Important Facets of the Medical Transcription Profession - Part 1

The Medical Reports

There are a variety of medical reports generated every day in physician offices, clinics, and hospitals. Medical transcriptionists should be familiar with those dictated in each work setting. Physicians in private practice frequently dictate office chart notes, letters, initial office evaluations, and history and physical examinations. Medical reports dictated in hospitals and medical centers are numerous in category; however, they invariably include dictations from the "basic four" reports: History and Physical Examination, Consultation Report, Operative Report, and Discharge Summary. Emergency Department Reports, hospital progress notes, and diagnostic studies are often dictated as well.

The Healthcare Record

The healthcare record is chronological, documented evidence of a patient's initial database, initial evaluation, identified problems and needs, objectives of care, prescribed treatment, and end results. The record may be paper, stored digitally in electronic format in a computer, or a combination of the two. The healthcare record is the property of the hospital, medical facility, or office in which it was originated, and it cannot be removed from the premises without a subpoena or court order. It is maintained in a Health Information Department usually headed by an RRA (registered record administrator), an ART (accredited record technician), or an MBA (master of business administration).

Technology & MT Equipment/ Tools

A discussion of medical transcription equipment should begin with the most important but often overlooked asset...the human brain. The machines used in medical transcription today are simple devices, and without human knowledge and intervention, machines are basically useless. The transcriptionist is the brain of the machine. Dictation systems: As physicians depend on their stethoscopes, scalpels, and tongue depressors, medical transcriptionists also depend on the tools of their trade ... the computer, desktop controls, a foot pedal, and a headset.

Dictation systems have evolved through several different stages: wax cylinders, phonograph-type records, belts, tank systems, Mylar reel-to-reel tapes, and cassette tapes. All of these systems had drawbacks even though each represented an improvement over the current technology.

Today we still see some Mylar tape cassette dictation systems in use, but most have been replaced with digital technology. A digital system works much the same as a compact disc (CD). The CD reproduces sound using digital technology that is extremely complicated; however, the end result is a dictation that is without any background noise, hiss, or other extraneous sounds found on Mylar tape. In digital systems, voice files are stored in "digital" (computer) format rather than "analog" (tape) format, and the dictation is usually free from mechanical noise.

Keyboards have had a similar evolution cycle: from manual typewriter, to electric typewriter, to the Correcting Selectric? typewriter, to word processors, and currently to virtual keyboards and even speech recognition. The input of data, whether via traditional keyboard, Dvorak keyboard, steno machine keyboard, or speech recognition systems, proves once again that it's the human brain interacting with the machine, not the machine itself, that produces quality transcription.

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Digital File Types for Audio Transcription

There are a variety of recording systems available, suitable for dictation to conference recording. If you already have a digital recording mechanism, there is a good chance that it will record a variety of different file types for different purposes. This article aims to discuss these different types and suggest the right one for you, depending on your circumstances. If you are still considering which digital recording device to purchase then you have the opportunity to consider the file types it will produce before you buy.

If you do not know what file types you are working with, you can tell by looking at the file extension. This is the set of three letters that follow the dot, as in, for example, 'interview.wav'

The different file types all have advantages and disadvantages for transcription services, the most obvious of which is a trade-off between quality and file size. Sound files can be very, very large if they are not compressed, but compression is 'lossy'; in other words a complete or 'lossless' audio file has been taken and compressed, which removes data that is considered redundant, resulting in reduced audio quality, which can cause problems for the transcriber.

It may initially seem obvious that you and your transcriptionist want the best quality but in fact, many lossy formats have a negligible quality loss but are much smaller files. If you are planning to email files for transcription to your transcriptionist, the advantage of a 2MB file, as opposed to one 40MB in size, should be obvious! No sound file of any length is small, but at least it is possible to email a 2MB file for transcription. Most service providers will not allow a 50MB file through, and even if they did it could take hours to download, blocking both your email and your transcriptionist's. More and more transcriptionists are using a system which bypasses email; you can either upload files directly to their website or send your files using a simple file transfer programme. However, even these options have limits to the file sizes as a rule.

It also worth noting that depending on the playback software being used for transcription, your transcriptionist may only be able to play back certain file types. Some cover practically all digital file types while others are more limited, so it is worth checking first.

The 'right' file type and attributes for you and your transcriptionist will also depend on what the purpose of your recording is. If it is a dictation, a lower sound quality will still provide a clear enough recording for a digital transcription.

If you are recording a focus group, for example, where several people are seated at different distances from the recorder and speaking at different levels and pitches, you will probably need a higher sound quality to accommodate this.

Your recording equipment may allow you to set different attributes for the same file type. This can make an enormous difference to the sound quality and size of the file, and consequently the transcription quality. In some cases, for example dictation (one person speaking into machine, in a quiet environment) you can probably afford to loose sound quality and the recording will still be clear for transcription. In other cases (focus groups, noisy environments) you may find you need to choose a slightly larger file size in order to maintain decent sound quality.

Attributes are often shown as Hz. 8,000kHz mono is suitable for dictation and the range goes up to 44,100kHz stereo, which is the top quality, used for music CDs.

Examples of different file formats and some details about their use in transcription follow:

WAVeform Audio (.wav)

WAVeform Audio (.wav) is a common file format and was one of the first audio file types developed for use with the PC. It is lossless, but generally very large. This means that you will probably need to send the files on a CD, rather then emailing them, although some transcriptionists, including myself, on my site www.penguin-transcription.co.uk, have a system whereby you can send large files via the internet without using email. You certainly need a broadband connection, or similar, to utilise these effectively though. Warning! Not all wav files are the same! Although they all end .wav, depending on the recorder, you and your transcriber may need a special 'codec' to play it back. An example is Sanyo; a popular and moderately priced recording system but one that records specifically Sanyo wav files. You should check that your transcriptionist has the ability to transcribe Sanyo wavs. If not, Sanyo may oblige by sending out the relevant codec on CD, if you ask them nicely!

The following types are all lossy, but generally the sound quality change is negligible and you will save significant time and money with reduced transfer times. This is not an exhaustive list of all audio file types; there are a huge number. It aims to cover most of the types recorded by available transcription software.

MPEG-1 Audio Layer 3 (.mp3)

This is a compressed WAV file often used in music. Many digital dictation recorders will also record mp3 or allow you to record WAV and then compress to mp3 to send on for transcription. The compressed files will be around a twelfth the size of WAV files.

Windows Media Audio (.wma)

Windows Media Audio (.wma) was developed for Windows Media Player which is bundled with all Windows-based PCs these days. It is even more compressed than an MP3, to about one thirty-sixth the size of a .wav, but apparently retaining the original sound quality. I have to say that in my experience of transcribing I am not sure whether this has always been the case.

Digital Speech Standard (.dss)

In my experience, most playback software used for transcription will play .dss files. If not, there is a free download available on the Olympus site. I believe .dss was developed by Olympus and almost all, but not all, Olympus recorders will record .dss files. Lanier and Grundig recorders also generally use .dss. The file size is reduced by twelve to twenty times, as compared to a WAV file, and is ideal for transcription as it is small and easy to email.

DVF

This is Sony?s answer to the .dss file. It is a very highly compressed file, but fine for voice, and its small size makes it very easy to send by email.

Encrypted dictation (.dct)

Often used for medical transcription, which requires very high confidentiality, these recordings are encrypted at the recording end and need to be decrypted on receipt by the transcriber. A wide variety of playback software will deal with these files.

TrueSpeech from DSP Group

TrueSpeech, from the DSP group, was designed for personal computers and personal communications devices. It has very high compression ratios ranging from 15:1 to 27:1. If you are able to record this format it is probably best restricted to use with dictation or one-to-one interview in a quiet environment. It is probably too lossy for focus groups etc.

There are a whole host of other file types available so don't worry if the type that your machine produces is not listed above. Contact your VA and s/he will probably be able to assist you, or at least point you in the right direction.

CD Audio file (.cda)

These files are standard recordings onto CD, and are generally the file type of music files bought no CD. As I understand it (not too well!) the CDA is actually just a sort of cover file that says this is a file on a CD, and the underlying file is probably a wave file or one of the other file types listed above. Most transcription recorders will not record to CDA but if you are having a professional recording made of a conference or series of lectures, for example, you may well find yourself with CDA files. Most transcription software will not work with CDA format. There are a number of ways to convert CDA files but these can be expensive and/or time consuming. Transcriptionists specialising in digital transcription will probably be able to transcribe these files but you may be charged a surcharge for the time taken in converting them to a useable format. There are a variety of converters available, but one that I have used successfully, and that provides a trial version, is Easy CD Ripper, a shareware with a fully functional trial version that can be downloaded from various places including http://www.tucows.com/preview/209478

You will probably have only a limited range of file types available for your transcription, depending on your recording equipment, but any equipment should provide you with a range of options depending on your needs. If you have the opportunity it is always a good idea to make a test recording with the settings that you think will be right. Then play it back, or send it to your transcriptionist to play back, in order to check that the sound quality is acceptable.

Finally, I would just like to say that this information is based on my understanding and experience of digital transcription. I cannot absolutely guarantee its accuracy but would be very interested to hear of any errors and happy to correct them. Similarly if you feel that there is an important area I have not covered, please let me know and I will do my best to incorporate it.

Penguin Transcription (http://www.penguin-transcription.co.uk), part of Penguin Office Services, offers an affordable transcription service by tailoring each quote to the exact requirements of the client. The more information the client can provide us with, and the better the quality of the recording for transcription, the more affordable the transcription service will be. Why not visit our site and fill in an enquiry form at http://www.penguin-transcription.co.uk/PTS_enquiry_form.html to receive a quote for your transcription requirements.

Work From Home Transcription Services

?Working from home? is a very common phrase In developed countries like United Sates of America. It is now slowly getting towards the developing nations like India, China, and Romania also. Thanks to the increasing penetration of the internet in these developing countries and the globalization effect. So, millions of people all across the world are looking for opportunities where they can make good amount of money by just sitting at home. If you are a person among them then transcription service providing is just like a dream opportunity for you.

Transcription is nothing but the art of converting recorded audio or video signals into a text format. It is just the ability of hearing the audio version quite perfectly and converting into written form in a consistent manner. There are different types in the form of transcription service providing. Some are just translation professions and needs no specialized background. However, some other transcription services like medial transcription, legal transcription need a good and solid background in those respective fields. If not, it is quite hard to make a good profession out of those sectors.

Medical transcription industry is growing enormously in the last few years. It is employing good number of people all across the world every year. Most of the local clinics and hospitals are providing jobs to people in this domain right from their homes. Working from home is just a tremendous advantage in this domain. However, if you want to get employed in this domain you need to have reliable internet connection, good computer and good head set at home. You should also be good at oral and written communication along with the basic medical knowledge. If you posses all of these qualities, you can make good amount of money in this profession, just working from home itself.

Legal transcription is another transcription service that needs a specialized law background. Legal transcription is nothing but the preparation of legal documents from any type of written information or even dictated information. Apart from these generic services, some of the popular legal transcription service providers will provide services like drafting and filling legal documents, calendaring and tracking other important works. If you are interested in this legal transcription service providing, then it is always a better idea to join an established company as a full time employ first, before you think of working from home to provide legal transcription services. However, if you are enough confident of your legal knowledge then you can go ahead with your work also.

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Medical Transcription - Online Versus Classroom Training

If you've considered a career in medical transcription, you've probably already spent at least some time looking into the study options. And there are some serious decisions to be made when it comes to those training options. Should you study medical transcription in a classroom? Or would an online or correspondence course be better? It depends on your personality, your location and your needs.

Start by looking into schools in your area that offer medical transcription in a classroom setting. The sheer fact of your location in relation to any schools you'd be interested in attending may very well make the decision for you. While location is sometimes the deciding factor, don't let yourself be talked into taking what you consider to be second-rate medical transcription training just because it happens to be nearby. You can certainly get quality training from an online or correspondence school if there's nothing close to your location.

Your own personality - and limitations - should also play a role in your choice of training options. Do you work well without strict supervision and deadlines? Can you set goals for yourself and follow through? If your answer to those questions isn't a resounding "yes," you may not do well with online or correspondence training. There's a big difference between sitting in a classroom every day (or once a week) and being turned loose to do your own work. In a classroom, you're held responsible for keeping pace with the class. A correspondence class allows you to set your own pace. Some people simply need the structure of a classroom setting.

That's not to say that you have to attend classes in person to get that structure. Many distance learning programs allow students to "meet" with instructors and even classmates on a regular basis via computer. You simply set up a webcam at your location and you have the opportunity to interact with the teacher and even others taking the class. In some ways, this is the best of all possible worlds for the busy adult who still needs some structure to accomplish the goals of medical transcription training.

If you think the online "meeting" is a good idea for you, take a minute to look at your own computer and your connection. A dial-up connection with a slow computer may simply not be able to present the class in "real time." The lag can be annoying or even embarrassing, and you may find yourself losing out on some important points.

Regardless of what kind of training you choose, be wary of those offering claims that seem simply too good to be true. No one can guarantee that you'll find a job the week you complete your training and a school that offers those kinds of promises may very well be exaggerating other points of their training as well. Take time to be sure that any training facility you choose is reputable and that your hard work will end with training that will make you qualified to work in the medical transcription field.

Visit medical transcription online courses | medical transcription course or medical transcription school for more information on a career in Medical Transcription.

Getting Hired as a Medical Transcriptionist

So you've gone through training as a medical transcriptionist and you're ready to work. Surely someone will hire you!

This may be the hardest part if your school does not offer job placement assistance or if you studied on your own. Not all or even many companies hire inexperienced medical transcriptionists. It can pay, however, to check with companies whose listed requirements you do not meet due to lack of experience. Some may make exceptions if you can pass their test.

Testing is a quick way for a company to find out what your skill level is. If the company is local, they may test you at their location; distant companies may send out a test or have you test online. No matter how the test is performed, don't rush, and make sure to check your work.

A good school will help you with finding companies willing to test and hire you.

You will want to have some idea as to the schedule you will be willing to work. I would suggest being available for at least 20 hours per week. Some companies may require that you stick to a schedule, so be realistic about the hours you can work. Don't assume that any children you may have will cooperate or that naps will always be a particular length. You'll have an advantage if they are in school, but otherwise, be ready to work at night or early in the morning when the children are asleep. You will need peace and quiet to be able to understand some of the doctors.

Be careful when you choose an employer, as there are scam companies in this field, just as in many other work at home opportunities. Some companies out there claim to hire completely inexperienced people and train them as medical transcriptionists, but so far I have not heard of one that was not a scam. The catch is that you can never meet their standards to become a paid employee. Don't fall for it.

Fortunately, there are plenty of good companies out there. With outsourcing to other countries it can be a little rougher than it used to be, but the jobs are still out there. If your school offers help in landing that first job, take their help. Some only include it with their more expensive plans, so you want to think ahead even before you begin training.

All is not lost if you don't have help finding that first job. Research medical transcription employers and ask on medical transcription forums about companies willing to hire new graduates. Check with local doctors, dentists, chiropractors, etc. The jobs are out there, it just takes a little effort to find them.

Stephanie Foster writes about her experience in medical transcription at http://www.homewiththekids.com/medical-transcription/. You can learn more about landing your first medical transcription job at her site.

Getting Started in a Medical Transcription School

In most cases, the only things you will need to get started in a medical transcription school (besides an intense motivation to work at home) will be a computer and an Internet connection. The Internet connection assumes that you select an online medical transcription school, which is highly recommended. An online program will most closely approximate the real world experience. And as you start out this extra online experience will give you a significant competitive advantage.

As far as computers go, it is generally not necessary to go out and buy a brand new computer in order to get started in a medical transcription school. A used Windows based computer will do nicely. You really just need something that is a Pentium class or higher and that has Internet connectivity. You will also need a good word processing software package, such as Microsoft Word. Any computer that was manufactured in the past 5 years or so should be adequate for most medical transcription schools. If you feel compelled to purchase the latest and greatest computer make sure you shop around. A lot of the high end capability of most new computers will be wasted as most of what you will be doing will revolve around word processing. The most intensive computer activity you will likely be performing -- either in your training or on the job -- will be downloading digital dictation files from the Internet to your hard drive.

Once you have the requisite equipment, you are ready to enroll in a medical transcription school. If you have done your homework you should feel confident about your enrollment decision. Paying for your schooling is probably the biggest obstacle most people have to overcome. Many medical transcription schools have counselors that work with prospective students to help them explore financing options. A reputable school will probably have access to Sallie Mae financing, which is an academic finance company that specializes in educational funding. Depending on your school, you may also find a variety of other financing options and possibly scholarship opportunities that will help defray the costs of the program. Don't be afraid to ask about these things when you discuss your enrollment options with an enrollment counselor.

It can be hard to know where to start in selecting the right medical transcription school. Make sure you choose a medical transcription school that understands your needs as a person, and can work around your budget, schedule, and lifestyle to aid you in becoming the best MT possible! Remember, all you need are a few basic skills and a medical transcription education, and you'll be on the road to personal freedom and financial stability!

Chris Dunn has created a website to help stay-at-home moms (and others) pick a good medical transcription school.

Characteristics of a Quality Medical Transcription School

First and foremost, a good medical transcription school will have a comprehensive curriculum designed specifically for medical transcription training. This does not mean some off-the-shelf program that mixes and matches curriculum and study material from a hodge-podge of medical and non-medical sources. You are looking for a solid A to Z curriculum that was designed by Medical Transcriptionists specifically for medical transcriptionists. There is a big difference. You don't want a version of anatomy that is adapted from a veterinarian course. Yes, this sounds crazy, but you would be surprised at what you will find out there!

You are looking for a medical transcription school that teaches you the medical terminology, human anatomy, physiology and disease processes, abbreviations and plurals, and a host of other foundation material -- all from a medical transcriptionist's perspective.

Second, and of no less importance, the medical transcription school that you select must have an extremely strong focus on practical application. All the text-book training in the world is insufficient without a strong practicum to go along with it. Sitting in a classroom without applying what you are studying would be like memorizing vocabulary and learning to conjugate verbs in a foreign language and then assuming you could immediately go to that country and speak fluently with the natives. It just isn't realistic. It takes a lot of practice before you can start actually doing it well.

The best medical transcription schools will not graduate you until you can demonstrate a level of practical competency. And guess what? The way many doctors dictate reports is more reminiscent of a foreign language than anything else. Slurred speech, poor grammar, rapid wording, and run on sentences only serve to exacerbate an already complex and specialized language -- the language of medicine!

But in the end, the best way to select the right school is to find out where the national medical transcription employers are recruiting. You can rest assured that they are doing their homework. They will not be in the habit of hiring graduates from institutions that have not proven themselves capable of producing productive graduates. Getting a good job with a great company is really what counts isn't it? In the ideal world you want the employers to come to you!

Chris Dunn created Medical Transcription School.com in order to help stay-at-home-moms, and others, to find a great career that can fit into their schedules. Visit his site to learn more about this awesome career path.

A Career in Medical Transcription

If you're looking to switch careers, you might consider becoming a medical transcriptionist. This is someone who interprets and transcribes dictation by healthcare professionals. There are many benefits to a career in this field. For instance, you can, in many cases, work out of your own home at your own pace. Also, the demand for jobs is pretty high right now, provided you know what you're doing. Most professionals seeking out a transcription service prefer someone who has been through training at a community college or trade school and has some work experience.

Besides the proper training, you'll need the proper equipment. Since a medical transcriptionist listens to dictated information using a recording device and headset, you'll need to purchase these items. A foot peddle is also necessary to start and stop the recording device and the information you gather will have to be entered onto a computer or word processor. You will also need medical and pharmaceutical directories since you'll be expected to know the proper terminology. If any words or phrases are unfamiliar to you, it will be your responsibility to look them up in one of the aforementioned reference books. You should know the principles of basic grammar and be able to spell check and proof read your own work. Since you'll be transcribing dictated information, you'll also need to be a good listener.

Whether you're working through a medical transcription service or on your own as an independent contractor, the type of clients you have will probably include doctor's offices, hospitals, free clinics and rehab centers. You'll be transcribing any number of documents including patient histories, autopsy reports, referral letters, consultation reports and other medical records.

If you're interested in becoming a medical transcriptionist, you must first get the proper education. Courses in this field are available at colleges, trade schools and even online. Most programs take about two years and some require you to work an internship at a medical facility. Further information regarding a career in this rewarding field can be gathered at the library or on the Internet. Good luck!

James Hunt has spent 15 years as a professional writer and researcher covering stories that cover a whole spectrum of interest. Read more at www.transcription-services-guide.info

Finding an EMR System that can Handle Medical Transcription SOAP Notes

Searching for the Right EMR Solution

The electronic medical record, or EMR, is a standard electronic database solution used by medical practices and medical service providers. The EMR solution technology effectively manages medical histories, records, and notes; however, all EMR solutions are not created equal. Before adopting an EMR solution, medical practices and medical service providers must search for the EMR solution that meets their specific needs. Two important needs common to most medical practices and medical service providers include medical transcription and SOAP note management.

Sifting through EMR Software

The best way to find what youre looking for is to begin with the end in mind, as Steven R. Covey says. Companies may have a small staff, or they may still be using a transcription machine. A practice may need more security, more automation, and better control of SOAP notes or other medical transcription information. In order to find what you need, you need to list them out. The list may look similar to this:

Medical Transcription and SOAP Note Management
Document Scanning Attachments
Customized Data Fields
Medicare or Medicaid Billing Software
Procedure Code (HCFA 1500 forms, CPT code books, ICD.9 codes)
Medical Billing Software
Medical Billing Specialist Support
Diagnosis Code Directory

Finding the right EMR Online

Search engines are one of the most popular tools for finding the software you need, but finding the right EMR online presents its own challenges. For example, typing EMR system into any of the big three search engines will yield results similar to the following, which I looked up the day I posted this article: Google 566,000; Yahoo 547,000; MSN 242,835. This means that hundreds of thousands of indexed pages claim to have what you are looking for. So how do you sift through them all? Sometimes searches have to be narrowed by using the listed items above as a part of the search. Since medical practices and medical service providers need to control SOAP notes and medical transcription, use these terms to begin to narrow down the search.

EMR Benefits

An earlier article on EMR benefits lists characteristics of an EMR system that a medical practice or a medical service provider might enjoy with an EMR. In the Information Age of business, speed and efficiency are paramount to success. And when it comes to medical services, success is not only measured by a fiscal year but by a satisfied customer. An EMR system can make an office run smoothly, so that the customer always comes first.
Joe Miller is an online advertiser, specializing in medical software. More information on EMR and Medical Transcription, visit AdvanceMD.com.