Will we see you at AHIMA?

The 82nd AHIMA Convention and Exhibit is almost here! The gang from M*Modal will be there (booth 2109) and we hope to see many of you!

Transcription service providers often attend AHIMA to exhibit and to take advantage of the opportunity to meet in person with customers. It is definitely a terrific venue for networking and customer relationship building.

But what I like so much about AHIMA’s national convention is that it is such a terrific learning opportunity. Not only is it full of educational sessions and presentations, but what better way to hear about what the HIM users of clinical information are talking about?  What are their concerns? Their challenges?

As MTSOs, this is a great place to get ideas about how to better serve your HIM customers. How can you change your service offering to help them to be more efficient? To eliminate some of their pain points?

In short – what can you take away from AHIMA that will help you to increase your value to your HIM customers? What problem can you solve for them that will make it clear that you are more than a typing service – and that you are not merely an expense to be eliminated?

HIM is in more of a transitional state than perhaps they’ve ever been in before. With ICD-10 looming, talk of meaningful use and the EMR, challenges presented when systems designed for clinical use don’t necessarily meet the needs of HIM, increased demands for documentation for coding and reimbursement, RAC reviews, and of course – despite all the talk of the electronic record, even facilities who have made great strides towards adoption and use of the EMR still have years and years worth of paper documentation to deal with.

Just a few of the interesting topics that will be covered:

  • ICD-10-PCS (Procedure Coding System – inpatient procedure coding) and ICD-10-CM (Clinical Modification – diagnosis coding).  What does the change from ICD-9 to ICD-10 mean to your customers?
  • Audits and Quality – how do RAC reviews and other quality audits affect the HIM? What is the difference between how the MTSO measures quality of documentation and how the HIM looks at it for their purposes?
  • ARRA and the HITECH Act – are you caught up with your reading about meaningful use? ARRA and HITECH? What do these hot topics mean to your customers – and subsequently to you?
  • Clinical Documentation Improvement programs – capturing sufficient information about severity and complications affects hospital reimbursement levels as well as hospital performance ratings.  How can you help your customers to collect the more accurate and complete information that they need?  Do you know how documentation can be used to improve CC/MCC capture? To improve their CMI? And ultimately to improve patient care?

If you are attending the convention – take advantage of this terrific learning opportunity.  If you aren’t attending, AHIMA has a wealth of information available on their website. HCPro also has a tremendous amount of educational material available as well.

Here is a homework assignment…if you don’t know what these acronyms mean, find out. Being knowledgeable about HIM will increase your value to your customers and will help to keep you viable well into the future of clinical documentation.

I hope to see you in Orlando!


A New Concept in Healthcare?

Hello everyone:  I’ve been reading about the accountable care organization (ACO) with great interest, in particular a blog hosted by The Commonwealth Fund (www.commonwealthfund.org).

The ACO is a concept that encourages groups of physicians to work together as teams to promote better health outcomes and decreased costs.

This idea is exciting. Instead of paying for expensive clinical tests which may or may not be beneficial to a patient’s care, or for expensive treatment AFTER a patient has become severely ill, these organizations are paid to keep patients healthy. Not only is this obviously good for the patient, but it is also an opportunity to decrease healthcare costs by decreasing the need for  expensive diagnostic tests, treatment, and surgeries after a patient has developed a condition or complication that could possibly have been prevented.

There are several potential options for payment models discussed by Karen David of The Commonwealth Fund in her blog posting Coherent and Transparent Health Care Payment: Sending the Right Signals in the Marketplace. These include the global fee option, where organizations are paid one fixed fee for all care for a health condition, and bundled acute case rates, where certain procedures are paid for by one rate that covers surgeon’s fees, anesthesiologist’s fees, the hospital bill…and even for after care should complications arise after the surgery! Sound too good to be true? According to Karen Davis in this same post, Geisinger Health System in Pennsylvania already offers a global fee for several procedures performed there. Ms. Davis in her post states that she is proud to serve on the board of directors for Geisinger, and well she should be!  This is truly an exciting, and seemingly a common sense, approach to healthcare finance.

As with any major reforms of this size and scope, the ACO will need to overcome numerous challenges and obstacles if it is to be successfully adopted – but I will continue to watch with great interest!

For more interesting reading, go to www.commonwealthfund.org. There is a LinkedIn group (subgroup of Healthcare Executives Network) at http://linkd.in/dxFOli.  Go To LinkedIn Groups directory and search for Accountable Care Organizations to request membership to the group.

What do you think?


What Factors Contribute to MT Career-Mindedness?

As we get ready for our AHDI – M*Modal management series, I’m thinking more and more about MT management and in particular, compensation and the challenge of attracting, and keeping, Career-Minded, dedicated professionals to the field.

I had the opportunity last week to visit a healthcare facility and to participate in the training of their MTs for editing of speech recognized text.  These MTs are employees of the health system and work from home.

Yes, the facility is certainly interested in increased efficiencies and decreased costs – but they are also very quality driven. And even more interesting, they are quite effectively making use of narrative dictation supported by MTs in an electronic environment – getting the best of both worlds.

What I found especially interesting though is how they feel about and manage their MTs, how  long their MTs had been with them, how happy their MTs are, and how open and eager they were to learn to edit.

Here are some interesting observations:

  1. The MTs do not feel threatened by the conversion to editing and were very focused and determined to learn to edit effectively.
  2. They are paid hourly. So paychecks aren’t threatened by unrealistic expectations for productivity increases.

    They are valued for WHAT they do, for the quality they produce – NOT just for the volume they produce. They are paid for the time they put in. Think about the impact to quality and need for QA this could have.

    The facility respects the physician’s time enough to know that MTs are a valued part of the documentation process. And in fact they expect transcription volume to increase, not decrease.  So MTs do not feel their jobs are threatened.

  3. The MTs are treated, and behave, like employees
  4. They are expected to work assigned shifts – the entire shift – regardless of how many lines they produce.  There is no “I met my goal, I’m done for the day.”

    They are held to minimum productivity expectations BUT are expected to do as much as they can do in a day. They are expected to put in a good day’s work – not work to a number.  There is no rushing to make up line counts at the end of the pay period because they work a full day every day. Imagine the impact that has both on TATs at the beginning of the pay period, and out of work situations at the end.

  5. They were allowed sufficient time for initial editing training  – and will be encouraged through follow up sessions in coming weeks.
  6. They are following best practices for distribution of work – MTs are transitioning to editing only when there is volume sufficient to keep them busy in editing for most of the work day.
  7. All MTs are expected to edit. There is no “keep your high producing typists out of editing” mentality because they want the benefits they will gain by having their best MTs working on the bulk of their volume. It is expected that editing will be the way transcription is done there. Period.

Just some food for thought as we get closer to our Innovative Management for the MTSO series!

Stay tuned…..


Lynn goes to the Doctor

The Doctor, by Sir Luke Fildes (1891)

Image via Wikipedia

Well, how is this for relevant?

Today, because my old and ongoing neck pain left me with a numb left hand yesterday that still hadn’t recovered by this morning, and also because I’m sneezing and wheezing every night all night despite the Allegra-D and Advair, I thought I’d better go see the doctor.

So I was pleased to get an appointment for this afternoon.

My doctor’s office has started using an EMR since I was last there and the medical assistant and then the doctor sat down in front of a keyboard in the exam room.

“How do you like having to do that?” I asked the doctor.

“I hate it. I like that I can find information when I need it but I hate that I spend all my time looking at this computer instead of at my patients.”

Funny she should mention that because…

As she sat in front of the keyboard (with her back to me after I’d jumped up on the table as asked), she asked if I’d ever tried this medication, if I’d ever tried that one.  As she came across something she thought would help, she entered the prescription.

“This is going right to your pharmacy. No paper prescription. And here is an order for a neck x-ray.”

So as I was swept out of the office in record time, and was handed a printed up summary of my visit on the way down the hall (I barely slowed down) I realized something.

I’ve had asthma since I was 8 years old. In all the years that I’ve gone to the doctor with all my seasonal allergy woes, I have never once NOT had my breathing listened to, or my nose, eyes, ears, and throat checked.  I’ve never NOT been asked how many times I was having to use my rescue inhaler.


Isn’t it amazing how that EMR made it possible for that doctor to treat me, send my prescriptions straight to my pharmacy, order my neck x-ray, and hand me a printed summary of my visit all without ever examining me?

Maybe next time I can just answer a few questions on a website. Who needs a doctor at all?

So why then am I sitting here still wondering if I am doing permanent damage to my nerves by not treating my neck problems, if I can continue doing yoga without causing harm, and if my asthma is going let me get through the fall without a trip to the ER?

Technology is a wonderful thing….


Healthcare in One Voice…

Did you see Jay Vance’s post yesterday in the AHDI Lounge?   Don’t Confuse me with the Facts

He mentions an article he read recently that talks about how groups of people believe what they want to believe despite evidence to the contrary – and how as our trust in large groups such as the government diminishes, our faith in our smaller network groups grows. He relates that to our position in health information, and specifically  in the medical transcription industry.

I’ve definitely seen evidence of this as I frequent blogs and discussions held by various groups in the industry. The HIMSS blogs talk only about technical requirements and implementation.  AHIMA discussions center around increased information requirements with the coming ICD-10-CM conversion.  AHDI and MTIA talk about keeping the narrative in clinical information…

We are all talking about the same thing – health information – but each group looks at the topic from its own perspective. We all see the problem in a different way.

I agree with Jay that it is difficult to see the big picture – especially when the information available to us depends largely upon with organization is most active and outspoken at the time.

And I also agree with him that we have the ability to go beyond our own narrow perspective to see through to the bigger picture.  We have the ability to speak as a unified voice for the good of health information – not just about our own concerns.

Are we concerned about the loss of transcription only because of what it will mean to our wallets? Or do we honestly believe that transcription is a valuable and important part of health information that really IS useful and meaningful.

I know how I would answer that question – how about you?

Thanks for the insight Jay!


Back to School Time for Medical Transcription!

back to school

Hello all!  It’s getting close! M*Modal and AHDI will be announcing the timeline for our series, Innovative Management for the MTSO, soon!

The general outline is as follows – but we’d like to hear from you before we get started.

What topics are of particular interest to you?  What do you most want to discuss?

AHDI and M*Modal will be collaborating in a series of conversations over the next few months to discuss these topics and more. We will be using several different venues, including webinars, articles, blogs, and online chats (and maybe a few that we’ve never used before!) to talk about the following and more:

Introduction – What is transcription and why is it still relevant?

  • What is our product – what is it that we provide?
  • Why is our product still relevant in the changing world of healthcare IT?
  • What value do we bring our customers that they can’t get elsewhere?

Product offerings and messaging

  • Documentation service levels
  • Useful information – not bottom-cost lines

Wanted: The Career-Minded MT

  • The changing face of the Medical Transcriptionist
  • How do we attract, nurture, and retain the Career-Minded MT?
  • The rise of the “Hobby MT”
  • Taking transcription seriously

Managing for efficiency

  • Using speech recognition to its highest potential – how to get the biggest ROI (…or everything you ever wanted to know about speech rec that most speech rec vendors won’t tell you…)
  • Efficient workforce management
    • Scheduling and workflow distribution
    • Managing the independent contractor
    • Managing by metrics
      • Productivity – proficiency versus output

Transcription Innovation in the World of Meaningful Use

  • Increasing the value of the transcription product
  • The MT of the future
  • Education and skill requirements

What else do you want to talk about? What are your particular concerns?

Give us a shout out by commenting on the blog. If you don’t wish to comment publically but still have comments or suggests, please feel free to email me or contact me privately.

I can’t wait to hear from you!


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