Dare We Say The Emperor Has No Clothes (Or At The Very Least Is WAY Underdressed)?
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
Right on TARGET! The skill set for doing SR editing is exactly the same as transcribing. For some MTs, it's actually more difficult, and personally I find that it leads to more fatigue and stress. and it's worth less money? Explain this to me!
She's absolutely on target! I commend her for publicly expressing this most honest assessment of the technology in her role of senior management. Prior to this we as the general workforce have been given the tacit impression that the MTSOs are truly baffled that the MTs are asserting that on the whole the technology doesn't work as marketed and that it has a severe negative impact on both our income and that of patient care, a most disingenuous device on the part of the MTSOs.
As for as what working MTs can do about the situation, I, like many others, don't have a clue. All I know is that each year I continue to spiral deeper into an abyss of poverty despite working an unreasonable number of hours per day in a skilled profession.
I'm looking forward to reading more comments on this post.
Finally someone from the MTSO world has said it out loud. Speech recognition software just isn't there yet, but investing in it has been done at the expense of MT compensation. I'd like to hear more people to shouting about this.
She is absolutely right. Somewhere, sometime, some salesman made a pitch for SR software by promising transcription providers that it would enable MTs to be twice as productive. Providers eagerly jumped on the bandwagon and budgeted accordingly. The promise has never been realized, but the budget savings were, so now there's no turning back.
I wonder if SR continues not to live up to its double production, higher earnings lure if we will see more of the American MT workforce quit the profession entirely.
I was thrilled to see Linda Sullivan's take on speech rec. She was so right about the payment situation.
Someone else who has been very eloquently making the same case for a while is Lynn Kosegi of M*Modal. Lynn presented at AHDI Florida twice last year, at our technology workshop and at our annual meeting, and she explained that paying speech rec editors at 50% the line rate effectively punishes the best producers and those producers will ultimately be lost to the profession, replaced by transcription dilettantes who work without commitment to turnaround time or quality. (You get what you pay for, after all.)
If an MT can transcribe 300 lines per hour doing traditional transcription on a keyboard, he or she will not increase production that much by doing speech rec, as the best you can ever get to is 1:1 transcription. In other words, you can only transcribe or edit as fast as the words are spoken. But still, that MT will be doing the work of 3 full-time equivalents (that is, 3 normal MTs). (This is on slide 45 of Lynn's presentation.)
She had some impressive metrics in her slides that really told the tale. Download her slides here at her blog:
http://mmodal2.wordpress.com/2011/01/24/transcription-in-health-information-understanding-the-value/
Look for the link that says "Florida AHDI 20110122" above the picture of the pretty purple Dodge Challenger.
Kudos to Linda and Lynn for "getting it"!
She got it right on. I was at 250-300 lines per hour transcribing. I can't double that in SR as I can't edit a report with a chipmunk as a dictator. I went from making .10 a line (as a CMT) to less than .05 per line in SR. My income dramatically dropped, AND because my pay reduced, I lost my health insurance as well. The MTSO required a minimum dollar amount per pay period rather than a line minimum to maintain your health insurance eligibility. SR is destroying our profession -- a profession I once loved.
This has been my argument from the beginning. It is not less work (yet) it is different work.
If my MTSO needs to slash my pay and benefits in order to keep their head above water, I wish they would just be truthful about it.
Right now I need about 0.05 to 0.1 more a line just to be able to keep my head above water and make a little over minimum wage. Receiving e-mails about working 13 hours to put in 8 hours of work is not helping my morale at all either.
Absolutely agree, and it would have been nice to have some "back-up" a few years ago when my former coworkers (I've moved on from transcription after 25 yrs) and I tried to explain why we weren't thrilled about the new "speech wreck" system to our bosses at the hospital. We were described as "resisting change." Now they have the radiologists doing their own editing, and it's not pretty. But they have a paper in the chart and apparently that's what it was all about all these years! It just goes along with the devaluation of all things literate in society. Physician knowledge itself hasn't decreased, IMO, but its expression has greatly deteriorated. And the pay, or lack of, is now entrenched, too.
Unfortunately, it seems as if most users of medical reports have decided they'd rather settle for lower quality than pay higher prices. How many of you have been told that a great deal of the punctuation and grammar we used to be held responsible for no longer matters in SR editing? How much of the formatting that used to bring clarity to the report is now gone? We can argue all day about whether every comma mattered, but much of what we're now being told to overlook did matter. If we say we can't do twice as much in SR, that's the party line we get: You need to stop over-editing. Sounds like blaming the victim to me.
My biggest question with all of this is: If we as MTs don't like it and the physicians who dictate don't like it (it slows them down by at least 1/3 and sometimes more), then why are we being forced to use it? Who is forcing the issue?
I have worked on 3 different speech recognition programs. It worked minimally well for radiologists, who speak in a relatively quiet environment. It worked somewhat for other physicians if the environment was QUIET. It DOES NOT work if the physician is on the floor, in the middle of an office party, dictating from his cell phone, speaks a foreign dialect and puts all his/her words in the wrong order in the sentence, and it does NOT and will NEVER work as well as my own EAR and MIND that were created to understand and automatically fix all the above at a high rate of speed.
I think that this entire debacle is the most disgusting thing to occur for patients, physicians, and healthcare workers. I do not think anyone in the regulatory side of this industry has objectively looked at the amount of errors generated by speech recognition.
What concerns me the most now is that when the errors are in the patient's record, they are not just there locally but globally. It would take an act of God Himself to fix it. That is a crying shame for patients, physicians, and healthcare across the board.