake City, Utah. I had the opportunity to attend the conference this year as an AHIMA member, an AHDI Director, and a representative of my employer, Superior Global Solutions--a company, I'm proud to say, which has been extremely supportive of my involvement in both AHDI and AHIMA. The conference was held in the beautiful Salt Palace Convention Center in downtown Salt Lake City, and from my perspective, the event was very well planned and executed. While some vendors I spoke to felt like the number of exhibitors was down this year compared to previous conferences, there were still plenty of vendor booths with a wide variety of products and services on display. I was a little surprised that there weren't more EHR vendors in attendance, though.

Salt Palace Convention Center, Salt Lake City, UT

In addition to the exhibit hall, the AHIMA convention offered attendees a full slate of keynote addresses and break-out sessions. I had the opportunity to attend several of these, including presentations by Dr. Carolyn Clancy of the Agency for Healthcare Research and Quality, Dr. T.B. Ustun of the World Health Organization Department of Health Statistics and Informatics, and AHIMA's new CEO, Lynne Thomas Gordon.

AHIMA General Session audience

AHIMA CEO Lynne Thomas Gordon

I also enjoyed the closing keynote address by 8-time Olympic short-track speed skating medalist (and Dancing With The Stars champion!) Apolo Anton Ohno.

Apolo Anton Ohno

I also had the opportunity to attend a break-out session conducted by my esteemed colleague Lynn Kosegi and Dr. Jurgen Fritsch of M*Modal. Their presentation was entitled, Natural Language Processing--Is It The Silver Bullet?

Lynn Kosegi and Jurgen Fritsch, M*Modal

This was a very informative--and refreshingly candid--look at the current state of natural language processing (NLP) as it relates to healthcare documentation. As Dr. Fritsch pointed out, NLP is not a stand-alone solution for the challenges of documenting healthcare encounters in today's EHR environment:

One other event of note which I was able to attend was a joint meeting of the executive boards of AHIMA, AHDI, and CDIA. This meeting was a very timely and productive opportunity for the leadership of these healthcare information-related organizations to talk about ways we can work together to further our common interests. I'm very optimistic about a number of synergistic collaborations which were discussed at the meeting, and about which I imagine we'll be hearing more in the coming months.

Special thanks to Karen Fox-Acosta for her recommendation of Caffe Molise, a great little Italian restaurant in downtown Salt Lake City. Highly recommended!

All in all it was a very enjoyable conference from my perspective, a sentiment which seemed to be shared by other attendees I spoke with. Next year's conference will be Sept. 29 through Oct. 4 in Chicago, IL.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Upcoming Webinar: Boosting Your Paycheck With Expanders

2011-09-29T09:52:00.001-04:00

Presenter: Laura Bryan, CMT, AHDI-F
Time: 3 PM Pacific / 4 PM Mountain / 5 PM Central / 6 PM Eastern
Duration: 1 Hour
Registration Close: October 5, 2011
CE Given: 1 TW or 1 MTT

This webinar will introduce methods for creating text expansion shortcuts. We’ll cover systematic approaches to creating shortcuts to help with recall and also for the most efficient use of shortcuts by keeping your fingers close to the home keys. Both transcriptionists and SRT editors will learn clever ways to increase their productivity.These ideas and techniques are applicable to any brand of text expansion software.

Laura Bryan is the author of Technology for Medical Transcriptionists and MS Word for Healthcare Documentation, both published by LWW (Stedman's). As an author and consultant, Laura focuses on productivity through the optimal use of keyboard shortcuts and software tools. Laura is the owner of MTWerks, a technology consulting business, and MedEDocs, a transcription software services company.

Cost: $10

CLICK HERE TO REGISTER

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Medication instructions you couldn't follow even if you wanted to

2011-09-26T14:17:00.003-04:00

From failblog.com comes this classic:

I think I may have transcribed for the doctor who ordered this one!

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

New Study: Speech Recognition Error Rate 800% Greater Than Transcribed Dictation

2011-09-23T17:14:00.005-04:00

In a study published in the latest edition of the American Journal of Roentgenology, researchers found dramatically higher rates of major errors in patient records created using front-end speech recognition technology, as compared to reports which were dictated and transcribed. Quoting from the study abstract (emphasis mine):

Of 615 reports obtained, 308 were generated with ASR and 307 with conventional dictation transcription. At least one major error was found in 23% of ASR reports, as opposed to 4% of conventional dictation transcription reports. Major errors were more common in breast MRI reports (35% of ASR and 7% of conventional reports), the lowest error rates occurring in reports of interventional procedures (13% of ASR and 4% of conventional reports) and mammography reports (15% of ASR and no conventional reports). The error rates did not differ substantially between reports generated by staff radiologists and trainees or between reports generated by speakers who spoke English as their first language and those whose native language was not English. After adjustment for academic rank, native language, and imaging modality, reports generated with ASR were 8 times as likely as conventional dictation transcription reports to contain major errors.

In the study, "major errors" were defined as errors which had an impact on the understanding of the report as well as errors affecting patient management, i.e., incorrect units of measurement (millimeter instead of centimeter, etc.) or a missing or added "no" (for example, malignancy instead of no malignancy).

These are the kinds of cold, hard facts we need to be shouting from the housetops. What working MTs do every day is risk management/clinical documentation improvement any way you slice it, and the powers that be need to understand just how much of their bacon is being saved by skilled MTs who can actually THINK. We've got to figure out a way to tell them so they'll listen.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Come Poke The Box!

2011-09-22T12:37:00.002-04:00

Kathy Nicholls, CMT, AHDI-F has taken the initiative to work with AHDI staff and a number of respected members of the MT community to offer a series of affordable, credit-worthy webinars for working MTs. The following is her introduction to the series. - JV

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“The job isn’t to catch up to the status quo, the job is to invent the status quo.” – Seth Godin

Seth Godin is one of my favorite authors, and that quote is a great explanation of the concept of poking the box, which is what we’re doing!

Our industry is in a huge state of flux. Changes are happening all around us, it’s tough to know which way to turn, and it’s critical that we spend some time poking the box and figuring it out. The reality is we simply don’t have the time to get stuck in that “paralysis by analysis” mode that often hangs us up.

Next week begins a series of webinars offered by AHDI titled “Looking Forward: The Future of Healthcare Documentation.” These are sessions you won’t want to miss.

The kick off for these series is Tuesday, September 27 at 5 p.m. Mountain Time, and I will be presenting. The great news is that the first one is free! That's right, totally free, all you have to do is sign up and show up! That presentation is called "Starting Projects, Making a Ruckus, and Taking More Risks." We'll be talking about the concept of poking the box, taking action, and how to not get stuck in fear mode that paralyzes us with all of the changes we're facing today. I'm counting on you to show up for this and participate so please get registered today and secure your seat!

The next six webinars in this series are scheduled about every two weeks through December. In AHDI’s effort to poke the box related to educational offerings, each webinar is being offered at only $10! That $10 applies to anyone, regardless of your membership status. We want you to have access to the education and come together to talk about the future.

Registration is now open for these webinars, and seating is limited so sign up today! The sessions include these great topics and speakers:

Boosting Your Paycheck with Expanders! - Register Now - Laura Bryan, CMT, AHDI-F

Job Search Skills is the New EHR World - Register Now - Sarah Barton

Research Skills 2.0 for the MT - Register Now - Cheryl Blake, CMT

What's New with HIPAA? - Register Now - Brenda Hurley, CMT, AHDI-F

Dreaming of a Good Night's Sleep: Parasomnias and Other Sleep Disorders - Register Now - Deb Nolan, CMT

Let’s Chat About Medicolegal Terms: It’s More Than HIPAA - Register Now - Kim Buchanan, CMT, AHDI-F

How about it? Ready to take a bold step and start poking the box about our future? I can’t wait and hope to see you there!

Kathy Nicholls, CMT, AHDI-F

TMI? New ICD-10 Codes May Tell You More Than You Really Wanted To Know

2011-09-20T10:52:00.003-04:00

I recently came across a great article in the Wall Street Journal highlighting the impending move to the new ICD-10 healthcare diagnosis codes. As the article points out, to say that the new codeset provides for greater specificity is somewhat of an understatement. Take these gems, for example:

Y9272 - Injury sustained in a chicken coop
Y92253 - Injury sustained in an opera house
R46.1 - Bizarre personal appearance
W22.02XA - Walked into lamppost, initial encounter
V91.07XA - Burn due to water-skis on fire (my personal favorite)

There are codes for injuries due to attack by duck, goose, macaw, or turkey, as well as codes for "bitten by turtle" and "struck by turtle." There are codes for injuries received while sewing, ironing, playing a brass instrument, crocheting, doing handcrafts, or knitting—but not, oddly enough, while shopping.

Thanks to some web programmers at the WSJ with a wee bit too much time on their hands, you can find some...interesting...ICD-10 codes on your own using this handy online tool.

Enjoy!

Jay Vance, CMT

Lounge Administrator/Moderator

The Phoenix ACE "Hot Jar"

2011-09-19T19:54:00.002-04:00

As I'm sure you can imagine, there were some ACE attendees this year who thought the weather in Phoenix was just a tad warm. In fact, on Thursday, Aug. 18, Phoenix set a record temperature for the date of 112 degrees, with a haboob dust storm thrown in for good measure! One attendee in particular, who shall remain nameless (but her initials are Susan Lucci), was rather vocal about the heat from the very start of the conference. It got to the point where I finally announced to an informal gathering of the AHDI board that as a citizen of the host state, I was going to institute a "hot jar," similar to a "cuss jar," where you had to put in a dollar every time you complained about the heat. This became somewhat of a running joke throughout the week.

The situation culminated during a break at the Leadership Summit when Susan came up behind me while I was deep in animated conversation with someone else at the table, and loudly stated, "Just take all my money now, because it's HOT, HOT, HOT!" She then proceeded to dump a fistful of dollar bills on the table in front of me. Fortunately Patti Niemeyer was on hand to record the occasion, as you can see:

To add insult to injury, Susan waited until the pictures were taken and then took back all the money!

Thanks, Susan, and all the other ACE attendees, for suffering through the Arizona heat, and thank you, Patti, for the great photos!

Jay Vance, CMT

Director, District 1

AHDI National Leadership Board

Lounge Administrator/Moderator

The Famous (or Infamous) AHDI-West "Claim To Fame" Slide Show from ACE 2011

2011-09-19T16:30:00.002-04:00

ACE 2011 Claim to Fame by AHDI-West

Jay Vance, CMT

Director, District 1

AHDI National Leadership Board

Lounge Administrator/Moderator

Joint AHDI/AHIMA Meeting Breaks New Ground in Texas! (News from District 5)

2011-09-19T12:01:00.000-04:00

We all know the saying about everything being bigger in Texas, and I think part of the reason the adage rings true is that Texans always seem to embrace new and innovative ideas. Texas AHDI did that again on September 10, 2011, with its first ever mid-year seminar. This one-day event was offered to reach out to those individuals who are not always able to attend the large annual meeting held in February each year. True to form, since they were going about the business of new ideas, Texas AHDI invited Texas AHIMA (TxHIMA) members to participate...and were amazed at the response from this sister organization. The theme of this meeting was "Breaking New Ground," and I'm sure all of the attendees would agree that this is just what happened.

Pat McMahon (President), Kathie Anderson (President-Elect), Kathy Melton (Secretary), and Jerry Shoemaker (Treasurer) contacted local TxHIMA leaders to see if they would be interested in coming to the event to discuss AHIMA and what it offers to its members. Because TxHIMA leaders were so excited about this opportunity, it was decided to host a round-table discussion with a panel of individuals representing both AHDI and AHIMA, to have discussions around certain topics, and then allow the attendees to ask questions.

The day began with Isadora Arzu, MD, PhD, who discussed breast cancer research and provided us with wonderful information on the updates in that arena. Next, we enjoyed a presentation by Laura Bryan, CMT, on the ABCs of healthcare. With all of the acronyms we all see and hear every day, we appreciated Laura's explanation of so many of them, and her presentation was as entertaining as it was educational. The third speaker was Dr. Carla Tyson-Howard, EdD, MHA, RHIA, who is the Department Chair of the Health Information Technology program at Houston Community College. Dr. Tyson-Howard discussed the education initiatives involved in HITECH, and the consortium of community colleges who are working together to train new health information professionals daily. Dr. Tyson-Howard is a fount of information regarding these free programs, and encouraged as many people as possible to be proactive in applying to them. It is estimated that we will need over 50,000 new health information professionals within the next several years, and so far, only a few thousand have taken advantage of the free education and certificate program,which is scheduled to end soon unless the federal government extends the deadline.

At this point, we took a break for some announcements and drawings for door prizes, which included two free AHDI new or renewal memberships, as well as continuing education opportunities and other great prizes. This was followed by a lunch and networking opportunity for all attendees. After lunch, we had the much-anticipated round table discussion with a panel of AHDI and AHIMA representatives to talk about current trends in the health information marketplace. The panel consisted of:

          Bonnie Bakal, CMT, AHDI-F
          Carla Tyson-Howard, EdD, MHA, RHIA
          Pat McMahon, RMT
          Cynthia C. Alder, RHIT, CMT, AHDI-F
          Laura Bryan, CMT
          Diann Brown, MS, RHIA, CHP

What we learned from this interesting discussion was that we all have so much in common in the health information field. Technological advances are expected to change the way we all do our jobs - from speech recognition technology (SRT) affecting healthcare documentation specialists to computer-assisted coding (CAC) programs affecting coders, we need to change our ideas about what our jobs should become, and start talking about where we find a place at the table when it comes to patient care and safety concerns.

Bonnie Bakal discussed how the industry has continued to change over time, and mentioned that this is nothing new to health information professionals - we have been adapting to new technologies and emerging roles for years. Dr. Carla Tyson-Howard discussed the importance of education in ensuring a brighter future for workers in the industry. I talked about change management, and how we approach and deal with the current industry climate. Laura Bryan talked about the importance of the Health Story Project in capturing the narrative that tells us about the patient, as well as extensible markup language (XML) which helps add coded data to the background of a document so that a computer can "read" it and assist with the coding responsibilities. Diann Brown talked about the similarities and differences in the various functions of every member of a health information management team. She stated that each member is an important part of the whole, and provides a service that helps a health information management (HIM) department function.

The audience asked a lot of very good questions during this two-hour portion of the event, and we were able to hold open and honest conversations about the future of HIM and clinical documentation, and I believe we all left with a renewed sense of purpose in working together to meet our mutual goals.

After the round table discussion, Diann Brown, MS, RHIA, CHP, Director of Health Information Services for Texas Health Resources (THR) offered a presentation on how THR has implemented their electronic health record (EHR) entitled "EHRs Impact on HIM - A Success Storoy or Are You Dreaming?" This was a very informative and enlightening presentation showing how healthcare documentation specialists and coders are changing how they do things, while remaining a relevant and important part of patient documentation and care.

Our final presentation of the day was offered by Nancy Young from Special Health Resources for Texas (SHRT) in regard to the ongoing care and support of individuals living with HIV/AIDS. The organization does an amazing job of raising funds to educate and provide care for patients affected by the diseases.

With 7 CE credits offered on this one day, attendees certainly got their money's worth, saw some amazing presenters, learned a lot of new things, and broke new ground by making this a joint meeting for both AHDI and AHIMA members. The round table conversation alone was an eye-opening and groundbreaking event for both organizations.    The presentations were all so interesting and informative.

I began my part of the round table discussion with the old adage - "MTs look at coders and say, 'without me, you wouldn't have a job to do,' and coders look at MTs and say 'without me, you're not getting paid!'" That type of competition has existed in our industry for so long, as a good-natured reminder that we all depend on one another to accomplish patient care goals. All attendees gained a better understanding of how we might all work together to advance the cause of effective and efficient healthcare delivery. As the meeting came to a close, we heard TxHIMA members saying it was the best meeting they had ever attended, and Texas AHDI members seemed to share that sentiment.

After seeing the amazing results of this joint meeting, I would encourage every AHDI component to reach out to their AHIMA counterparts and plan similar events. We are all more alike than we are different, and we are all in the same boat, so to speak. It is time we coordinated our efforts and began rowing that boat in one direction - toward the future of health information and clinical documentation. Our efforts are an important part of good patient outcomes, and that is in everyone's best interest.

Joint Commission Weighs In On Medical Scribes

2011-09-16T07:57:00.005-04:00

The Joint Commission, formerly known as JCAHO, has issued guidelines regarding the use of scribes in U.S. medical care facilities. Medical scribes are defined as "unlicensed person[s] hired to enter information into the electronic medical record (EMR) or chart at the direction of a physician or licensed independent practitioner." The Joint Commission further states that "the scribe does not and may not act independently but documents the physician’s or licensed independent practitioner’s dictation and/or activities."

I find the Joint Commission's list of requirements and restrictions for scribes rather interesting. These include (emphases added by me):

Signing (including name and title), dating of all entries into the medical record—electronic or manual. For those organizations that use Joint Commission accreditation for deemed status purposes, the timing of entries is also required. The role and signature of the scribe must be clearly identifiable and distinguishable from that of the physician or licensed independent practitioner or other staff. Example: “Scribed for Dr. X by name of the scribe and title” with the date and time of the entry
The physician or licensed independent practitioner must authenticate the entry by signing, dating and timing (for deemed status purposes) it. The scribe cannot enter the date and time for the physician.
Although allowed in other situations, a physician signature stamp is not permitted for use in the authentication of “scribed” entries-- the physician must actually sign or authenticate through the clinical information system.
The authentication must take place before the physician and scribe leave the patient care area.
Authentication cannot be delegated to another physician or licensed independent practitioner.
If the organization determines that the scribe will be allowed to enter orders into the medical record, those orders entered into the medical record cannot be acted on until authenticated by the specific physician/licensed independent practitioner who provided the orders scribed. Authentication includes the physician signature (electronic or manual) and the date and time (for deemed status purposes).
The organization implements a performance improvement process to ensure that the scribe is not acting outside of his/her job description, that authentication is occurring as required and that no orders are being acted on before they are authenticated.

Without having worked in an environment where scribes are being utilized, I obviously can't offer any informed opinions. Thus I can only wonder out loud, as I read over all the things a scribe can't do according to the Joint Commission, about how much time, energy and money is really being saved by using scribes. Clearly there is a market for scribing services at this point, but I'm really curious to see what the long-term outcome will be after a few years' worth of numbers have been crunched. With all the recent advances in natural language processing (NLP) technology coupled with the human intelligence offered by medical transcriptionists, I'm optimistic that the healthcare industry will come back around to the realization that what they've been looking for has been right here all along.

Jay Vance, CMT

Director, District 1

AHDI National Leadership Board

Lounge Administrator/Moderator

RMT Study Group Available

2011-09-14T10:19:00.002-04:00

The AHDI New Professionals Alliance is now offering an RMT Study Group. There are 14 openings for this 12-week-long free course starting October 1, 2011 and going through December 31, 2011. Daysha Weller, RMT, will be moderating the first course. Please review the policies and register before September 25, 2011.

Send your desire to sign up to Tina Wilson, Professional Programs Administrative Assistant at twilson@ahdionline.org along with your facebook ID. If you do not make it into this first round, we will be opening it up again starting in January. Tina will make an announcement on the list when the seats are full. Please do not submit your interest in signing up if you do not plan to participate in the entire 12-week program.

Items required in order to take the course:

1. Facebook account - weekly meetings will be held via facebook

2. AHDI Membership (any category)

3. NPA Membership

4. Book of Style, 3rd Edition by Sims (available in AHDI store)

5. RMT Exam Guide: A Walk Through the Blueprint by McSwain (available in AHDI Store)

6. Language of Medicine, 9th Edition by Chabner

For more information, contact Tina Wilson, Professional Programs Specialist, at twilson@ahdionline.org or (209) 341-2456.

NPA RMT Credentialing Study Group – Information & Policies

Cost: FREE to AHDI New Professional Alliance Members

Membership: Visit www.ahdionline.org to become a member of the Association for Healthcare Documentation Integrity. Membership in the New Professionals Alliance is free to any AHDI members. NPA Membership can be subscribed to on the AHDI website at www.ahdionline.org by clicking on “Get Connected.” Membership will be verified upon joining the study group.

Timeframe: 12 Weeks a total of 4 courses offered per year for the pilot year.

Time Commitment: Plan for no less than 15 hours per week of study time. That provides for two hours of reading and studying each week and 1 hour for the live meeting.

Instruction: An Administrator from the NPA will be assigned to each study group. The Administrator will be available for questions, comments, and be present at any live meetings. Administrators will be comprised of NPA volunteers.

Live Meetings: The study groups will meet once per week for up to 1 hour on the AHDI RMT Study Prep Facebook group. You must have a Facebook account to attend these meetings. Meetings will be held on Wednesday evenings at 5:30 PT / 8:30 ET. The very first meeting will be held officially through AHDI using their GoToMeeting platform. Links to the meeting will be sent out a day or two prior to the meeting.

Reference Requirements: Study participants need to secure their products prior to the start of the study group.

1. RMT Exam Guide: A Walk Through the Blue Print – Rebecca McSwain, PhD, CMT

2. Book of Style for Medical Transcription (current edition) – Lea Sims, CMT, AHDI-F

3. Language of Medicine, 9th Edition – Davi-Ellen Chabner, BA, MAT

Required Expense Estimate:

$35 RMT Exam Guide (eligible AHDI member rate)

$50 Book of Style (eligible AHDI member rate)

$50 Language of Medicine, 9th Edition (approximate price if purchased on Amazon)

$0 EHR Readiness Toolkit (available free on www.ahdionline.org, click on “Professional Practices”)

$135 = Total Estimated Expense

Additional Recommend Resources:

1. Technology for the Medical Transcriptionist – Laura Bryan, CMT, AHDI-F

2. RMT Prep Assessment Course through AHDI & OAK Horizons – sign up on the AHDI website at www.ahdionline.org, click on “Continuing Education” and “Online Courses.”

Quantity Allowance: The NPA RMT Study group will only allow a maximum of 30 study participants in a given course.

Registration: AHDI Staff will take registrations via email or phone on a first-come first-serve basis. The course registration will be announced via the NPA list serv. Email Tina Wilson, Professional Programs Administrative Assistant at twilson@ahdionine.org or toll free at 800-982-2182 x2456. The course will allow a total of 30 participants only.

New Diversity Survey For Medical Transcription

2011-09-13T15:10:00.003-04:00

I am currently finishing up my master's project, which is going to focus on increasing diversity in the health information and healthcare documentation professions through greater awareness and educational opportunities for inner-city students. I have already received information from AHIMA on the HIM profession, but the same data does not currently exist for the healthcare documentation/medical transcription community. I have worked with AHDI personnel to create a very brief diversity survey and am attempting to collect as much data as possible in a very short time frame. This diversity survey was distributed to AHDI members recently and is on the webpage, etc, but again, I am hoping to collect as much data as possible and hoping to get this survey out to as many MTs and advanced students/recent graduates as possible. The reality is many are not members of AHDI and so will never see this survey. If you would please be so kind as to not only take this survey but also forward to your recent graduates and second-year or near-graduating students, I would greatly appreciate it. It is a super-short survey and literally takes less than 60 seconds to complete. The data will be used to demonstrate the need to increase diversity in the health information and healthcare documentation professions, and I propose to do this by working with inner-city high school students.

The link to the survey is http://www.surveygizmo.com/s3/621692/Diversity-in-Healthcare-Documentation

Thank you so much. I appreciate your time and consideration.

April Martin, RHIA, CPEHR, CHSS, CMT, AHDI-F

amartin@qidtranscription.com

It's All About The People

2011-09-12T20:54:00.001-04:00

Carol and I have just made it home from a wonderful vacation in Hawai'i where we visited our son and daughter-in-law and took in some of the beauty of the islands. While we were there we were able to arrange an impromptu meet-and-greet with some AHDI District 1 members in the Honolulu area, and we had a great time just getting to know one another and talking about the profession we all love. Beverly Barton and Patricia Compton, like Carol and me, are long-time veterans in the industry. Beverly works for Lofin/Intellitype while Patricia is with Nuance. Michelle Look is a CareerStep student who plans to finish her coursework by the first of December, and she was all ears as the "old-timers" shared some observations and tricks of the trade. She later sent us a very gracious email thanking us for the invaluable opportunity to meet and learn from some industry veterans.

To me, this informal get-together, while certainly nothing fancy or dramatic, was a quintessential example of what our association is really all about. Not only was this the first time Carol and I had met Patricia, Michelle, and Beverly, none of them had ever met each other in spite of the fact that, as they discovered, they all live within a mile of one another in the Honolulu area! It was just a wonderful, practical reminder that the heart and soul of AHDI will always be the people. Not policies, procedures, or programs, but the hard-working people who make up this great organization. I truly believe that one of the primary roles of the AHDI leadership must be to find ways to facilitate this kind of networking and communication among our members, be it virtual or face-to-face. The resulting personal and professional relationships will, I believe, prove to be the most valuable benefit we will ever offer our members.

Carol and I want to extend a heartfelt mahalo for the warm aloha extended to us by Michelle, Beverly, and Patricia, and we can't wait to meet them again!

Jay Vance, CMT

Director, District 1

AHDI National Leadership Board

Lounge Administrator/Moderator

ACE 2011: The Wrap-Up

2011-08-23T20:31:00.001-04:00

Sunday was the final day of ACE 2011 in Phoenix, and we went out on a high note. The highlight of the day was certainly the annual Integrity Awards luncheon at which outstanding members of AHDI are recognized and celebrated. This year's winners were:

Rising Star - Susan Rovito

Educator of the Year - Pat Stettler

Excellence in Credentialing - Carrie McComb

Advocate of the Year - Sheryl Williams

Membership Impact - Capital Chapter

Employer of the Year - Spectrum Health

Innovation Through Technology - Christine Tyrrell

Distinguished Service - Health Professions Institute

Lifetime Achievement - Laura Bryan

Member of the Year - Kathy Muelker

The awards luncheon was put together very well and the food was delicious. I can't even begin to give enough props to the AHDI staff who worked tirelessly behind the scenes to make this year's conference a success; we absolutely could not do it without them!

As I look back over the week's activities, here are the key takeaways for me:

1. The opportunity to build relationships is what makes our association worth belonging to.

Without a doubt there are things we need to do better when it comes to providing compelling reasons for people to join and stay. These days there has to be a perceived value to something before people will spend time, energy or money on it. But in all honesty, once you experience for yourself the valuable relationships you can build and the business connections you can make as part of an AHDI component or event, the whole thing takes on a totally different perspective. As important as it is for the association to provide tangible products and services which offer a perceived value, the most valuable asset we can offer our members is the opportunity to form meaningful personal and professional relationships. Quite frankly, I think as an association we have moved away from that emphasis over the past few years in an effort to be perceived as more "professional" and more "credible" within the greater healthcare delivery universe. Yes, we needed to learn how to interact in a more meaningful and effective manner with other healthcare entities, and we're making progress in that regard. But in order to survive and thrive as an association, our first concern must be to meet the needs of our core constituency, the hard-working healthcare documentation professionals who are the heart and soul of this organization. Every successful politician understands one thing above all else: in order to have a shot at the general election, you have to win the primary by solidifying your base. The truth is that as an association we have not done a good enough job of solidifying our base, and that will be my primary goal as a National Leadership Board director over the next two years.

In terms of how this relates to ACE 2011 specifically, I was struck by the fact that even though a lot of the information presented to conference attendees did not paint a particularly encouraging picture of the future, by the end of the meeting I sensed an attitude of real optimism and determination. I believe this was because in spite of the challenges we face, we realized that we're not alone in the struggle. Rubbing shoulders with our fellow professionals gave us a sense of camaraderie and shared determination that we so often miss out on in our isolated working environments. This conference has convinced me more than ever before that the true measure of success for AHDI will be our ability to effectively communicate the value of the relationships available within our community, and then actually facilitate that relationship-building process in the real world.

2. We must understand what business we're in.

Theodore Levitt, author of the revolutionary book "Marketing Myopia," said it this way in the Harvard Business Review:

The railroads did not stop growing because the need for passenger and freight transportation declined. That grew. The railroads are in trouble today not because that need was filled by others (cars, trucks, airplanes, and even telephones) but because it was not filled by the railroads themselves. They let others take customers away from them because they assumed themselves to be in the railroad business rather than in the transportation business. The reason they defined their industry incorrectly was that they were railroad oriented instead of transportation oriented; they were product oriented instead of customer oriented.

One of the themes I took away from this year's conference was that we as MTs must understand that we are in the healthcare information business, not the typing business or the speech recognition editing business. How we do what we do is vastly less important than what it is we're actually doing. I heard the same admission from a wide variety of industry professionals, from the C-suite level on down: we have fundamentally failed to understand our own value to the healthcare documentation process, and consequently we have failed to adequately communicate that to the other healthcare entities with whom we interact. We have allowed ourselves to be marginalized into widget makers rather than knowledge workers, and again, there's plenty of blame to go around. The challenge now is figuring out how to get out of this rut we're in and reframe the conversation around value instead of just price.

The key to cracking this nut, in my view, will be our ability to not only generate accurate raw data, but out of that data provide both accurate and meaningful information. In the current healthcare environment, "meaningful" has taken on a whole new...er...meaning! Meaningful information will enable healthcare providers to adapt to the new paradigms that have been thrust upon them. Success for our clients will no longer be measured in terms of quantity--how many patients were seen and how many procedures were performed--and success for us will not be measured in how many lines we can pound out. Rather, our customers' success or failure will be judged by the quality of their treatment outcomes, which can only be determined by accurate and meaningful information, so we must find a way to tie the quality of our knowledge and skill set to the quality of the information healthcare providers now require in order to stay in business. The more of that pipeline we control, the greater our ability to command fair compensation for our efforts.

3. This was not just another AHDI conference.

In terms of numbers of attendees, there wasn't anything special about this year's meeting; I think the final count was just under 300 fully paid registrations. There wasn't an overwhelming number of vendors on display, less than 40. There were no major new initiatives unveiled, no gee-whiz announcements to speak of. And while the JW Marriott Desert Ridge Resort venue was fantastic, that alone would not have been enough to differentiate this year's event from those in previous years. No, what made this conference special for me was the fact that the association's leadership had the courage to let the sunshine in and give members the opportunity to actually talk about stuff that matters to the members. Don't get me wrong, I fully support our advocacy efforts and the other "big vision" initiatives the association has embarked upon in the last few years. But the plain fact of the matter is that there are some things that really resonate with the membership, and those are the things they want to talk about. During my presentation on the future of MT, I actually used the words "fair and just compensation" on stage, in public, at an officially sanctioned AHDI event. I don't know how many people told me afterward how much they appreciated hearing somebody actually talk about things the association normally skirts around. In the same vein, this year's "Great Debate" was a smash hit with conference attendees because it gave us the chance to openly and honestly acknowledge that there are differing opinions within our organization regarding some of the most fundamental issues facing our profession--and that's okay! This event was the first crucial step toward what I fervently hope and trust will be a new era of transparency and honest engagement among AHDI members and leaders. Let me put it this way: if we don'tcontinue to pursue open engagement with our members, we're doomed as an association, of that I have no doubt whatsoever. I believe this year's conference has given us a chance to breathe new life into our professional association, and we must take advantage of this window of opportunity.

I've been to enough conferences of one kind or another during my lifetime to know that it's easy to get pumped up while you're there, but the hard work starts after you get home. So now it's time for all of us in AHDI to get down to business and do the heavy lifting required to get our association on the right track. I believe we have the will and the ability to make it happen, and I'm excited to see what the future holds.

Oh, one last thing. Here's a great group photo of all the folks in District 1 who came to our reception on Saturday. I couldn't be prouder to represent such a wonderful group of people!

Jay Vance, CMT

AHDI Lounge Moderator/Administrator

Director, District 1

AHDI National Leadership Board

Update from ACE 2011: Technology Innovation Keynote, Deciphering The Future, The Great Debate

2011-08-21T09:27:00.001-04:00

To say yesterday was a full day for me here at ACE 2011 in Phoenix would be somewhat of an understatement! The day began with breakfast in the Exhibit Hall as vendors took advantage of their final opportunity to display their offerings before the hall was closed at 10:30 a.m. After breakfast I participated in the "Friend & Follow" social media informational session held in the lounge area of the exhibit hall, helping attendees understand the world of blogging, Facebook, Twitter, and LinkedIn.

At 10:45 Robin Lloyd, VP/GM, Managed Speech Services at Nuance Communications, gave the day's keynote presentation on "Navigating the Maze of Reform and Technology Innovation." I found the session quite useful in that Robin was able to draw parallels between other service sectors and medical transcription, showing us that the evolution of technology and its effect on productivity and compensation is not at all unique to our industry. In his view, medical transcription has reached a point where the bulk of the market disruption in terms of pricing pressure is behind us. Interestingly, Robin stated that in his opinion, computer-aided coding is considerably behind the curve compared to transcription, and that the CAC sector is likely to encounter a great deal more disruption in the near future.

Read more at ACE365.org!

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Update from ACE 2011: "Shed Or You're Dead," Full Day Of Workshops

2011-08-20T09:39:00.004-04:00

Thursday was another full day of activities here at ACE 2011 in Phoenix, the first day with a full slate of workshops in Clinical Medicine, Industry Trends & Technology, Workforce Development, and Laptop Workshop tracks. The highlight of the day for me was the opening keynote speech from Kathy B. Dempsey, a motivational speaker based here in the Scottsdale area. Her presentation was entitled, "Shed Or You're Dead: How To Stay Alive & Thrive In The Midst Of Healthcare Change!" Kathy has a background in medicine and is very much aware of the challenges facing our own industry as well as many sectors of the U.S. healthcare delivery system. Here is a sampling of Kathy's message recorded at one of her previous engagements:

Click here to read more!

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Update from ACE 2011: Last HOD Meeting, Leadership Summit, Exhibit Hall

2011-08-19T10:07:00.002-04:00

Yesterday was another busy day here in Phoenix at the AHDI 2011 Annual Convention & Expo. The first part of the morning was taken up with a Delegate & Leadership breakfast designed to spotlight and celebrate the contributions of AHDI's component and alliance leaders. New CEO Nancy Brighindi hosted a "Coffee Talk with Nancy" in which she interviewed a number of component and committee leaders about themselves and the projects they're involved in.

We also enjoyed some fun "Minute to Win It" breaks where members of the audience participated in short challenges based on the television game show.

Read more at ACE365.org!

Jay Vance, CMT
AHDI Lounge Moderator/Administrator

Update from ACE 2011: Board of Directors Meeting

2011-08-18T09:16:00.003-04:00

Greetings from "warm" Phoenix, Arizona! Yesterday I had the opportunity as the National Leadership Board District 1 Director-Elect to participate in the AHDI Board of Directors meeting held in conjunction with the Annual Convention & Expo. My fellow district directors-elect and I were invited by the BOD to sit in on the meeting and participate in the discussions, although according to our bylaws we were not allowed to vote on any items on the agenda since our terms of office don't officially begin until September 1. It was a very enlightening and encouraging experience for me to see the national leadership of AHDI in action, and I can honestly say I'm optimistic about the future. Certainly there are many challenges facing our association, but I believe we have the resources, human and otherwise, to overcome every obstacle.

Read more at ACE365.org!

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Irish Hospital Reports Offshore Transcription Outsourcing Privacy Breach

2011-08-03T09:53:00.005-04:00

According to RTE News, an Irish hospital has reported a breach of patient information related to transcription services performed in the Philippines by a company identified as Uscribe. The article and accompanying statement from the hospital chief executive are somewhat vague as to exactly what happened, but do note that "information has been subject to unauthorised access and disclosure." There was also mention of a failure to follow a policy of not including patient identifiers in dictated reports, as well as letters which were dictated but which "did not come back transcribed."

An investigation is ongoing, involving both UK and Filipino agencies.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

MedQuist's New CEO: Re-Branding On The Horizon

2011-08-01T11:01:00.006-04:00

In a recent interview published by The Tennessean, new MedQuist chairman and CEO Vern Davenport drops some hints about the future of the company, including the likelihood of a new company name. Among the highlights of the article:

The company's headquarters will be moved to the Nashville, TN metropolitan area.
A re-branding effort will commence after the M*Modal acquisition is completed.
The new combined CBay/MedQuist/Spheris/M*Modal entity will be more than just a services company or a technology provider but rather a "solutions company" offering "collaborative intelligence" to its customers.
The new company will "accelerate" the technology innovations M*Modal has been working on.
The M*Modal acquisition was "not a roll-up deal" but rather a "strategic merger."
The new company's three major emphases will be on helping physicians adopt electronic health records; continuing to streamline the narrative capture/editing/coding/billing workflow; and producing "more information, more intelligence" on the back end to support better clinical decisions.
About half of MedQuist/CBay's transcription work is being done overseas, including 28 sites in India, and Davenport expects the trend toward offshore outsourcing to continue.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

More Details Emerge On Upcoming HIPAA Audits

2011-07-28T11:23:00.002-04:00

A recent article in HealthcareInfoSecurity.com reveals further details on the upcoming HIPAA compliance audits by federal contractor KPMG. Among the highlights of the article:

The first step in the process will be to create comprehensive protocols for how the audits will be conducted and exactly how compliance will be measured.
Up to 150 on-site audits are anticipated to be conducted through the end of 2012.
OCR has not yet determined whether it will audit business associates as well as covered entities, but KPMG will develop protocols for business associate audits.
The first round of audits will likely assess overall compliance with the HIPAA privacy and security rules, rather than focusing on specific narrower issues.
OCR will provide advance notice to entities selected for audits and advance requests for documentation. Draft audit reports will typically be shared with the organization and responses will be incorporated in the final report.
OCR has not yet decided whether it will publish individual audit reports or summary reports on trends identified by the audits.
A decision on whether to continue the audits beyond 2012 won't be made until the results of the initial round have been evaluated.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

The Power Of A

2011-07-19T09:43:00.003-04:00

In an article published in ADVANCE for Health Information Professionals, Linda Brady, CAE, Director of Member Relations for AHDI, has written an article about the power of association. She shares some information about a new campaign from the American Society for Association Executives (ASAE) called "The Power of A: Stronger by Association." ASAE notes that there are 1.9 million associations and non-profit organizations in the U.S. providing their members with opportunities for networking and mutual benefit. I hope you'll take a few minutes to read Linda's article and post your comments here.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

EMR Jobs: Johns Hopkins Is Hiring And This Is What They're Looking For

2011-07-18T13:00:00.004-04:00

Johns Hopkins Medicine is in the midst of a 3- to 5-year process of moving to the Epic electronic medical records platform. As part of that process, the hospital is actively recruiting for a number of positions related to the EMR rollout. According to the job solicitation, Johns Hopkins is looking to fill "a variety of strategic positions for the implementation of the Epic modules across the Johns Hopkins Medicine ambulatory system over the next 18 months. This will include modules related to the ambulatory electronic medical record, registration and scheduling, patient portal, and related clinical analytics and clinical research.

Qualified applicants who are chosen to join the initial Implementation Team will undergo Epic Certification, a rigorous and professionally rewarding achievement that will help you advance your career and gain valuable leadership experience."

Job titles include:

Epic Application Coordinators (Levels I, II, III and Lead)
Epic Principal Trainers
Epic Report Writers
Epic Programmer Analysts (Levels A, B, C and D) and Software Engineers
Epic Administrative and Managerial Positions

The list of available jobs and their requirements provides some useful insight into the kinds of job skills that will be needed in the coming years as more and more facilities adopt EMRs.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

DOJ: Individuals Can Be Prosecuted For HIPAA Violations

2011-07-15T11:02:00.003-04:00

In an unmistakeable signal that HIPAA violations are being taken seriously these days, AISHealth.com is reporting that the U.S. Department of Justice has brought a criminal indictment against an individual who was not an employee of a covered entity (CE). What makes this case unusual, according to experts quoted in the article, is that prior to the passage of HITECH in 2009, only CEs were liable for criminal charges for breaches under HIPAA. However, under a little-known provision of HITECH, even individuals who are not employees of a CE can now face criminal prosecution for HIPAA violations:

“Section 1177(a) of the Social Security Act (42 U.S.C. 1320d–6(a)) is amended by adding at the end the following new sentence: ‘For purposes of the previous sentence, a person (including an employee or other individual) shall be considered to have obtained or disclosed individually identifiable health information in violation of this part if the information is maintained by a covered entity (as defined in the HIPAA privacy regulation described in section 1180(b)(3)) and the individual obtained or disclosed such information without authorization.’”

The article quotes Adam Greene, the senior health information technology and privacy advisor at the Office of Civil Rights (OCR) until he entered private practice in May: “Under this new provision, any individual who obtains or discloses PHI without authorization of the CE is now subject to the criminal violations.”

The relevance to individuals working in the medical transcription industry seems clear. In addition to the liability business associates such as MTSOs and independent contractors face under HIPAA/HITECH, it appears that even individuals, including MTs, can be criminally prosecuted for mishandling protected health information. If we didn't already know how critical it is to be HIPAA compliant at all times, this is yet another wake-up call for our industry and for every person who works in it.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Nuance Makes Webmedx Acquisition Official; MTEC Included In Deal

2011-07-14T08:19:00.003-04:00

In a press release issued this morning, Nuance Communications, Inc. has confirmed earlier reports that it has acquired rival medical transcription service provider Webmedx. The purchase price was not disclosed. The press release also specifically states that Medical Technology Education Center, MTEC, acquired by Webmedx in 2008, is included in the acquisition.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Sims To Resign As AHDI/CDIA Professional Programs Director

2011-07-12T16:21:00.002-04:00

Dear Colleagues,

It is with mixed emotions that I share with you my decision to resign my position as Director of Professional Programs with AHDI and CDIA. I have been offered an executive communications role with another organization and will be departing AHDI on July 24, 2011. While I am excited about the growth and opportunity of a new frontier, the decision to leave what has been a challenging and fulfilling role here was not an easy one.

Because our association is in the midst of critical transition, it was very important to me that I reach out personally to our leadership and members to share this news. This is an exciting time as we shepherd through a new era for the association with the arrival of our new CEO. We will see many innovative changes throughout the association and I have promised Nancy that I will simply shift my role of support from a staff position back to a volunteer one. I intend to stay in a contributory and participatory role with those association initiatives I have a strong connection to as much as my new schedule will allow.

I want to extend a deep and sincere thank you to each one of you who has worked with me over the years on association committees, initiatives, and projects. We have done a great work together, and I leave the association knowing that we have accomplished so much. I am truly proud of our efforts, but there is a lot of work left ahead of us, and I hope you will commit, as I will, to the continued work before us.

I have learned a great many things in my 7+ years here, so I thought I would leave you with some final thoughts and words of encouragement:

• Always keep in mind that the journey together is slower than the journey alone (John Maxwell). When we are tempted to get frustrated at our slow progress, it’s important to remember that a speedboat can move faster but holds only a few people. If we want everyone across the finish line and not just an elite few, we have to commit to the slow but inclusive race even when the finish line seems invisible.
• There will always be those who question and criticize the size and attributes of your ship, the layout and design, the resources used to keep it moving, the direction it’s heading, and the people who are on it. Listen carefully to those concerns but don’t let them stall the ship. A ship adrift is one that has no purpose at sea. This belief has fundamentally sustained me during my tenure here. We have to keep moving.
• No conviction of purpose, no mission, no objective is more important than relationships. I leave AHDI wrapped in quilt of friendship – each patch and stitch unique and amazing. The diversity of opinion and experience represented by those relationships is what makes our association a home, but sometimes we get so swept up in the zeal of our purpose that we forget what truly connects us – each other. We must assume good will and confer value on others even when we fundamentally disagree.

Thank you again for the honor and privilege of serving you in this role, and I hope to see you all at ACE in Phoenix.

Gratefully,

Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI & CDIA

Mayo Clinic Unveils New Social Networking Site

2011-07-12T06:20:00.002-04:00

The Mayo Clinic is now offering its own social networking site providing a place where its 500,000 annual patients and 50,000 employees can connect. The site offers discussion forums, news articles, blogs by Mayo staffers, and a section for videos covering a wide variety of topics, including navigating airports close to Mayo locations. The site is very well done, with a clean, uncluttered look. The home page includes a featured video, a listing of active forum discussions, as well as a real-time Twitter feed.

By investing a significant amount of time and effort into this endeavor, the Mayo Clinic clearly recognizes the value of social media in helping its patients and staff members stay connected--a move which is not only good for its patients but good for business as well.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

MedQuist To Acquire M*Modal For $130 Million

2011-07-11T17:37:00.003-04:00

According to a press release posted on the MedQuist website, MedQuist has entered into an agreement to acquire speech understanding technology provider M*Modal for $130 million. The purchase price consists of $48.4 million in cash paid at closing, $28.8 million in installments paid in cash over the next three years and 4.1 million shares of MedQuist Holdings common stock currently valued at $52.8 million, based on $12.76 per share. In conjunction with this move, MedQuist has also brought a new CEO on board, Vern Davenport, who recently oversaw the merger of Misys Health with Allscripts.

According to the press release, MedQuist will host a conference call on July 12, 2011, at 8:00 a.m. CT to discuss the transaction. A live broadcast of the call will be available online at www.medquistholdings.com, under Investor Relations or http://www.videonewswire.com/event.asp?id=80865 on July 12, 2011, beginning at 8:00 a.m. CT. The online replay will follow shortly after the call and continue for one year.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

HHS Appoints Contractor To Conduct HIPAA Compliance Audits

2011-07-05T09:04:00.003-04:00

The U.S. Department of Health and Human Services has awarded a contract to KPMG to become the government's HIPAA compliance auditor, according to an article by Adam Greene of the law firm Davis Wright Tremaine. The contract calls for KPMG to develop a HIPAA compliance audit protocol and then perform audits on approximately 150 covered entities and business associates before Dec. 31, 2012.

Quoting from the contract notice:

Site visits conducted as part of every audit would include interviews with leadership (e.g., CIO, Privacy Officer, legal counsel, health information management/medical records director); examination of physical features and operations; consistency of process to policy, observation of compliance with regulatory requirements.

As Greene points out, there are still a number of unanswered questions surrounding the audit process:

We do not know the scope of the audits, such as whether KPMG will review general compliance with the Privacy and Security Rules or whether the audits will be focused on specific issues. [W]e do not know how entities will be selected for audit (the contract synopsis suggests some level of stratification, indicating that entities of different size and scope will be selected, but we do not know to what degree selection will be through a random process). Most importantly, we do not know whether the audit program will be used as an enforcement tool (leading to resolution agreements or civil monetary penalties), or whether it will be used strictly as an educational tool to improve general compliance.

As Greene notes, if in fact the target number of audits in the next year and a half is 150--including BOTH covered entities and business associates--the chances of any particular firm being audited is extremely low. But the same could be said about having an automobile or fire or life insurance claim! Every business associate, from the largest MT service providers to independent contractors, would do well to take steps now to ensure HIPAA/HITECH compliance.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

A Credentialing Journey

2011-07-04T09:25:00.002-04:00

Note: This material was first shared by the author, Carrie Dugger, in the AHDI New Professionals Alliance discussion group.

I was asked to share my story with you regarding obtaining my RMT credentials. It was not an easy road, but definitely a road worth taking!

I started my MT schooling in mid-November 2010. I had just been told that my employer at the time was closing their facility here. Needless to say, I had choices to make. I was always interested in medical transcription, but now the chance finally arrived to make it my profession! I worked very hard in school and completed my classes on April 22, 2011. Once I had completed my classes, I knew that I would need credentials before I would have any chance of obtaining a job as a "newbie" MT. Not only that, but I wanted to prove to the world (and myself) that I had indeed learned the skills necessary to do the job. I joined AHDI while I was still in school. The member savings made it well worth the dues.

I soon realized that the school I had attended had not, in my opinion, given me enough instruction to pass the RMT. You know, the old adage "you don't know what you don't know." I found out and decided that I wasn't about to let anything stand in my way.

I ordered the Book of Style, 3rd Edition and the workbook that goes along with it. Once I read some of it, I knew that I still needed more knowledge. I did A LOT of research on the web. I have been on just about, if not every, MT site on the web. I read comments, asked questions, and to my surprise gained a heap of valuable advice.

It was suggested that I re-take classes based on the SUM program. Well, I'm sure you all know that being out of a job and paying for more schooling just didn't seem possible. Then I learned that HPI has a Career Development series. I ordered it about the same time that I ordered my RMT Exam Blue Print workbook. Then I ordered the AHDI Mega MT Challenge CDs. My original plan was to take the RMT exam in April right after I got out of school, then it was May, then I pushed it out to June...the very last day of June that it was offered. I was nervous that I wouldn't know enough to pass the test.

I studied relentlessly and kept asking questions to everyone and anyone that would give me answers. Again, I was delighted to find that everyone was more than willing to help me. I joined SE-AHDI on Facebook, then I joined the MT Inner Circle website. The price of membership is small, but the tests and information available there is extremely valuable. As I'm sure most of you that frequent these sites know, I had a bit of a meltdown the last two days before taking the test.

One of the things that really encouraged me were the emails that I received from AHDI staff and members alike. I still can't believe what an awesome support group is available for us if we are only willing to embrace it.

Anyway, I took some wise advice and spent the day before the test just brushing up. I got a good night's sleep and was actually more excited than nervous when I arrived at the testing facility. I went in to take the exam with just my headset. I started the test and was really surprised at how many of the questions I was able to quickly go through! Don't get me wrong, I marked plenty for review. I actually completed the test in just over an hour and a half. I spent the next half hour reviewing the questions that I had marked. I was extremely scared when I clicked the Submit button...then it pops up and says "Are you sure you want to submit your answers now? You will not be able to make changes after you have clicked submit." I paused and said to myself, I've done my best and that's all I can do. I clicked to submit and almost instantaneously the results came up "Passed"!!! I was so elated I almost cried.

I have heard a lot of people on some "MT" sites say that they don't believe in the need for credentialing and that they don't care about it. I believe that it is that very attitude that has us (MTs and especially "newbies") in the position that we are in today. We graduate from a school and because there isn't enough standardization, we still can't get a job. I believe that the only way that we can ever move forward as professionals is to unite in the cause of solidifying our knowledge base and getting all MTs credentialed.

I know for sure that I earned my RMT! It makes me feel accomplished to have those credentials next to my name. It means something to me, and before all is said and done I truly believe it will mean even more to the profession.

Sorry it was a little long, but I just want you all to understand that it is not impossible to get credentialed. Not only is it possible, but it is in my humble opinion, imperative.

Thanks for listening. Please feel free to contact me personally if I can ever be of assistance to any of you.

Sincerely,

Carrie Dugger, RMT

The Great Debate

2011-06-30T17:04:00.004-04:00

One of the criticisms leveled at AHDI over the years has been the perception that the leadership hasn't shown a willingness to engage in productive discussions about "hot button" issues. The association is taking what I consider to be a significant leap forward in addressing that concern by sponsoring "The Great Debate" at this year's Annual Conference & Expo in Phoenix, AZ this August. This will be a 2-hour, facilitated, collegiate-style debate on five key industry topics, including:

“Mandatory” Credentialing: Worth the Effort or Waste of Time?
Offshore Outsourcing: Restrict it or Regulate it?
Incentive Compensation: Carrot or Stick?
Trending Technology (EHR/SRT): Threat to Transcription or Opportunity for Growth?
AHDI & CDIA Partnership: Collaboration or Conflict?

Each topic will be presented by both point and counterpoint opening statements, followed by timed debate from the floor and an audience poll. We're looking for attendees with good presentation skills and a strong affinity for either point of view to write and present the point or counterpoint for each of these issues. If you're interested in participating, please contact Lea Sims, CMT, AHDI-F, as soon as possible.

Again, I think this is a big step in the right direction in terms of encouraging dialogue regarding the issues that we know are on the minds of working MTs.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

The Results Are In: AHDI National Leadership Board Election Successfully Completed

2011-06-29T16:25:00.003-04:00

The official results of the AHDI National Leadership Board election have been posted on the AHDI website. The board members-elect are as follows:

District 1 Director – term from September 2011 to August 2013 - Jay Vance, CMT
District 2 Director – term from September 2011 to August 2014 - Bonnie Monico, CMT, AHDI-F
District 3 Director – term from September 2011 to August 2013 - Martha Songer, RMT
District 4 Director – term from September 2011 to August 2014 - Diane Warth, CMT, RHIT, AHDI-F
District 5 Director – term from September 2011 to August 2013 - Cynthia Alder, RHIT, CMT, AHDI-F
District 6 Director – term from September 2011 to August 2014 - Ann Donnelly, MS, CMT, AHDI-F
At-Large Director – 2 positions for a term of September 2011 to August 2014 - Linda Giles and Susan Lucci, RHIT, CHPS, CMT, AHDI-F

Congratulations to each of the successful candidates and thanks to all the candidates who participated in the process. Most especially, much respect to all the AHDI members who made the effort to cast a vote to make a difference for the future of our association.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Let Your Voice Be Heard!

2011-06-24T16:03:00.003-04:00

Voting for AHDI National Leadership Board candidates continues through midnight on Monday, June 27. All eligible voting members of AHDI should have received an email containing a link to the online ballot and personalized log-in credentials. Even though some candidates are running unopposed, a minimum of 10% of eligible voting members must cast their ballots in order for the election to be valid. Please take a moment to exercise one of the privileges of AHDI membership and let your voice be heard!

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

ONC Releases Health IT Training Materials To The Public

2011-06-23T17:48:00.002-04:00

In a rather amazing example of the taxpayers actually getting something for their money, the Office of the National Coordinator for Health Information Technology made the following announcement today:

The Office of the National Coordinator for Health Information Technology (ONC) is pleased to announce that a set of 20 curriculum components is now available to the public at no cost, including all institutions of higher education nationwide and internationally. Funded by the $10 million ONC Curriculum Development Centers Program, these teaching materials have been in use for the past year by the 82 member colleges of the ONC Community College Consortia Program. It is expected that these materials will fill an urgent need in the educational marketplace.

Designed around the six mobile workforce roles identified by ONC, the components are intended to become the building blocks of health IT courses at community colleges and universities. In-service training and continuing education programs at health care institutions and Regional Extension Centers may also benefit from the use of the components. Each component is made up of several units that can be modified and combined to meet the needs of instructors as they design their courses. The components include slide-based lectures with audio narration and transcripts, learning activities, self-assessment questions with answer keys, and instructor manuals.

The components cover topics such as workflow process redesign, technical support, networking, usability, and project management, among others. Three of the components offer a hands-on lab experience for students supported by the VistA for Education electronic health record software package, also available at no cost.

Totaling over seven gigabytes of information across more than 200 units, these innovative teaching materials offer a robust new set of tools for health IT instructors.

To obtain the materials, go to http://www.onc-ntdc.org or http://www.onc-ntdc.info to set up a profile and download the components.

Visit the ONC website to learn more about the Curriculum Development Centers Program and other ONC health IT workforce development programs.

What this means is that employers and training institutions in healthcare-related fields can set up their own health IT training programs to prepare workers for jobs in an EMR environment. This is, in my opinion, a truly momentous development that MT companies and schools should jump on without delay.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Relevance Is A Two-Edged Sword

2011-06-23T09:58:00.006-04:00

A word I'm hearing--and saying--a lot these days within the medical transcription field is "relevance." We're all concerned about staying relevant in a healthcare culture that has gone gaga over electronic medical records, and we wonder and worry about what the future will hold for our profession. Most folks I talk to agree that we need to stay relevant, but not everybody means the same thing when they use that term.

The truth is that relevance depends entirely on our assumptions regarding what or who it is we're trying to stay relevant TO. In the context of the medical transcription community, the things working MTs might consider relevant to their everyday lives and work environment aren't necessarily the same issues that determine the relevance of our industry within the bigger picture of the U.S. healthcare delivery system. Particularly with regard to our professional association, the definition of relevance is going to vary widely depending on who you're talking to.

I thought of an example from the world of organized religion that illustrates this point. The church I attend is affiliated with a very well-known Protestant religious denomination which has a strong emphasis on sending out missionaries to the far reaches of the globe. At the same time, each local congregation has the autonomy to set their own priorities and spend funds as they see fit. All of the funding for the "big picture" initiatives pursued by the national denominational organization has to come from cooperating local churches, and of course the local churches are supported entirely by donations of time and money from individual members. Thus there is a direct correlation between the level of financial and moral support provided by individual church members and the level of global, big vision initiatives the national organization can pursue.

The challenge for the national leadership, of course, is to convince the average churchgoer that what happens in a village on the far side of the world is somehow relevant to the lives of everyday Americans. Clearly in order to do that, an appeal has to be made to some higher purpose, a cause bigger than ourselves. Folks who are struggling just to make ends meet are asked to give of their precious time and money in order to support something that will most likely offer no tangible benefit to the day-to-day existence of the donor.

Any of this sound familiar???

The reality, of course, is that in every facet of human existence there is a constant tension between altruism and generosity on the one hand and the basic human instinct to look out for one's own best interests on the other. No organization, be it a local church, a worldwide denomination, a local associational chapter, or a global professional membership organization, can ignore either one of these forces and expect to keep the doors open for long. With regard to AHDI specifically, there's no question that we have to find ways to provide tangible benefits to our members. That will be one of my primary goals if I'm elected to the National Leadership Board. But at the same time, we can't ignore the importance and necessity of reminding our members that there are in fact bigger fish to fry than just what we see happening on a local level. The very nature of our remote workforce tends to breed a narrow, isolationist viewpoint, I think, which can prevent us from recognizing larger trends that at some point WILL have a direct impact on our lives.

Just as the average churchgoer in the pew must balance the demands of his or her own needs with the needs of others at home and abroad, so too must AHDI members find a place where "What's in it for me?" can coexist with "Do it for the good of the profession." And in both examples, leadership will play a crucial role in helping individuals find that middle ground. There will never be a perfect balance, and we will no doubt swing more to one side or the other at times, but at the end of the day we have to find a way to accommodate both.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

A Solid Foundation For Healthcare Documentation Quality

2011-06-20T11:11:00.003-04:00

Dr. Rebecca McSwain, PhD, CMT, Professional Practices Associate at AHDI, has written an article in ADVANCE for Health Information Professionals online magazine entitled, "Laying the Foundations for Documentation Quality." In her article, Dr. McSwain provides information on resources for preparing medical transcriptionists for existing and future roles in the healthcare documentation process. Specifically, the article focuses on AHDI's Healthcare Documentation Quality Assessment Best Practices Tool Kit, the RMT Exam Guide and the CMT Exam Guide. I hope you'll take a few moments to read Dr. McSwain's article and pass along the information to anyone who might find the information useful.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

New Professional Association For Medical Scribes

2011-06-20T07:43:00.004-04:00

A new professional organization for medical scribes has been formed, the American College of Clinical Information Managers (ACCIM). According to the organization's website, which is clearly a work in progress, "ACCIM is a non-profit 501(c)3 organization devoted to advancing the education, proficiency and professional standing of medical scribes. We are the only governing body charged with upholding the standards of excellence for accreditation, training, and evaluation. After gaining membership into the ACCIM, and working over 100 hours as a medical scribe, our members can obtain professional certification as a Clinical Information Manager. This distinction underscores individual commitment and certifies the mastery of the myriad skills required to assist physicians with real-time documentation and efficiency in the modern clinical environment."

According to the website, the association's president, Michael Murphy, MD, and vice-president, Luis Moreno, MD, are both executives with scribe services provider ScribeAmerica. Treasurer Alex Geesbreght, JD, is the CEO of PhysAssist scribe company, while secretary Mark Richmond, MD, is a founding partner of Emergency Medicine Scribe Systems. The organization's physical office address is listed as Caldwell, New Jersey.

The website describes several different categories of members, including certified ($20/year), registered ($20), affiliated ($30), and corporate ($15,000). There is also mention of a $250 fee for scribe service providers wishing to become affiliated with ACCIM, although this fee will be waived through the end of 2011. The cost of the individual certification exam is listed as $40.

The requirements for certification eligibility include having worked at least 100 hours as an unassisted scribe and having received training in such areas as medical terminology, basic anatomy, CMS Core Measures, basics of coding, documentation for billing and medical legal liability, HIPAA compliance, functions of hospital or clinic electronic data information source, basics of history and physical documentation, clinical scenarios, EMR training. In order to be eligible for certification a scribe must have completed a minimum of 100 patient encounters and pass a 90-question certification exam with a score of at least 80%.

The formation of a separate organization purporting to represent medical scribes would seem to highlight the divergent paths of medical transcription and medical scribing, but it remains to be seen whether or not AHDI has a role to play in this emerging field.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

AHDI Election Ballot Now Open

2011-06-13T16:26:00.004-04:00

Online voting for AHDI National Leadership Board candidates is now open. All eligible voting members should have received an email with a link to the online ballot as well as login credentials. If you are an eligible voting member of AHDI and did not receive your voting information by email, you can contact the AHDI Member Relations Department by telephone at 1-800-982-2182 or by email at ahdi@ahdionline.org. A quorum of 10% of eligible voters is required in order for the election to be valid, so it's important to vote even for candidates running unopposed. The online ballot will close at midnight on June 27.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Meet the Candidates: AHDI National Leadership Board (Post 4)

2011-06-09T17:39:00.002-04:00

Today's candidate question drills down on personal passion and platform issues:

Every director or speaker comes to their new role with a particular passion for something – whether it’s components, credentialing, advocacy, education, etc. This typically will become a platform issue for that leader and helps to define what their unique contributions will be during their tenure in that role. What would you identify as your primary platform issue? What will be the indelible mark you hope to leave on the association when you’re term is over?

Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI

Meet the Candidates: AHDI National Leadership Board (Post 3)

2011-06-08T19:05:00.002-04:00

Today's Candidate Question relates to membership recruitment - something all associations spend a significant amount of time and energy strategizing around:

It’s no secret that AHDI, like many nonprofit associations, has had its challenges convincing industry professionals to invest in membership, and our membership numbers continue to reflect that reality. How would you suggest the association specifically address membership recruitment? What unique ideas would you bring to your role as director or speaker for growing our membership base?

Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI

Executive Shakeup At AHIMA

2011-06-08T15:04:00.000-04:00

Not sure what's going on over at AHIMA, but HealthcareITNews.com is reporting that both the CEO and COO are no longer with the organization. The article quotes AHIMA's PR director as saying that CEO Alan Dowling and COO Sandra Fuller had left "within the past month." The spokeperson not only would not comment further, he also declined to say why he couldn't comment further, but did say of the departures, "We think this is in everybody's best interest at this point."

He would not say whether Dowling and/or Fuller had been fired.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Meet the Candidates: AHDI National Leadership Board (Post 2)

2011-06-07T14:25:00.002-04:00

Question #2 for our candidates is a two-part question related to a critical association objective - professional credentialing:

1. How would you respond to an MT who believes that AHDI promotes credentialing merely to generate revenue? How would you convince an MT who doesn’t think they “need” it to achieve or maintain employment to seek credentialing?

2. What ideas do you have for helping AHDI promote credentialing to students, working MTs, and employers? How would you articulate the value of credentialing to an industry employer?

Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI

Working For What You're Worth

2011-06-07T12:57:00.005-04:00

It seems that yesterday's post, "We Have Met The Enemy And He Is Us,"has generated a fair amount of discussion--here in the Lounge as well as on other MT-related blogs and forums--on the topic of what role medical transcriptionists themselves play in the decline in MT compensation. I think a number of very valid and diverse viewpoints have been expressed on the issue, which is exactly what we need in our industry. Here are some follow-up observations and clarifications from my standpoint.

In my post from yesterday, I used the phrase "working for less than what you're worth." That can certainly be interpreted in a number of ways, right? I used that phrase in the context of the article in Matrix magazine which was the focus of the blog post. I quoted the author of the article, Kenneth Schafer, who in turn quoted another MT service owner as saying she had MTs who would "do a great job for low pay." When I read that quote, I interpreted "low pay" as meaning lower than the going rate of what a skilled MT can reasonably expect to receive. That is the context for my phrase "working for less than you're worth." As was pointed out in a comment on yesterday's post, who doesn't think they're worth more than they're getting paid?! But that's not my definition of working for less than what you're worth. The going rate is what it is, and working MTs have little control over the market forces which determine the average industry salary or line rate for medical transcription. (That's probably a subject for another blog post.) However, an exception to the previous statement is that if large numbers of MTs consistently work for less than the going rate--less than what a skilled MT is worth in the marketplace--then that does contribute to the the downward pressure on compensation. I hope this clarifies the context of my statements with regard to "working for what you're worth."

There have also been some comments made with regard to "leading by example." I totally agree with that viewpoint. In the context of my previous paragraph with regard to the definition of "working for what you're worth," it has not been all that long ago that I had opportunity to negotiate with an employer as to the "going rate" for the work I was performing for them. An important factor in determining the fair market value of my job was what another employer in the same field would offer for a similar position. As a result of that negotiation, with the employer's understanding that I knew the fair market value of the work I was performing and the knowledge that I would consider changing companies if necessary, the end result was an increase in my compensation. I believe MTs can and should use a similar approach in determining the "worth" of the work they perform. Referring back to the original article by Schafer and the example he gave of the MTSO who was paying her MTs a "low rate," my advice to those MTs would be find out what they could be making with competing MT service providers in order to determine what they could and should reasonably demand from their current employer. Naturally, in order to negotiate effectively, an employer has to be convinced that an employee is willing to leave if they aren't offered fair compensation; that's simply part of the process.

Finally, there have been some comments on my statement (which was itself a comment on my original post) that "my hope is that there will be someone who needs to hear that their skills are worthy of fair compensation and will have the courage to stand up for themselves. Again, if enough MTs did that in an organized fashion, the MT service providers would have to take notice." Again, this statement as well as everything else I've written on this subject, is in the context of the original article about MTs working for "low pay," that is, compensation that's less than the fair market value of the work being performed. If all the MTs at who worked for that MT service owner took a stand together--"in an organized fashion"--that service owner would most definitely take notice. That was what I was referring to; there was no intention on my part to allude to unionization or some other mass organized movement on the part of MTs across the industry.

I want to make it very clear that it was not my intent to blame low MT compensation in general on MTs; nothing could be further from the truth. As I said previously, the market factors that impact the going rate for MT work are outside the average MT's sphere of influence. My focus was solely on situations where MTs are working for less than the going rate; my intent is to encourage--"put courage into" as Lea said--MTs to have the confidence in themselves and in their abilities to not settle for sub-par compensation.

Again, I'm very happy to see that this subject is being discussed, I think it's something that needs to be addressed from a variety of perspectives.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Meet the Candidates: AHDI National Leadership Board (Post 1)

2011-06-06T11:38:00.003-04:00

This will be the first of several questions I will be posting here in the Lounge to our National Leadership Board Candidates. Each day this week, I will pose a question to our candidates and provide them an opportunity to post a response via the comment area. Feel free to post followup questions to the candidates here, but please try to stick to the subject posted for the day. If you have other questions for the candidates, let us know at lsims@ahdionline.org.

Question for Day 1: Based on the state of both the industry and the association, what do you perceive AHDI’s current strategic priorities to be, and where, if anywhere, would you recommend a change or shift in priority?

Don't forget to join us for tonight's Meet the Candidates Webinar (Part 1). Register here.

Lea M. Sims, CMT, AHDI-F
Director of Professional Programs, AHDI

"We Have Met The Enemy And He Is Us"

2011-06-06T07:29:00.006-04:00

Pogo Possum was the creation of comic strip author Walt Kelly, and this is probably his best-known quote. I personally have found it quite useful over the years to express my frustration, often at myself, at our tendency to be our own worst enemy. I had occasion to use it yet again today as I read through the latest edition of AHDI's member magazine Matrix. I can't link to it since it's available to AHDI members only, but I can tell you about one article in particular by author Kenneth W. Schafer, owner of Expert Medical Transcription in Miami, FL. The title of the piece is "Why Is My Paycheck Pitiful?" and it deals with the very timely issue of falling compensation for MTs. Schafer says he conducted an informal poll among other MT service owners about why working MTs aren't doing better financially, and some of the responses were what you'd expect: speech recognition technology, offshore outsourcing, and template-driven EMR systems. But there was one response that really illustrates that some of the downward financial pressure on MT compensation is self-inflicted.

According to Schafer one MTSO told him that "she has MTs who will do a great job for low pay."

I'll let you think about that for a moment...

As Schafer points out, "as long as there are people who will work for a lower wage, why would any company pay them more money?" That's Business Ownership 101. It's the same reason why as a consumer I shop around for the best deal before I buy something; why would I pay more for something I can get for less?

As much as we'd like to blame "the suits" for falling MT wages, as long as skilled transcriptionists are willing to work for less than they are worth, MT service owners will be more than happy to accommodate them. Is it a scary thing to ask for a raise? It certainly can be for many of us. Is there a risk that asking for fair compensation could result in an employer saying "I pay what I pay, take it or leave it?" Of course--but is that the kind of employer you really want to work for?

If there is one message I believe working MTs desperately need to hear from their professional association, it is that you don't have to settle for less than you're worth. If enough MT practitioners take a stand against sub-par compensation, the industry will have no choice but to pay a fair wage or line count. As much as you the working MT need a job, MT service providers are just as dependent on you to provide the skilled labor necessary to fulfill their obligations to their clients. Settling for less than you're worth not only hurts you, it drags down compensation for the whole profession.

Business owners are going to run their businesses in a way that provides the highest return for the lowest investment; that's reality and it's not going to change. But as skilled workers, medical transcription professionals have more clout than they realize, especially if they'll stick together. I believe AHDI can and should provide more encouragement to working MTs in this regard; it's the very least we should expect from a professional association that exists to serve its hard-working member practitioners.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

New CEO For AHDI/CDIA

2011-06-03T08:37:00.002-04:00

The following announcement was made late yesterday:

Dear AHDI and CDIA Members,

On behalf of the Board of Directors, we are excited to announce the hire of our new Chief Executive Officer — Nancy Brighindi, PhD, MBA, CAE. Dr. Brighindi comes to us with extensive experience in membership development and marketing, association management, strategic planning, component relations, professional advocacy, and alliance-building. She has spent the last 11 years with the American Society of Addiction Medicine and has unique experience working with and for healthcare professionals in an association setting.

Dr. Brighindi will be joining the AHDI/CDIA staff on June 20, 2011, and we look forward to working with her to identify strategic priorities and objectives that will continue to position this industry and our members for greater relevance in clinical documentation and position the associations as organizations of impact and credibility in the sector. She will be based in the Washington, DC, metro area.

Please join us in welcoming Dr. Brighindi to our associations, and we look for your participation and engagement as we work with Dr. Brighindi moving forward.

Sincerely,

Barb Marques, CMT, AHDI-F, AHDI President
Noel Bambrough, CDIA Chairman

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

And Now A Word From Your Moderator

2011-05-26T15:13:00.005-04:00

Earlier this week I learned that the AHDI nominating committee had finalized the ballot for candidates for the new National Leadership Board, and yours truly is among that group. I'm very honored, humbled and excited at the possibility of serving in a leadership role for AHDI as a representative of District 1. With this in mind, I've discussed with AHDI leadership my role as administrator/moderator for the Lounge blog, to make sure there would be no conflict of interest, now or in the future if I were to continue to serve in this capacity. I've been assured there should be no conflict, but I want to keep everything out in the open to avoid any misconceptions in this regard.

First, the only compensation I've ever received for my services as a writer, administrator and moderator of the Lounge blog since I took on these roles in January 2010 has been the waiving of my AHDI annual membership dues, CMT renewal fee, and ACE registration; I have received no other compensation. I have been informed that if I'm elected to the AHDI NLB, my annual membership dues and ACE registration would also be waived, and I will not be due for renewal of my CMT until January 2014, after my term on the NLB is over. Thus there will be no conflict of interest with regard to any financial interest on my part relating to the Lounge.

Secondly, the Lounge is by no means my own private soapbox. All current directors, NLB candidates, regional/state/local component leaders and AHDI members at large are strongly encouraged to participate here in the Lounge, by commenting on existing topics and/or starting new ones. Guest posts are always welcomed. With regard to NLB candidates in particular, we will all have the opportunity to answer questions from members during the week of June 6, in conjunction with the "Meet The Candidates" webinars scheduled for that week (more information on that will be published here shortly.

In closing I'd like to say that it has been an honor and pleasure for me to serve as a facilitator for the many lively discussions we've had here on the Lounge. I hope to continue to do so, at the pleasure of our members, regardless of what other opportunities may arise in or out of AHDI in the future.

UPDATE: I've been informed that board members' annual membership dues are NOT waived as stated above.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Passionate Engagement and Association Membership...it's all around us!

2011-05-24T13:42:00.005-04:00

Recently I sent out an informal request to association leaders at component and district levels around the country, asking them why membership was important to them from both personal and professional perspectives. Below is a compilation of the responses I received. It was exciting to see the common themes throughout the responses, reflecting a spirit of likeminded thinking.

10. Professional networking and relationship-building that occurs by not just being a member but actively engaging in association life. That networking yields opportunity, something an isolated MT cannot tap into by living her career in a vacuum. Networking opportunities. Oftentimes it is not what you know but who you know. Networking opens doors if one is actively engaged.

9. Advocacy—letting the public know who it is that keeps track of what physicians include in the individual health record. Being visible and being heard by lawmakers—this takes lots of members and a dedication to being vocal as well as being visible.

8. Expanded career opportunities.

7. Educational growth and continuing education are necessary for keeping your skills sharp.

6. Understanding technology.

5. Escaping the isolated “vacuum” feeling common to those working remotely, being reminded that the profession is over 300,000 strong.

4. Leadership growth opportunities.

3. Being part of a group of like-minded professionals. Being with others who understand why we can spend 30 minutes and 15 e-mails discussing whether or not to hyphenate, or why it is important that enterococcus by itself is not capitalized and when and why it is important that department names are not capitalized.

2. Being “in the know.” Staying abreast of industry changes through connectivity to industry and profession updates.

1. Volunteer leadership roles provide an opportunity to develop confidence and know-how which can be conveyed into professional advancement.

Want to know more? This survey result is part of a longer article on the nature of passionate engagement that will be coming out soon in Plexus.

Lisa Day Johnson, CMT, AHDI-F
Secretary, AHDI Board of Directors

Leadership For A New Business Paradigm

2011-05-24T07:59:00.003-04:00

I recently came across a great blog post over at advanceweb.com entitled simply, "10 Leadership Tips" by business consultant Francie Dalton. Of course, articles on how to be a better leader are a dime a dozen, but this list struck me as being particularly relevant to the new business environment we find ourselves in. The fact is that a lot of the old rules of thumb regarding business leadership simply don't apply anymore, and the sooner we come to grips with that the better leaders we can become.

Here are some of the highlights of the article that I thought were particularly relevant to our profession and our professional association; emphases are mine.

Embrace unity. Leaders must make employees (or members) essential contributors to shared goals. Unity isn't cognitive. Even if borne of shared belief, unity is an emotional state, and is palpable. It is built not through dogma or a series of completed transactions, but through a quality of leadership that resonates with those being led.

Build community. Does your organization have an online, annotated human capital directory that is searchable by name, function, capabilities (whether part of current function or not), hobbies, affiliations, etc.? Assuming you have an intranet, are you regularly featuring employee accomplishments? Is there an employee "bulletin board"? If not, you have an employee base, not a community.

Be approachable. An open-door policy, a suggestion box, an invitation delivered at an all-staff meeting to "come visit," even a memo promising folksy charm isn't the kind of approachability employees want from their leaders. Get out there! Don't sit back passively waiting for them to initiate contact. You have to do the approaching.

Think versatility. Typically leaders create, apply and direct multiple types of capital simultaneously: financial, intellectual, natural, human, etc. There is another type of capital leaders also use every day, but perhaps with less fluency: social capital. Resolve today to stop waiting for others to become who you wish they were, and instead, develop the versatility to work effectively with who they actually are.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

OCR: Final HIPAA Security Rule Will Not Require Encryption

2011-05-17T12:40:00.003-04:00

HealthDataManagement.com is reporting today that the final HIPAA security rule, expected to be released within the next few months, will NOT include a requirement that all electronic protected health information (ePHI) be protected through encryption. This is according to Susan McAndrew, deputy director for health information privacy in the Department of Health and Human Services' Office for Civil Rights. McAndrew was specifically asked if some type of encryption mandate would be in the final rule. She pointed out that none of the earlier proposals called for a change to the existing security rule on encryption, an consequently such a mandate won't be in the omnibus final rule. "If the requirement for encryption changes from an addressable implementation specification to a required implementation specification under the security rule, then normal notice and comment rulemaking processes would need to follow," she said.

The fact that the final HIPAA security rule will not make data encryption mandatory should not be an excuse for not encrypting data. There are plenty of good reasons to encrypt, and very few to NOT encrypt. If nothing else, breaches of encrypted data don't have to be reported under the current breach notification rules.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Happy National Medical Transcriptionist Week!

2011-05-17T07:40:00.003-04:00

Twenty-six years ago President Ronald Reagan proclaimed May 20-26, 1985 as the first National Medical Transcriptionist Week. Medical transcriptionists were vital to the health and well-being of Americans back then, and we still are today. In honor of this special occasion, here are some original songs for the working MT, composed and performed by yours truly. I hope you enjoy them!

SONGS FOR THE WORKING MT

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Let's Talk About...Credentialing Our Industry Leaders

2011-05-11T07:56:00.003-04:00

AHDI President-Elect Sherry Doggett and Kristin Hagen, CPHIT, CPEHR, CPHIE, AHDI-F, have written the latest in a series of open letters to healthcare documentation professionals. The letter is entitled, "Let's Talk About...Credentialing Our Industry Leaders." In their article, Sherry and Kristin address what has become the topic of some, shall we say, "spirited" conversation on some online MT-related venues, and that is whether or not AHDI board members should all be required to hold a CMT credential. This conversation is particularly relevant in light of the resolution passed in August 2010 by the AHDI House of Delegates advocating for mandatory credentialing of all healthcare documentation practitioners, with the obvious implication that the AHDI Board of Directors should lead by example.

In their letter, Kristin and Sherry make the case for the need for directors holding credentials other than the CMT. They point to the decision by the membership in 2007 to change the name of the association while broadening the membership base to welcome practitioners from other healthcare documentation-related fields. Sherry and Kristin also point out the value of having directors with a variety of professional backgrounds and skill sets as a means of moving the organization forward in a rapidly changing healthcare environment.

The discussion surrounding professional credentialing in the healthcare documentation field will continue with an AHDI Town Hall meeting on Tuesday, May 17 at 4 p.m. Pacific/7 p.m. Eastern. The online webinar will be hosted by Brett McCutcheon, CMT, AHDI-F, and Lisa Williams, CMT, AHDI-F, and will give attendees the opportunity to weigh in on this important and timely issue.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Final HITECH Privacy & Security Rule Ready In "Months, If Not Weeks"

2011-05-10T13:25:00.003-04:00

From the I'm-not-sure-this-is-really-news department, Health Data Management is reporting that the omnibus privacy and security final rule mandated under HITECH should be ready no later than the end of the year. That's according to Susan McAndrew, deputy director for health information privacy in the Department of Health and Human Services’ Office for Civil Rights. She is quoted as saying, “Certainly by the end of the year, or one of us will be out of the door by the end of the year and I hope it will be the regulation” during remarks at the Safeguarding Health Information conference in Washington. “I really hope we are now targeting months, if not weeks, for the new regulation.”

The omnibus final rule will cover electronic protected health information (ePHI) security requirements for business associates, breach notification, and compliance enforcement, all of which will directly affect medical transcription service providers. It isn't known at this point how the final final rule will differ from the interim final rules announced in 2009 and 2010. And it's anybody's guess if the final rule will really be the "final word" on HIPAA enforcement!

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Things It Takes Most Of Us 50 Years To Learn

2011-05-09T13:11:00.003-04:00

Got these from a friend today and thought you might enjoy them as much as I did. No idea where they came from, otherwise I'd gladly give credit where credit is due.

1. The badness of a movie is directly proportional to the number of helicopters in it.

2. You should never say anything to a woman that even remotely suggests you think she's pregnant unless you can see an actual baby emerging from her at that moment.

3. The one thing that unites all human beings, regardless of age, gender, religion, economic status or ethnic background, is that, deep down inside, we ALL believe that we are above-average drivers.

4. There is a very fine line between "hobby" and "mental illness."

5. People who want to share their religious views with you almost never want you to share yours with them.

6. If you had to identify, in one word, the reason why the human race has not achieved, and never will achieve, its full potential, that word would be "meetings."

7. The main accomplishment of almost all organized protests is to annoy people who are not in them.

8. You should not confuse your career with your life.

9. A person who is nice to you, but rude to the waiter/janitor, is not a nice person.

10. When trouble arises and things look bad, there is always one individual who perceives a solution and is willing to take command. Very often, that individual is crazy.

Have a great Monday! 8-)

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Dancing with the Stars at the AHDI/CDIA Advocacy Summit

2011-05-09T08:18:00.002-04:00

The following is a guest post by Cherise Tasker, M.D., Chief Medical Officer for Transcend Services, Inc.

Celebrity politicians? Yes, it’s true there is glamour and excitement on Capitol Hill. The rotunda drawing us to look skyward. The microphones and cameras waiting to snag a sound bite and photo op. Members-only elevators and subway cars. Marble underfoot and surrounding us in countless columns. One of our Minnesota-based AHDI participants, Sheryl Williams, even succeeded in having Senator Al Franken sign his own bobblehead.

The politicians appear taller, older, shorter, thinner. The Capitol building looks grander or less impressive than on television. The House chamber is smaller or more colorful than during the State of the Union address. Those of you who have ever visited a place or met a person you had previously seen only in photos or on television know what I mean. Some aspects are as expected, but many are not.

Having attending last year’s summit, I had expectations. Again, some of our meetings with legislators and their aides were conducted standing in a hallway or reception area. Some of the legislative buildings are quite old and space-limited, especially those offices assigned to more junior staff. If we were offered seats at a table, there may have been only 4 chairs for 5 people. Other appointments were conducted in glass conference rooms with space for everyone. Similar to last year, some legislators met with us personally; most sent aides who had varying degrees of interest and investment in our cause.

Exceeding expectations, however, was the degree of enthusiasm and scope of knowledge of our members. We are stepping up to history and meeting the challenge of the current legislative agenda. This is our moment and we are not going to miss our opportunities. We are educating ourselves on healthcare documentation interoperability, CDA tagging, Health Story and workforce investment.

Exceeding expectations further was the legislative offices’ concern for healthcare issues. Whereas last year the discussions of regulatory minutiae and specifics often felt administrative and paper-based, this year the staff members we met had more of a sense of the patients on whose backs the regulations are formed. As ARRA, meaningful use and HITECH come to life, the lives affected become three-dimensional. These constituents not only vote, they are our legislators’ neighbors, friends and family members. When the legislators sit with us AHDI/CDIA members now, we are voicing concerns heard outside the Capitol “ballroom” as well. The legislators and their staffs hear the concerns regarding patient safety, information security and preservation of the physician-patient relationship from their own doctors, mothers and coworkers.

As our group explained the point-and-click documentation process to one of the representative’s legislative aides, the aide nodded sagely. I am sure her last doctor’s appointment included less personal interaction than it ever had before. I know this because I could see it in her eyes. Perhaps unlike her last doctor’s appointment, this talk with AHDI members was actually a conversation and not an interaction between symptoms, technology, billing and reimbursement.

Political action involves not only a carefully-orchestrated set of dance steps, it requires passion, proactive measures and the confidence to win. Our 2011 advocacy is a critical move in an ongoing effort. This week the tango, next week the waltz, and all year long excellence in our work and a resolution to preserve, promote and grow our critical role in healthcare documentation.

Cherise Tasker, M.D.
Chief Medical Officer
Transcend Services, Inc.

Tilting At Windmills, Arguing With Umpires

2011-05-04T07:02:00.007-04:00

Is it ever a good idea to fight a battle you really don't think you can win? Is life too short and energy too precious to waste on a cause that has little chance of success? Are there times in life when we ought to take a stand on principle alone and let the chips fall where they may? I must confess this is a challenging topic for me, because I have found myself on both sides of the fence over the course of my lifetime, and certainly during the 10-plus years I've been involved in the medical transcription industry.

As my wife will tell you, I have a generally pragmatic personality, and as a result I tend not to get too worked up about a lot of things. Most of the time I'm content to deal with the world as it is, and don't expend a lot of energy railing about how things ought to be. But like the Gulf Stream blazing a trail through the Atlantic Ocean, there has always been, for as long as I can remember, a strong streak of idealism running through my psyche that has stubbornly refused to surrender to the bonds of mere reality. Always in the back of my mind is the belief that the world CAN be a better place, that it IS possible to change the status quo, that "NO" isn't always the last word.

The challenge, of course, is to figure out which hills are worth dying on and which battles aren't worth the effort. As every parent can attest, this tension is a daily reality as we try to raise our kids to be decent human beings. And every one of us has, at some point in our working career, had to decide when to "go along to get along" on the job and when to "rock the boat" when we see things happening at work that just aren't right. No two individuals are going to make exactly the same choices when faced with similar circumstances, and far be it from me to pass judgment on folks who have taken paths divergent from my own. Truth be told, at the end of the day there may not be only one "right" way to deal with some issues.

So what does any of this have to do with medical transcription in general, and AHDI in particular? Simply this:

Sometimes we need to temper our pragmatism with a healthy dose of hot-blooded idealism.

Have you ever wondered why baseball managers get themselves thrown out of ball games for arguing with the umpire? Has there ever been one instance where a manager has convinced the umpire to change a call? So why bother? The answer is that a smart manager knows that sometimes "taking one for the team" is exactly what the team needs to get motivated. It's not uncommon for teams that have been playing mediocre baseball to "catch fire" after their manager has gotten tossed from a game. The fact that their manager is willing to go to battle for them--a battle that everyone knows ahead of time will be lost--can be the perfect morale booster the players need to spur them on to victory.

Here's my question for the members and leadership of AHDI: at what point are we going to challenge the status quo, to go toe-to-toe with a seemingly unbeatable opponent, to "rage against the machine" in order to fight for--not just "advocate" for--the working MTs we're supposed to represent? What hill are we willing to die on? I totally understand that we have limited resources; I get that politics is the art of the possible. But even the most jaded politician understands that people will rally around a cause they believe in, regardless of whether or not the odds are on their side. I'm all for efforts to be "team players" with the rest of the healthcare industry in order to have a voice, the "seat at the table" that we desperately (and rightfully) crave. But the stark reality is that AHDI has not yet found a way to generate the kind of enthusiasm among rank-and-file working MTs that will give the organization the credibility it needs to justify a seat at the table. And I truly believe one of the main reasons for this is because as an association we've forgotten that sometimes arguing with the umpire is a good thing!

At the most recent AHDI board meeting I understand there was considerable discussion about the need to build a sense of community within the membership and to connect members to the mission. I could not agree more, but we need to try some different tactics in order to accomplish this. With all the upheaval within our industry, with the sense of powerlessness many MTs are feeling right now, I truly believe that many of them would respond to an organization that was willing to get up in somebody's face once in a while, to speak out against practices that are hurting working MTs even if there's not much we can do to change things. But if we as an association are so intent on "going along to get along" that we don't want to rock the boat, in the not-too-distant future there's not going to be anyone left to paddle.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Advocating For America's Healthcare Story

2011-04-28T07:53:00.005-04:00

Lea Sims, CMT, AHDI-F has written a great article for ADVANCE for Health Information Professionals on the topic of advocating for the preservation of America's health story through accurate and thorough healthcare documentation. The message AHDI and CDIA will be bringing to legislators during the 2011 Advocacy Summit on May 3 & 4 in Washington, D.C. is that every American citizen has a health story, and we can't afford to lose it. Lea lays out a number of issues the two organizations will be emphasizing to our elected officials and their staffs:

The need for a federal requirement for EHR systems to receive transcribed reports generated from narrative dictation so that physicians can document a patient's full health story and still meet federal requirements for EHR adoption.
The availability of existing innovative technologies that will convert narrative text into the kind of codified data required by EHR systems.
The role of the documentation knowledge worker in partnering with physicians and these emerging technologies to ensure that the focus is not just on how health information is captured but also on how well and how accurately it's being recorded.
The need for federal funding for workforce development to ensure the skills of healthcare documentation professionals will continue to play a relevant and contributory role in the healthcare documentation process.

Lea also provides practical steps healthcare documentation professionals can take to support this advocacy effort, including becoming credentialed, preparing for emerging roles in healthcare documentation, staying current on regulatory compliance, and actively advocating for the importance of our sector in preserving America's health story.

Also included in Lea's article are a couple of links to promotional materials that should prove very useful in advocacy efforts. One is a poster entitled, "Capturing America's Healthcare Story."

The other link is to the AHDI/CDIA Advocacy Agenda which contains a wealth of information and focused talking points. Both of these resources can be used by working MTs in our own spheres of influence to make the case for the value of what we do. As important as it is to lobby our legislators in Washington, the real work of advocacy has to happen at the grassroots level in order to educate the healthcare industry and the public at large about the critical importance of an accurate patient story.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

"The Realization Is Now, The Opportunity Is Here"

2011-04-25T13:40:00.005-04:00

These are the titles of two related articles by Seth Godin (here and here). Godin's premises are simple and extremely profound all at the same time: the Industrial Revolution is over, America's (and the world's) workers are faced with a new paradigm, and only the brave will succeed.

Here are some salient quotes from the first article:

"It's one thing to read about the changes the internet brought, it's another to experience them. People who thought they had a valuable skill or degree have discovered that being an anonymous middleman doesn't guarantee job security. Individuals who were trained to comply and follow instructions have discovered that the deal is over... and it isn't their fault, because they've always done what they were told.

This isn't fair of course. It's not fair to train for years, to pay your dues, to invest in a house or a career and then suddenly see it fade.

It's unpleasant, it's not fair, but it's all we've got. The sooner we realize that the world has changed, the sooner we can accept it and make something of what we've got. Whining isn't a scalable solution."

In the second article, Godin offers what he calls "an opportunity, not a solution" to the crises he describes in part 1:

"[E]very individual, self-employed or with a boss, is now more in charge of her destiny than ever before. The notion of a company town or a stagnant industry with little choice is fading fast.

Right before your eyes, a fundamentally different economy, with different players and different ways to add value is being built. What used to be an essential asset (for a person or for a company) is worth far less, while new attributes are both scarce and valuable.

Are there dislocations? There's no doubt about it. Pain and uncertainty and risk, for sure.

If you're looking for 'how', if you're looking for a map, for a way to industrialize the new era, you've totally missed the point and you will end up disappointed. The nature of the last era was that repetition and management of results increased profits. The nature of this one is the opposite: if someone can tell you precisely what to do, it's too late. Art and novelty and innovation cannot be reliably and successfully industrialized."

How much of this is relevant to our industry, or to the individual working MT, would be a great topic of discussion. But it seems clear to me that Godin is onto something here, and we would do well to pay attention.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Small Physician Practices And Small Transcription Services: A Match Made In Heaven?

2011-04-21T18:57:00.003-04:00

It's no secret in our industry that large transcription service providers are looking for economies of scale when it comes to new clients. That means hospitals, large clinics and group practices are the targets of choice for national MTSO sales personnel, and take it from someone who knows, the competition is fierce out there. So where does that leave one- or two-person physician practices and small transcription service providers? I think there's a case to be made that they are MFEO.

(That's "made for each other" for you non-"Sleepless In Seattle" fans, if there could possibly be any of those!)

My wife Carol and I cut our MT teeth on the local physician transcription market in the city where we live; at one time we had 15 local clients and a number of subcontractors working for us. Nowadays I work for a top-10 national MTSO, so it's fair to say I've seen how this business works from both sides of the fence. Certainly there have been a lot of acquisitions and consolidation in recent years in our industry, and there's no doubt a larger percentage of medical transcription is being done by corporate service providers than in times past. But there are still opportunities for the small MT operator to make a good living providing a level of personal service larger companies find it difficult to match. Over the past decade I've had the pleasure of getting to know a number of individuals who operate small transcription services, and some of them are doing very well for themselves, even in this bad economy.

The truth is that, all the hoopla over electronic medical records notwithstanding, there will always be some physicians who for one reason or another will choose dictation and transcription as their documentation method of choice. In fact, I came across an interesting study not long ago from Healthcare IT News that shows that less than two-thirds of pediatricians, OB-GYNs and psychiatrists in private practice will be eligible for the government's EMR stimulus money. Overall, around 15% of all private-practice doctors don't qualify for the incentive and don't have an EMR. Of course, no doubt some doctors who aren't eligible for the stimulus money will end up getting EMRs, but on the other hand, some who are, won't. Furthermore, while we all have horror stories about doctors (or their office manager wives) who can make a transcriptionist's life miserable, there are still physicians out there who care about quality and are willing to pay a decent price to get it. And because servicing small practices simply isn't cost-effective for large MT service providers, I'm confident there will continue to be growth opportunities for smaller, nimbler, more service-oriented transcription operations.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Well, That Explains A Lot!

2011-04-13T14:00:00.002-04:00

Have you ever listened to a doctor dictate at the speed of light and wonder to yourself, "Do they learn that in medical school, or what?!" Well, as it turns out, maybe they do!

At a new client pre-implementation meeting recently, the transcription manager who worked at a teaching hospital shared an interesting tidbit with me. She said that one time she just came out and asked one of the doctors why he dictated so fast. He told her that during his residency, some nights when he and his fellow residents were bored and trying to stay awake, they would compete with one another to see who could dictate the most words in the shortest period of time!

I've heard horror stories about resident doctors who are incredibly overworked, but after hearing this anecdote, I'm convinced some of those physicians have TOO MUCH time on their hands!

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Let's Talk About...Advocacy

2011-04-11T17:32:00.004-04:00

The latest in a series of open letters to the medical transcription industry, "Let's Talk About...Advocacy," has been written by Karen Fox, CMT, AHDI-F. Karen's letter examines the definition of an advocate (just about everyone is an advocate for something), explains why advocacy and alliance-building are important, and gives examples of how AHDI and other organizations are stepping up to the plate to give medical transcriptionists a voice in the discussion surrounding healthcare documentation. Karen responds to those who say AHDI's advocacy efforts are a useless waste of time and resources, and looks at some key alliances AHDI is working to forge with other organizations with common interests.

"Let's Talk About...Advocacy" is the third in a series of four articles leading up to an online AHDI Town Hall meeting on the topic of "The Value of Association" to be held Tuesday, April 19 at 4 p.m. Pacific/7 p.m. Eastern, hosted by Barb Marques and Ava George. Karen's letter is also very timely with regard to AHDI's upcoming Advocacy Summit scheduled for May 3-4, 2011, in Washington, D.C.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Computer Data Backup Survey

2011-04-11T12:00:00.002-04:00

With more and more attention being focused on HIPAA/HITECH compliance for business associates, including medical transcriptionists, I thought it would be interesting to get a sense of the state of the industry with regard to backing up computer data. Please take a couple of minutes to complete the following survey. The survey is completely anonymous; not even your IP address will be collected. Check back next week for a report on the results.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Let's Talk About...Quality

2011-04-01T12:01:00.007-04:00

The latest in a series of open letters to the medical transcription industry, entitled, "Let's Talk About...Quality," has been authored by Susan Lucci, RHIT, CMT, AHDI-F, and Kristin Hagen, CPHIT, CPEHR, CPHIE, AHDI-F. In this article, Susan and Kristin approach the topic of quality from the patient's perspective, in the context of the push toward electronic health records and greater patient participation in the healthcare delivery process. They point out the value of the Healthcare Documentation Quality Assessment and Management Best Practices Tool Kit, developed jointly by AHDI, MTIA, and AHIMA, in helping to promote quality in healthcare documentation. The authors also point out that even though it may seem that quality is of lesser value than pricing to some clients, the importance of accurate medical records is of great concern to consumers of healthcare services. Furthermore, as experts in the field of healthcare documentation, medical transcriptionists bring added value to the documentation process.

"Let's Talk About...Quality" is the second in a series of four articles specifically intended to lead in to an online AHDI Town Hall meeting on the topic of "The Value of Association" to be held Tuesday, April 19 at 4 p.m. Pacific/7 p.m. Eastern, hosted by Barb Marques and Ava George.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Let's Talk About...AHDI and MTs

2011-03-30T11:42:00.004-04:00

Barb Marques, CMT, AHDI-F, 2011 AHDI President, has written the latest installment in the "Let's Talk About..." series of open letters to medical transcription professionals. The article is entitled, "Let's Talk About...AHDI and MTs" and focuses on what Barb feels are some critical misperceptions that exist with regard to AHDI and its efforts on behalf of working MTs.

Barb's letter examines three basic questions:

What is AHDI able to do for MTs?
What are we not able to do?
Of the things that can be done, how is AHDI working to accomplish those things?

In the "can't do" category, Barb talks about issues such globalization, technology, and compensation as areas where AHDI has little power to influence the industry. The "can do's" include job preservation and credentialing.

This letter is the first of four which will serve as lead-ins to an upcoming AHDI Town Hall webinar on the topic of "The Value of Association" to be held Tuesday, April 19 at 4 p.m. Pacific/7 p.m. Eastern, hosted by Barb Marques and Ava George.

Barb's letter is well worth reading, and I welcome your comments on what she has to say.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Listening To What Is Said, Transcribing What Is Heard: Speech Recognition Technology In Medical Transcription

2011-03-30T10:38:00.008-04:00

Dr. Gary David, Associate Professor of Sociology and Associate Professor of Information Design and Corporate Communication at Bentley University, has published a scholarly work on the impact of speech recognition technology (SRT) on the medical transcription industry. The paper is entitled "Listening To What Is Said, Transcribing What Is Heard: The Impact Of Speech Recognition Technology (SRT) On The Practice Of Medical Transcription (MT)."Dr. David is well-known in MT circles as the principal author of a landmark study in 2007 of the state of the medical transcription industry, as well as a follow-up survey now in progress.

Dr. David's examination of the impact of SRT on the MT profession is remarkable both for its detailed look at the nuts-and-bolts of editing speech-recognized drafts and for its big-picture view of this important aspect of our industry. As Dr. David writes:

In this paper we explore how MTs do the work of editing ‘back-end’ (BESR – edited after they are dictated) speech recognition-generated documents. In doing so, we will illustrate how the work of MTs is far more complex than just typing what is spoken in voice files. Their work requires complex professionally-informed interpretive acts that in turn require sustained attention to the social order properties and content of the doctor’s dictation, knowledge of medical terms and procedures, and an understanding of interactional processes, conventions of dictating, and of producing monologic speech acts. The MTs attention to these social order properties of the doctor’s (dictator’s) speech has direct implications for understanding the impact not only of the implementation of back-end systems, but also of front-end systems (FESR – edited as they are written) in which there is no transcriptionist involved.

While such technologies are marketed as a cost-effective and timely way to produce medical records, they may actually slow down the work and involve the potential risk of removing third-party quality assurance from the process. We conclude that, while new technologies have a role to play in the creation of healthcare documentation, such production technologies (and their implementation) should in most instances focus on facilitating and supporting, rather than replacing, the work of medical transcription done by skilled human workers.

The going gets a little slow as Dr. David explains in great detail the processes involved in editing SRT as opposed to traditional transcribing, and the methodologies used in examining the impact of SRT on productivity and quality. But this groundwork provides crucial justification for his conclusions and recommendations:

Our research has shown specific ways that the skilled work practices of MTs add value to the production of medical records. Furthermore, while MTs have typically been viewed as a cost and not revenue generating, the fact remains that in the US, with its profit-driven healthcare system, the work of healthcare professionals requires adequate documentation to generate revenue. In other words, it is not the work of the doctor (or other caregiver) himself or herself that ultimately results in creating revenue; rather, the documents are the things through which procedures are represented and revenue generated. Medical coders base their billing codes on these documents, and auditors use them to determine if coding is supported by the documentation. In fact, in instances where documentation does not support the claims of medical practice, payment can be withheld or rescinded. While technology has a place in enhancing healthcare documentation production, it cannot be adopted as a replacement without significant risk not only to patient care, but also to the revenue cycle of healthcare organisations.

Based on this research, a number of recommendations can be made to those exploring the implementation of SRTs. First, the social competence and professional knowledge involved in the work of MTs is a critical link in the effort to reduce medical errors and mistakes in medical records. Any technology that integrates into that role needs to be designed to support that work. Procedural, staffing, and technological changes intended to improve the accuracy of medical records and reduce costs associated with that work should take the contribution of MTs into account as they design their systems. Secondly, SRTs can be a tool to facilitate as much as automate. As such, they may not ‘save labour’ as much as ‘change labour’ in terms of how work is done. Thirdly, understanding the medical record as a socially-constructed boundary object that is essential for collaboration across institutional domains creates a different sense of how errors should be identified and evaluated. Medical records and other socially construction information have essential social properties (Brown and Duguid 2002, Garfinkel 2008), and as such need to be considered within the context of their use.

Something I pointed out to Dr. David after he shared this paper with me is that many of the concerns he identifies with regard to SRT are also quite relevant to a discussion of how electronic health record (EHR) systems are likely to impact our industry. He stated that he agreed and in fact is in the process of researching that very topic. I for one will be very interested to see what he comes up with.

I hope every MT and MT service owner will take the time to read and digest Dr. David's paper, and use it as a tool to make the case for the importance of healthcare documentation professionals to the creation of accurate medical records.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

A Balanced Look At MT Credentialing

2011-03-29T19:13:00.005-04:00

For The Record magazine has published a well-balanced article on the topic of credentialing in the medical transcription field. The author quotes a number of respected industry representatives, including AHDI CEO Peter Preziosi, AHIMA Vice President of Certifications Michael Niederpruem, Kathy Nicholls, Dale Kivi, Gisele Dubson, and Kathryn Anderson, President-Elect of Texas AHDI. The article does a good job of presenting the pros and cons of mandatory credentialing for MTs, pointing out the potential benefits as well as ongoing obstacles to widespread adoption of credentialing in the industry.

The article is well worth taking the time to read, and I'd love to hear your comments.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Medical Identity Theft On The Rise

2011-03-21T07:36:00.004-04:00

Healthcare IT News is reporting on a Ponemon Institute study showing medical ID theft is becoming more prevalent, with both the number of victims and the average cost of remediation on the rise.

Some interesting findings from the survey include:

49% of medical ID theft victims took no new steps to protect themselves, and half did not even report the crime.
14% of medical ID thefts were as a result of data breaches by entities handling individuals' personal information, but only 5% of victims learned of their theft through breach notifications.
55% of respondents were not aware of new healthcare reform policies, and a third believe the creation of a nationwide electronic health record system will increase the risk of medical identity theft.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

"Small" HIPAA Breaches Swamp Enforcement Office

2011-03-17T10:17:00.005-04:00

The Journal of AHIMA has a story on an astounding number of data breaches affecting fewer than 500 individuals as reported by the Department of Health & Human Services Office of Civil Rights (OCR). In a written justification for its 2012 budget request, OCR noted it had received a total of 9,109 reports of these "small" HIPAA security breaches in a one-year period ending Sept. 30, 2010, averaging more than 25 reports per day. This compares to fewer than 200 instances of breaches affecting more than 500 individuals during the same time period. However, the actual number of individuals affected by the smaller breaches is unknown, as OCR has not reported that information.

In its budget request, OCR stated that it simply does not have the resources to investigate these sub-500 breaches, and that it had initially estimated there would be only 50 such incidents annually.

What's interesting to me is that the only reason we know about the huge number of small data breaches is because OCR had to justify its budget numbers, not because they thought the public had a right to know. The big HIPAA violations get the headlines (by statute, I might add), but the sheer number of smaller breaches should be cause for grave concern with regard to the healthcare delivery system's ability to secure patient data. I have a feeling the patient privacy advocates are going to have a field day with this, and rightfully so. If there's one thing that could possibly derail the all-out push for electronic medical records, it would be a mass uprising on the part of patients who simply don't believe their private health information is safe. This kind of news certainly isn't going to inspire public confidence, and clearly shows there's a lot of work to be done in this regard.

Jay Vance, CMT
AHDI Lounge Administrator/Moderator

Let's Talk About...Ethical Best Practices

2011-03-15T11:13:00.004-04:00

The latest in a series of open letters to the medical transcription industry has been written by Sherry Doggett, AHDI Board member and Treasurer. Her letter is entitled, "Let's Talk About...Ethical Best Practices." In the letter, Sherry examines the influencing factors which led to the creation of the AHDI/CDIA Ethical Best Practices manual. Among these were the need for industry self-regulation, not only in light of the increased scrutiny of our profession as a result of the HITECH legislation in 2009, but also to maintain a high level of ethical business practices as a matter of course. Sherry looks at the various components of the EBP manual and their usefulness to both large MT service organizations as well as individual practitioners and independent contractors.

I hope you'll take a few moments to read Sherry's letter and post your comments here.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

More HIPAA Enforcement On The Horizon

2011-03-15T09:19:00.004-04:00

Government Health IT is reporting that the Office of Civil Rights, tasked with HIPAA enforcement, is inviting all 50 state attorneys general for training on investigating and collecting fines for HIPAA violations affecting state residents. The net result of this outreach by the federal government will be even greater scrutiny of healthcare documentation-related activity in all sectors of the medical field, including ours. Yet more confirmation of the need to make sure your business practices are HIPAA/HITECH-compliant. AHDI has some great resources available for the individual practitioner as well as larger MTSOs to help keep you on the right side of the law.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

New Medical Transcription Survey From Bentley University

2011-03-14T11:11:00.005-04:00

In 2007, Dr. Gary David, a professor at Bentley University, created a survey for the medical transcription industry. The results of that survey can be viewed here. Dr. David and his colleagues have now created a follow-up MT survey to further assess the state of the industry in 2011.

From the survey introduction:

The 2011 Survey of Medical Transcriptionists (MTs) is part of a larger academic project (by Profs. Gary David, Donald Chand and Balaji Sankaranarayanan, Bentley University, Waltham, MA) seeking to understand the work experiences of MTs, as well as the value they add to production of accurate and reliable medical records. This survey is a continuation of the 2007 Survey of Medical Transcriptionists. A primary goal of the project is to provide a better understanding for those involved in medical records production regarding the work and value of MTs.

While the project is being conducted by an independent research team, it is endorsed by the Association of Healthcare Documentation Integrity (AHDI) and the Clinical Documentation Industry Association (CDIA).

This survey is critical to continue our understanding of the changing nature of the profession. The survey will be used to collect and analyze data on the demographic characteristics of MTs, their work experiences, experiences with technology, and questions meant to identify the issues that are most important to MTs.

The lack of objective, quantifiable data with regard to the state of the medical transcription industry has been an ongoing challenge for our profession for many years, and I'm thrilled to see that Dr. David is working to meet this need. I strongly encourage all MT practitioners to participate in this survey.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Medical Scribe Program At University Of Toledo Focuses On Medical Students

2011-03-11T10:11:00.003-05:00

From the University of Toledo News comes word of a medical scribing program at the university's College of Medicine and Life Science which is clearly aimed at medical students. The program's first- and second-year students make notes during ER patient encounters, review the notes with the attending physician, then enter the information into the hospital's electronic health records system.

What makes this story of interest to me is that the UT scribing program is internal rather than outsourced, and that the target labor demographic is clearly medical students rather than medical transcriptionists or other ancillary health workers. I also see this as yet more evidence that many of the current crop of EHRs are so user-unfriendly that doctors are looking everywhere for someone to do the data entry scut work for them. Fortunately for UT they've figured out a way to accomplish this without having to spend extra money.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Words Matter

2011-03-09T17:46:00.004-05:00

Since this is a blog geared toward medical transcriptionists, I know I don't have to work too hard to convince our readers of the importance of the accurate use of language. One of the key talking points we MTs are emphasizing to anyone who will listen to us is that words do, indeed, matter, especially when it comes to telling the whole story of a patient encounter. Although the anecdote I'm about to share doesn't deal specifically with medical transcription or healthcare documentation per se, it is an example of the importance of using the right words at the proper time in the appropriate context.

As long-time readers may already know, my wife Carol, also a medical transcriptionist, has been fighting what has so far been a spectacularly successful battle with ovarian cancer. She was first diagnosed at stage IIIC, grade 1 just over a year ago and had surgery shortly thereafter. She finished chemotherapy in August of last year and has been on Arimidex since then. By all accounts her treatment course (along with a lot of prayer) has resulted in an extremely good long-term prognosis, for which we're very thankful. Her CA-125 tumor marker blood tests have consistently run in the neighborhood of 6, which for a cancer patient is practically nonexistent, and her imaging scans have been devoid of any evidence of new disease. She feels good and looks good and has a generally positive attitude about her future. In short, we have every reason in the world to feel optimistic.

But as anyone who has had cancer or had a loved one with cancer can tell you, there's no such thing as complacency when it comes to fighting this disease. You're always on guard and you never take anything for granted. Every time it's time for blood tests or imaging scans or doctors' visits, there's always a certain level of apprehension involved, even if there's no reason to think the news will be anything but good.

So it was with the latest round of tests Carol underwent over the last couple of weeks in anticipation of a visit to her oncologist scheduled for March 15. However, right around the first of the month she got a call from someone in the doctor's office who said, "The doctor wants to see you sooner than your next appointment."

I'll just let you think about that for a minute...

Of all the things a cancer patient--or any patient, for that matter--doesn't want to hear, "The doctor wants you to come in sooner" has to be right up there at the top of the list. Logic goes out the window, and speculation runs rampant. No matter that all the signs up to this point have been wonderful, your mind immediately begins to jump to conclusions. You tell yourself, or your loved one, "He probably wants to go on vacation and is just clearing his appointment calendar," but in the back of your mind you're not sure if you believe it.

So today was the day for the expedited appointment, and needless to say we went in together. After a typically long wait in the lobby, and another in the exam room, the oncologist came in surrounded by his typical air of good humor, and proceeded to tell us that....

...everything was fine. Just like the last several visits, all the tests looked good and the long-term prognosis continues to be excellent. Exactly what we hoped/expected/hoped to hear.

But not a peep about why Carol needed to "come in sooner." No indication whatsoever that there was ever anything to worry about, no basis for any speculation or dread about why the appointment had been moved up.

The moral of this story? Words really do matter, not only the words that are said and the context in which they are spoken, but also the words that aren't said. If it was simply a matter of clearing the doctor's schedule, how difficult would it have been for the front office staff to have mentioned that when they called to reschedule? How much needless anxiety would have been spared if the right words had been spoken in the appropriate context?

Good communication is always important, in every aspect of life, but it seems especially true and significant when it comes to matters of health and medical care. Thankfully the effects of this particular breakdown in communication were short-lived, but the repercussions of the wrong words--or lack of the right words--in a permanent medical record could be much more serious indeed. It may not be as dramatic as battling cancer, but it's still a fight worth winning.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

Let's Talk About...Offshore Transcription

2011-03-04T12:59:00.004-05:00

AHDI Board Member Karen Fox-Acosta, CMT, AHDI-F, has written the latest in a series of open letters to the industry, this one entitled "Let's Talk About...Offshore Transcription." In her letter, Karen takes an honest, well-rounded look at this "hot-button" topic within the medical transcription community. She talks about the trends and technology which have given rise to outsourcing, both foreign and domestic, and she gives some background on the UCSF incident in 2006 which really brought the issue of offshore transcription into the national spotlight. Karen gives an even-handed examination of the pros and cons of offshore outsourcing from a variety of viewpoints, and discusses the role AAMT/AHDI has played in the conversation about this issue that has taken place within the healthcare community and beyond. She also deals with the one trend within the U.S. healthcare delivery system that poses a far greater threat to the MT profession than offshore outsourcing ever will.

I found Karen's letter to be a very reasoned and reasonable examination of what continues to be a controversial, even at times incendiary topic of discussion within the medical transcription industry. I strongly encourage you to take a few minutes to read and comment on what Karen has written. I would also encourage your participation in an upcoming Town Hall meeting at which Karen will be presenting, entitled "The Transcription Marketplace: Outsourcing, Offshore Transcription, and Ethical Best Practices." This online event will be held on Tuesday, March 15 at 4 p.m. Pacific/7 p.m. Eastern, and will also feature Susan Lucci, CMT, RHIT, AHDI-F. Click here to register now.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator

AHDI Members Approve Restructuring Plan

2011-03-03T08:20:00.004-05:00

From the official AHDI News & Information blog comes word that the votes have been tallied and AHDI members have overwhelmingly approved the restructuring plan presented at the 2010 ACE conference in Austin, TX:

AHDI voting members approved bylaws that reflect an association reshaping plan developed and approved by the AHDI House of Delegates at its 2010 Annual Meeting. After nearly two years of assessment, strategic planning, town hall listening sessions, and negotiations, the membership approved essential bylaws that create a National Leadership Board, puts stringent voting requirements into the bylaws, and clearly outlines the roles and responsibilities of the National Leadership Board and membership.

The membership vote required a minimum of 500 votes with a two-thirds majority to pass the bylaws changes. Voter turnout was 18.55% of the eligible voting membership. This is significant considering that AHDI historically receives only 6% to 9% of voters for national elections. With 66.67% affirmative votes needed to pass, the following was recorded:

Bylaws Revision 1 - 89.25%
Bylaws Revision 2 - 75.72%
Bylaws Revision 3 - 90.47%

The House of Delegates will review the voting results and begin plans for the next phase of implementing the reshaping plan at its March 9 online meeting. There will be a series of leadership meetings to discuss the implementation roll out with local, state, regional, and online components. Information will be announced in the upcoming weeks. We encourage you to reach out to the House of Delegates and Board of Directors if you have questions regarding the vote.

From my personal perspective, I'm pleased at the results of the vote and am hopeful that the association can now move forward with the important business before us. It's time to focus less on structure and more on substantive achievements.

Jay Vance, CMT

AHDI Lounge Administrator/Moderator