June 09, 2003
Medical Transcripts And Personal Medical Privacy
The San Francisco Chronicle has an interesting piece on the practice of hospitals and other health care providers sending medical charts out to be read and typed into computers. Many medical transcriptionists in the US work in their homes doing the work. But an increasing number of medical records are being sent to India to be entered into computer format.
Last month, for example, India celebrated World Medical Transcription Week. "India has become the favorite country for outsourcing in the U.S.," Prasenjit Ganguly, vice president of the country's largest medical transcription service,
This passing around of hard copy medical records into homes and even to other countries certainly does not inspire confidence that medical privacy is being well protected. While the advance of electronic communications makes it easier to send records abroad to be translated in the longer run technology will probably eventually eliminate the need for human medical transcriptionists entirely. Scanning software ought to eventually be able to read many paper charts. Also, voice translation software ought to be able to transcribe video records made by doctors. But eventually all data entry on medical charts will be done directly into encoded digital form. Even voice records should be translated into properly spelled words just as doctors speak into a recording device.
Advanced integration of test equipment and lab results with medical computer databases should entirely eliminate the paper copies of test results. Increasing portions of medical records will never even be generated as hard copy in the first place.
So my FuturePundit forecast on medical record privacy is in the short term even greater distribution of written medical records to distant countries for data entry. But in the longer term all human medical transcriptionist work will be entirely eliminated.
Will the end of hard copy medical records increase medical privacy? Or will medical records be sent between health care providers, insurers, and other organizations more rapidly and in larger quantities? Will increasing numbers of workers of those organizations will be able to more quickly and easily look up details of your medical history? Will the result be that so many medical records are accessible by any one person that a black market in medical record information will become easier to develop since a single worker in a hospital chain or insurance company will be able to sell the records of many people to interested parties?
I'm so glad I don't have anything in my medical records that I care in the slightest about. So other people find out I had a broken arm? Like that is going to concern me? They could always have looked at me to see the plaster cast.
You are SO wrong about medical transcriptionists being replaced. Never really sat down and LISTENED to a doctor mumble, stutter, chew, mispronounce, and laugh with the nurses his way through a medical report, have you? The voice-to-text does verbatim transcription. And believe me, no doctor, no hospital wants that in the medicolegal document. MTs don't just type, they "clean up" a dictation. We proof for good grammar, create it where it never existed in the first place. We will take "melanotic stool" dictated and voila it is transcribed melenic stool like it should have been dictated in the first place.
Y'all just DON'T know. :)
Thanks for you interesting comments. I am an MT in India saying "irritated bowel syndrome". Had me stuck for a while.
Would it be possible for you send to me the names and e mail addresses of firms doing medical transcripts around Ahmedabad and Baroda.
Dr Pradeep Ganatra
Would like to know names and e mail addresses of firms doing medical transcripts in chennai, Pondicherry, Tiruvannamalai areas as soon as possible.
Can I be any assistance w/ that? We have a firm in pakistan doing just that. If you are interested in getting your MT done at a cheaper rate, please e-mail me at firstname.lastname@example.org.
I totally agree with Kathy. I am an MT too, and there are WAY to many things that sound a alike like cirrhosis and psoriasis. How is a computer going to know that one involves the liver so it would not make sense for a dermatologist to be dictating about it? MTs will ALWAYS be needed!
Hi, I would like to know the institutes which offer MT courses near Mumbai, Thane or Dombivali.
I am from the Philippines and right now I am studying to be an MT. Here we are trained not to be empty MTs. I agree with Kathy, we don't just type, we are also trained to think.
Hi I wanted to do Medical Transcription course.Let me know about such in Dombivli or Thane.Tell me also about scope in future.
You are so wrong about us MTs being replaced, whether we are in India, Pakistan, some island in the South Pacific, we are necessary and will always be necessary. You have never heard the crap that comes out of the voice recognition software, the best in the business mind you. Never, never, never!!! You need a human with common sense, something that you will never duplicat in digital form to make sure these legal medical records are accurate. It's a small world and MTs can be in any part of our world with our common sense and able to turn gibberish into a medical legal document ready to go to court if need be and support that physician's decision and actions which to a physician I suspect is foremost in his life when he gets in this position to back up his medical decision making, tell me then that he is so hot for this so called 'progress' in medical transcription or he was glad that there was a human being eyeballing the dictation and making sure it was accurate or sending it back to him if he had misspoken as doctors are only human. How does the voice recognition pick up on that???? I am thinking of a doctor's career, not just the easy way out and oh, what progress we have made into the Jetson era : )
While we're at it, what about clanging instruments, crying babies, ringing phones or the paging system repeatedly asking for someone to go somewhere...all at one go, while the dictation goes on? Let's not forget, what if the doctor coughs or clears his throat? What about the units of measure and their abbreviation? will the automatic verbatim translator/transcription machine be able to correct age discrepancies compared to dictated birth date? Hmmmm...pronouns? dictated medical abbreviations preferred expanded on text? Capitalization? Just a few (so few among a multitude)concerns a human MT does. At any rate, I guess anywhere you go, the human factor is the real deal.
All the comments regarding the MTs NOT being replaced are definitely accurate. I don't see it happening in the foreseeable future. Here's another example of a word that the computer would never be able to distinguish...perineal and peroneal. These two words mean totally different things, but sound exactly alike when a doctor dictates them. We'll be here for a while longer gals (and guys). ;)
Yes, to all I agree. No way they can replace any of us. Some of the dictators are too messy to ever be understood by voice recognition and others well of course they cannot distinguish between perineal and peroneal. They also like to put medical terminology where there is just plain English. Also, lets not forget the lab values. It might sound like sodium is 29, but most us know that can't be right and we listen a little harder and find out it is 139 or something. As far as personal health information being compromised, I work at home, and I do not talk about my information with anyone. If I do ever say anything about something I have transcribed it is in a hypothetical type thing, not like it really happened. I have personal health information of my own that I don't think is anyone's business, so I treat the material I receive in the same manner. My computer cannot be accessed even by my husband, so people need not fear about their personal health information. I have worked as well with some of the best computer voice recognition there is, and there is no way they will ever replace the actual human factor.
What about being replaced by technology such as Epic. I have a hospital I work for and they are going Epic and we are losing some of their work. I once too thought that there was no way we could be replaced, but now I have to wonder what the future really does hold for the MT and whether or not I should change my career course if eventually I am not going to get as much work. Any ideas?