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January 14, 2013

The New Breed of Transcriptionists
By Mary Anne Gates
For The Record
Vol. 25 No. 1 P. 6

As speech recognition technology (SRT) continues to gain popularity in healthcare settings, scores of medical transcriptionists (MTs) are asking how they can remain employed in their chosen field. While previously learned skill sets are seemingly rendered less desirable, old-school know-how still matters. Combining that knowledge with a desire to learn new skills and a willingness to embrace today’s technology can open doors for frustrated MTs who may feel they are being squeezed out.

It’s All in a Name
Whether dubbed SRT editors or medical language specialists, a new breed of MTs is emerging. “Medical language specialists is our preferred term since it reflects this evolution beyond traditional transcription,” says Robin Lloyd, vice president of transcription operations at Nuance.

Whatever the designation, an MT needs much more than fast, accurate typing to successfully transition to speech recognition editing. “They need a deep knowledge and understanding of medical terminology, anatomy and physiology, pharmacology, and disease processes. They also need a comfort level with the more feature-rich editing products used with speech recognition,” Lloyd says.

While the technology continues to develop, the new environment is expected to be similar to what MTs encounter now. “Speech recognition technology is now being applied across all types and sizes of medical facilities and nearly every specialty area and work type, so we see the same diversity of environments for medical language specialists, who are primarily editing speech drafts, as well as for traditional transcriptionists,” Lloyd says. “The use of speech recognition provides some ability for medical language specialists to work across a broader set of facilities and physicians since speech recognition will manage some of the variability between dictators, but the work environment and operating models are not dramatically different.”

Regardless of job title, the core education and fundamental skills needed for transforming the spoken word into a medical document is similar. Differences occur in the actual application of the job. For example, MTs transcribing from verbally dictated notes need fast, accurate typing skills and an acute ear to pick up various nuances. Conversely, SRT editors need a more critical eye to proofread and detect errors such as misused homonyms. Additionally, they need an acute ear to accurately translate the voice file accompanying the original draft.

While the education and skills essentially are the same, editing places slightly less importance on typing proficiency and speed and more emphasis on understanding content. As the output from automated speech recognition can occasionally be garbled or nonsensical, the most effective editors possess a deeper understanding of medical terminology and concepts, according to Lloyd.

MTs searching for a solid educational program that incorporates the latest technology and best practices can sometimes be left wanting. However, several proven, established training programs teach speech editing skills and offer extensive practice on other widely used industry tools. “These programs have adapted to the needs of medical language specialists to reach the level of competency required for employment as quickly as possible,” Lloyd says. “Training on the use of speech technology and editing software is essential for all medical language specialists to be successful in the current environment.”

According to industry experts, the fundamental knowledge needed for an MT to attain certification is not significantly different from what is required to become an SRT editor or medical language specialist.

“There is currently no specific credential for speech editors,” Lloyd says. “The core knowledge needed to earn a CMT [certified medical transcriptionist] credential is very similar to the core knowledge needed to be an effective speech editor, so we do not see much value in creating a separate credential or designation. Editing is simply the evolution of the CMT role, and even our shift to using the designation medical language specialist does not reflect a wholesale change in the skills developed in the CMT credentialing process.”

Where the Jobs Are
As EHRs become more prevalent, gaining employment as a medical language specialist holds great promise and opportunity. “Entrada is currently recruiting aggressively to meet the staffing demands of our growth with a current goal of 30 full-time employees per month,” says Corie O’Reilly, director of editing operations. “Editors are required to have at least one year of recent transcription experience in either acute care or a clinical setting.”

The company, which offers a workflow solution for physicians transitioning to an EHR, allows its staff to work from home. “We offer the option of scheduling flexibility balanced with the needs of the account,” O’Reilly says. “Due to our rapid growth, our editors have ample opportunity for work continuously throughout their schedule.”

Compensation and Productivity
When it comes to salary, SRT editors pretty much are in the same boat as MTs. “Production-based compensation has become the standard for both traditional transcription and speech editing. Compensation rates are typically based on lines or characters produced,” Lloyd says. “Compensation is adjusted to account for the increased productivity medical language specialists can achieve editing drafts vs. transcribing without the assistance of speech. Years of experience are not factored heavily into compensation rates, but more experienced medical language specialists often achieve higher compensation levels based on their superior productivity and quality.”

At Entrada, the story is much the same, although there are other considerations taken into account. “Our extremely competitive per line editing rate is determined at the time of hire and modified depending on multiple factors, including experience, merit, productivity, and reliability,” O’Reilly says.

A New Beginning
Using speech recognition software to transform spoken words into text does not mark the first time someone has found a way to produce a written record of what he or she said. Prehistoric people used stone tablets and chisels to chronicle their spoken words. Later, ancient Egyptians, Greeks, and Romans put quills to papyrus or parchment. Later generations employed common writing tools such as pens and pencils and typewriters to transform spoken thoughts into written words. Multiple generations have graduated to computers—albeit sometimes reluctantly—but most have quickly mastered new skills as technology has improved. Today, technology can convert speech patterns to printed text on a computer screen minus the keyboard and sometimes even the MT.

“SRT gives us the ability to produce more volume per editing resource, and the combination of that with the changing way providers document will definitely result in an evolution of the role of the editor,” O’Reilly says. “Our experience indicates it does not signal the end of the career for MTs but a new beginning as they embrace the EMR and leverage their skills and experiences in future roles, such as clinical data improvement specialists. This change is also an evolution over time, and for the foreseeable future there continues to be a large demand for quality editors.”

For documentation specialists, this growth provides an opportunity for them to use their experience as a platform to build new skills. Once that’s accomplished, networking with colleagues and professional associations can help them find the ideal position.

It’s no secret speech recognition software together with EHRs has forever changed HIM. For MTs, it’s important to embrace modern technology and make it work to their advantage.

— Mary Anne Gates is a freelance writer based in Fort Wayne, Indiana.