Transcription Quality Redux

QA Cycle

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Hello everyone: We’ve had a number of comments on the blog and through email about the post Quality Health Information – a Transcription Wake-up Call and it is certainly a topic that deserves attention.

I am hearing more in recent months about a practice that some companies use to decrease the amount of work sent to secondary QA levels before delivery to the provider. Companies select a threshold for how much work can be sent to QA – usually a percentage of total work transcribed or edited – and the MT is paid a lower line rate for work sent to QA that exceeds that threshold.  Balancing the push for productivity with quality is a difficult balancing act. Pushing an MT for  higher productivity (especially if line rates have already been decreased as speech recognition was introduced) does increase the temptation for an MT to send jobs to QA. How does an MT balance the need for speed with the amount of time she should spend researching a term?

I cannot comment on the specifics of this practice since I do not know what all of these companies do to support the MT otherwise, but I do have some questions.

  1. Does the MT have resources available to help complete the terms she isn’t able to make out or find through research? Is there someone available to lend a second ear or to answer questions?
  2. Is the QA person able to provide comment? In other words – can the QA person say, “yes, sending this job to QA was indeed reasonable” so that the MT can be paid the full line rate for those jobs?
  3. Has the company provided sufficient training to the MTs? Does it provide supplemental training for ESL authors or unfamiliar specialties or work types?
  4. Does the company provide reference materials, samples for specific, difficult doctors, and other tools to help MTs?
  5. Does the MT receive feedback on the documents she sends to QA? Does she receive corrected copies?
  6. Is work assigned to MTs such that they are able to become familiar with difficult doctors and unfamiliar specialties?
  7. Are particularly difficult doctors exempted from the threshold?
  8. How is the QA threshold selected? Is it one arbitrary percentage across the company? Are less experienced MTs expected to meet the same threshold as experienced MTs? Is there a higher threshold for known difficult authors or more difficult specialties or work types? Are all MTs held to the same threshold regardless of the level of difficulty of the work?
  9. Is sufficient QA performed on final documents to ensure that quality isn’t suffering as a result of this practice?
  10. Are MTs rewarded financially for consistently high quality work?

My hope is that a company that penalizes MTs for sending work to QA provides the tools and support to MTs to help them to create a high-quality document.  I also hope that if MTs are punished for sending work to QA, that they are also rewarded for producing consistently high quality documents.

My fear is that companies expect to push productivity and decrease QA without taking the measures required to ensure quality… I hope my fears are not justified!

All my best as always,



2 Responses

  1. As always Lynn, you hit many of the high points of this very important subject. In teaching new transcriptionists, the balance point between quality and quantity is the hardest to define, especially since every MTSO has a different standard. There is one more point I’d like to add to the challenges facing MTs today and that is voice file quality. While the technology has improved, the reality is that dictators now think nothing of dictating in an echoing operating room, or on a cell phone while driving the convertible. The old data processing adage still applies: Garbage in, garbage out. Thanks for another great post.

    • Great point about audio quality Crystal…thank you!

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