Professional Development for Healthcare Professions Blog

ACE 2013 Great Expectations #ace13

Posted by Chad Sines on Wed, Jul 31, 2013 @ 03:45 PM

describe the imageThis is another year at ACE, AHDI’s Annual convention, and another chance to hear something big that will wow us. I look forward to this conference each year as it is one of the few times so many friends and colleagues are in the same location. We leave with new business contacts, ideas for the future, often with partnerships as well. A lot gets done in 5 days on very little sleep. 

While these are great times to networking, arrange business plans, and otherwise make plans for the upcoming year, we have yet to see an ACE that left us feeling that everything is about to change and in a good way. This is something that I heard each year and last night I heard many saying the same. With hard declines in revenue, shrinking staff, and membership concerns, we need some wow announcements to shake up membership and drive former members back. We have a great opportunity to flourish and I expect to be amazed this week. 

Here are some things I hope to hear because then we will know we are relevant:

  • We will re-define a healthcare documentation specialist as someone who not only knows medical transcription but also know medical coding. The future is not one or the other. The future documentation specialist will do both roles. Positioning our members for this now will give them a huge advantage. There is a reason MTs flock to Med-Line to learn ICD-9 and ICD-10 medical coding.
     
  • We are exploring a merger with AHIMA. The time really has come. We need to set aside our own agenda and position our members for long-term success. The membership and revenue of AHDI has steadily decreases as fewer and fewer are MT only. Many have left the association for AHIMA as they are the true gatekeepers of Healthcare Documentation. Such a merger would be of great value to all members.
     
  • All approved MT training programs will be required to be at least 12 months. There is too much to learn to force training into programs that are under 12 months. We need to be setting up graduates for long-term acute care success. 
What are the chances we will hear any of these solutions? What would you like to hear at ACE?

Topics: Industry Issues

Our Own Worst Enemy- The Dangers of Reactionism

Posted by Chad Sines on Fri, May 24, 2013 @ 07:00 AM

InformedSome recent conversations with MTs and coders have me questioning whether we are often their worst enemy. Right now I know that there are some sharpening their claws for the strike, but hear me out. Traditionally our profession is more reactive than proactive. I think that is an undeniable fact. Although we loudly voice what we do not like about the current state of the profession or where it is trending, we seem to shy away from the more successful proactive approach…or we begin to get involved, hit a speed bump, run back to safety and say “I tried and nothing changed.”

MTs are used to being the behind-the-scenes person who “types what we hear” (we hate the term but I think our actions, or inaction, speak louder that words) and dare not question the physician or offer ideas on improving dictation practices even though it could lead to reduced errors and increase patient safety. Coders are seeing changes pushed onto them as well even though physicians are ill-prepared to provide them the information they need to implement new changes.

We let vendors develop systems that we use on a daily basis without insisting on being part of the development and complain heavily after the fact about how it could be better. I recall a few years ago during a meeting where a vendor showed his nifty EHR that was in development. It was nice. It had a place for all medications, allergies, past medical history, etc. When asked if there was a shortcut key that would import that information into the record as the MT was typing, there was a look on his face where he realized that he should have thought about that. He mentioned that maybe he should have MTs give him ideas…wonder if any volunteered after the meeting. Obviously the EHR field has evolved immensely since then, but the main point is still relevant.

Over time I think we have allowed ourselves to be marginalized to a point where we have no voice. Even worse than not having a voice is that many have no idea what they should be voicing their opinions about. The age-old ostrich head in the sand. A discussion with some “seasoned” professionals recently led me to realize that even those in a position to know what is important to them, often simply do not read much, or any, of the information being sent to them.

Healthcare and healthcare documentation is changing at an exponential rate. We are seeing a push to the EHR with promises of cost savings and increased patient contact time despite after-the-fact corrections, the healthcare law that congress recently put into action changes the face of medicine to a degree that is unknown at this point, privacy concerns over the inability of many countries to ensure privacy is pushing work back onshore, MTs are being asked to know more for a lower rate of pay, we know we will need close to double the coders to handle ICD-10 even though there is currently a shortage….the list could go on and on.

I have heard professionals state that AHDI, CDIA (MTIA) - now gone, AHIMA, etc, are not saying or doing the right things; however, what are the complaining individuals doing to shape the future of this profession other than complain on a blog or forum? Interestingly each of these groups are run by people just like you and me who decided to be a part of shaping their association based on what they feel is best for the future. Being a part of the change is much harder than the Monday night quarterback approach that we see so often.

I do think each professional owes it to themselves to, at the very least, know the issues. That is what a professional does. We would not see a doctor, lawyer, banker, etc as a professional if they did not keep up with trends in their profession yet that is standard practice for many in this one. Although membership in a professional association is a great way to gain access to the information, there are endless other opportunities to find the information.

So here is the basic test on whether you are informed or not. Can you answer these three basic questions with confidence?

1) What is “meaningful use” and why is this term currently very important?
2) Why is the topic of the “narrative report” such a hot topic in healthcare documentation?
3) How does the recent HITECH Act affect you as an MT?
4) What is ICD-10 and why do some see it as critical while others see it as being a bad idea?
5) How is the Affordable Care Act affecting healthcare? 

These topics have been mentioned frequently and loudly in professional emails, webinars, and meetings as well as discussed in various healthcare documentation publications. AHDI, AHIMA, MGMA, AMA, and other professional associations have shared the information as well. We should all be an informed professonal and in turn be the ones educating others. Every non-student should know these topics by heart now. If not, there is a problem.

So where do you stand? Are you going to react to what someone else decides is right for your future and hope for the best or be proactive and shape that future the best way you can?

Topics: Industry Issues

Style Over Substance - Making Ourselves Irrelevant

Posted by Chad Sines on Fri, May 17, 2013 @ 07:00 AM

GrammarI was reading a blog entry comparing large MTSOs to Wal-Mart. The author made some interesting points that inspired the reader to think; however, she had a few grammatical errors. What struck me as off was that the comments seemed to suggest that since this MT made “glaring” errors, the substance of the article was not worthy of reading. The author apparently was to be shamed and discarded as seemingly irrelevant simply because of “mute” versus “moot” and other simple oopsies. While reading the comments I was almost yelling “WHO CARES??? Get off your pedestal and listen to the message!!”

This left me scratching my head and wondering if MTs have lost touch with who they are and what their role is. Why do we as MTs feel that we are the gatekeepers of grammar? Isn’t that a faulty view of our role? I was taught that our main focus is on patient safety. We transcribe dictated material and alert the physician when we notice a potential safety issue.

A prime example occurred at a meeting I attended a few years ago where an auditor gave a presentation on what she did. She showed us a transcription and asked us to find the errors. We saw “tylenol” instead of “Tylenol” and declared it proudly. We saw “you’re” instead of “you are.” We even found some subject-verb agreement errors. The auditor kept track until we declared ourselves finished.  We were so proud. A group of 20ish MTs had ripped that document to pieces and proved our relevance in healthcare documentation…or did we… After ensuring we were finished the auditor thanked us for proving her point that we have forgotten what our role is truly about. None of us noticed that there were four separate doses of morphine in the record as active prescriptions scheduled at different times which constituted a very lethal dose had they been administered. (a result of the physician increasing the strength but failing to DC the previous dose) Oops. Result- Pretty words, dead patient.

So why did a group of about twenty people with 20+ years experience for many including several instructors miss something that should have been glaring like a neon sign?

I think the reason is that we have moved away from patient safety and into the world of grammar keepers. We are fighting a battle that no physician/facility really cares about. In every example above, patient safety was never a concern; however, the one issue that was a severe risk was completely missed. In practice we have allowed so many style variations in templates that our QA spends the majority of their time checking style instead of critical patient information.

With the push towards the mandatory EHR, the role of the MT is changing overnight. The grammar keepers are being pushed aside for those who can bring value to the table. It is a very different way of approaching healthcare documentation. It requires one to look at the substance and disregard what is meaningless to all but other grammar keepers.

Now I am not saying that grammar/style is irrelevant, but I am saying it MUST not be how we define ourselves. It should be secondary except in cases where it honestly affects patient safety…And no..Safety is not affected just because we feel we want to throw our hands in the air. "I told the patient to go their" is understandable despite being grammatically correct and do not even get me started on "your, you're" or the use of commas.

I think we need to get back to substance over style. We have to refocus and get back on task. What is said must be more important than how it is said. In a blog, the writer’s interesting points could be missed leading to a lack of enlightenment for the reader which only stifles knowledge. In the case of a patient record, it could end up harming the patient. Unless we can wrap our mind around our true purpose, we are going to have little success showing outsiders why we are relevant.

Topics: Industry Issues

Comments about #ace365 #ahdi- Are we more than MT only?

Posted by Chad Sines on Fri, Aug 10, 2012 @ 01:00 PM

thinking

It has been a few years since we changed our name from AAMT to AHDI. The goal of this change was to incorporate a larger healthcare documentation role. If you look at the wording of our mission statement and strategic goals, it is clear that the aim is beyond just the medical transcription role. 

Despite this growth idea, we still have a lot of individuals who only want to see the medical transcription component discussed. When we have national director candidates we ask if they are medical transcriptionists and if they have their CMT. I heard this a few times before the last Board elections and here as well. This has bugged me for a while now. 

I would love to see an MBA who is in any healthcare documentation industry and can help lead us from a pure business side. I would love to see a medical coder who can help us do more than talk around coding topics. I would love to see a vendor company owner who can help us see issues from that end. I would like to see an MTSO owner of a larger company. It would also be great to see a computer programmer who works on healthcare documentation software. If any of these individuals ran, I honestly do not think they would receive a warm welcome. We would be stuck on whether or not they had a CMT even if they are a PhD computer programmer. 

Imagine what this Association could do if we could finally accept that we are not a medical transcription only industry and move beyond that image. At that point, I think we would begin to see such a dramatic change that our members would take notice and begin to rekindle that passion that we are longing to get back.

Your thoughts?

Topics: Professional Development, Industry Issues

Comments about #ace365 #ahdi- Workforce Development

Posted by Chad Sines on Fri, Aug 10, 2012 @ 06:00 AM

CommentWhat does workforce development mean for a medical transcriptionist? It can mean HIM training, EHR training, and many others. We are hearing a lot about medical coding at this year’s ACE conference. Med-Line has been on the forefront of sharing medical coding as a natural career path for medical transcriptionists, so we are happy to see this message taking hold. As the only medical coding program designed for medical transcriptionists, I have had a lot of MTs coming to me this week to learn more about and enroll in our medical coding bridge program. I have been very vocal about my feeling that the future documentation roles will be a single person who both transcribes and codes the medical document. This is a natural transition for the medical transcriptionist as the process only takes about 6 months to learn medical coding. Going from coding to transcription, well, that takes much longer. This has put the medical transcriptionist in a place of power, providing they are willing to step up and take advantage of the opportunities to take charge of their future. 

What are you doing to advance your training and prepare for the future?

Topics: Professional Development, Industry Issues

Comments about #ace365 #ahdi- Do more than complain

Posted by Chad Sines on Wed, Aug 08, 2012 @ 05:00 AM

ThinkingI am going to try to write some short comments during this ACE regarding items that come up. The timing will be as I have time.

While attending ACE 2012, I noticed just how often people were quick to offer an opinion about something they did not like, but they seemed to be offering little other than the comment. Over the years, I have noticed that those who complained the most were most often either someone who was heavily involved long ago but did not like that things change or they simply are not involved for no real reason other than some excuse. Advice is helpful but if all someone has to offer is what they do not like, then there comes a point where they are part of the problem. Karen Fox, current president, made a point that we need an "association by participation." This is not a sit back and watch others work association. We are all volunteers. When we say AHDI needs to do something, what we are saying is that we, ourselves, need to do something. We need to have people who are involved in more than providing negative feedback and are getting involved. The world is filled with Monday quarterbacks, but far too few actually do anything beyond talking. I jokingly made the comment today that we should require that anyone who says “I do not like…” should be required to end the comment by saying “and I volunteer to actively make it that way.” If only..

Am I alone in this thinking?

 

Topics: Professional Development, Industry Issues

Are We Being Unfair to Physicians?

Posted by Chad Sines on Tue, Jul 17, 2012 @ 10:00 AM

Medical transcriptionIf you read enough medical transcription forums and blogs, you will see a pretty common recurrent theme. Medical transcriptionists seem to thinkphysicians are a bit unitelligent because they cannot dictate clearly or they cannot spell medications and other medical words. I think this is more than a little short-sighted and continues to widen the rift between the MT and physician.

I will give a significant amount of support for issues relating to physicians being either unable or unwilling to dictate clearly. This is a skill that is necessary for the job. A medical transcriptionist has to have typing skills to transcribe even though their primary core is their medical knowledge.  A teacher or professor needs to have presentation skills even though their primary core is the knowledge they teach. The same can be said about a physician and dictating. While it can be very complicated to dictate an experience (try to dictate your day), it is a skill that should be mastered by all physicians. Their words become the medical record once they sign it. With many still not reading before signing, it is critical they be as clear as possible. The medical transcriptionist is a link in the risk management process and should have the clearest dictation possible so they can perform their job at an optimal level.

When it comes to spelling medical words or medications, I think we are being silly to assume that because a physician cannot spell omeprazole, he or she is somehow unintelligent. I think most patient’s primary concern is that the physician can properly identify the gastrointestinal disorder, order the appropriate tests, interpret them, diagnose the disorder, and order the right treatment. Physicians should strive to learn to spell new medical and pharmaceutical words, but I do believe it is more important that they know the pharmacology, side effects, and interactions more so than the spelling. I do not know any medical transcriptionists who can perform an esophagogastroduodenoscopy and then interpret the results, so the fact that the physician might have trouble spelling it is really insignificant in the scheme of things. Isn’t it?

When it comes to grammar,..well…unless it affects the outcome of the patient’s care, this really is more of a refinement of the report presentation, in my opinion. I think a few medical transcriptionists will cringe at that statement, but line it or not the EHR process is beginning to focus less on style. I do think it is important that medical transcriptionists learn and apply proper grammar, but I do not think it is the most critical issue for physicians when it comes to patient treatment so long as it does not affect the interpretation of the dictation.

I think it is fair game to poke some fun at physicians for their bloopers. It gives us a great source of entertainment and even many physicians will agree that they have said some really weird things without realizing it. I have had a few good laughs with some of my physicians over what I have heard and ultimately each led to a conversation about the need to be clear. That being said, medical transcriptionists should be more aware of each group’s role in the patient care experience. The physician has a set of knowledge they must master, the medical transcriptionist has a set they must master. There is some overlap, but I think it is unfair to assume that a physician will be focusing on grammar and spelling as opposed to issues that will affect the patient’s care. It is a symbiotic relationship where each depends on each other, and each should be more understanding of what the other is responsible for.

What do you think?

Topics: Industry Issues

Enough with the Name Changes- We are Medical Transcriptionists

Posted by Chad Sines on Mon, Mar 19, 2012 @ 10:00 AM

Med-Line School of Medical TranscriptionRecently AHDI released a decision the national Board of Directors made regarding changing the name of who we are. While this has been chatter in the past, it appears that the board made a decision to change the name without consulting with the membership.

According to AHDI, we are now Healthcare Documentation Specialists. This name change was based on a recommendation by the Model Curriculum Task Force. Interestingly, the Board voted to change the name to one recommended by the task force and then re-visited the issue to change it again. Why the rush to change it twice and why not involve the members in such a critical decision? Has the Association forgotten that the members are in charge of the Association? Is there such a thing as transparency? And most importantly, don't we have more pressing issues that we can all agree need immediate attention?

EMR Omniscribe and Med-Line support continuing the use of the term Medical Transcriptionist. We do not support changing the name especially when there are more critical issues to focus on and definitely not without approval by the membership.

Below is an email I shared with our AHDI West Board of Governors as well as national AHDI.

The feedback I have heard has many mixed but mostly negative. Many have shared a few common issues with the name change:

The timing. AHDI is in a very vulnerable position with weakened membership, weakened leadership, basement-level finances and what appears from the outside to be in a fight for survival from one ACE to the next. CEOs leaving, staff leaving, directors resigning, components failing…As we know with name changes, feelings are hurt and members leave. I personally know quite a few who left because of the AAMT to AHDI. Did that change help us? Some say yes, some no. Now we are changing their profession which is even more personal. Rebranding is useful only if it moves an organization forward. At the end of this we might have a new title, but what will be the tangible change for the members. MTSOs might leverage the cool title with clients although they could really care less about a title, but from an MT perspective there appears to be no substantive gains that outweigh the potential losses.

The way it happened. This is too big for a committee to handle and then a board vote. It has the strong appearance of a committee overstepping or at the very least something being done to avoid membership input or possibly a membership block. I was a bit surprised that it went from model curriculum to a BOD vote instead of to a group to move the idea forward in a member-centric fashion. This is a divisive issue that many are ready to rebel against. Change for the sake of change is pointless especially if you harm those you represent in the end or lose face with them. While there is no perfect way to handle this, most of us who are involved in the Association had no idea it was happening until it was done. Since the announcement I found out that there were some nonmember chats on some outside blogs. There was no discussion with members regarding their desire to do this now or ever and no discussion with them as to what the name should be. This way of doing things has bitten the Association in the backside enough times for us to know that anything other than absolute transparency is almost doomed to failure. 

If CDIA does not move this forward it is dead, just like they killed mandatory credentialing. Assuming we wanted to move forward with the name change, I think CDIA should have changed their job descriptions when it was announced or at least shared the date on which it would do so.  It really is time for us to honestly be a partner with CDIA or sever that relationship so we can move our agenda forward. If they choose to ignore this like they did mandatory credentialing, AHDI is going to suffer another black eye in terms of relevance to the industry like we saw with the failure to move mandatory credentialing past the delegate floor. It will resonate that CDIA controls the Association and AHDI is impotent to drive change.  (At the time I wrote this, it was not known that CDIA was gone.)

They wish to remain MTs. Plain and simple. This one needs little explanation because I would suspect everyone has heard this from at least a few dozen or more since the announcement. This is their Association and they want to decide their title. This would have been a great ACE topic. Speaking with members about the title, should it change, should it stay, etc. long before anything was done.

When I heard about this I had a flashback of the surprise CDIA partnership that popped out of nowhere leaving many disillusioned and the failed mandatory credentialing that we whooped and hollered about until it was immediately silenced by our “partners.” Personally, I think we have or should have bigger priorities and we need our members to rally behind us instead of potentially dividing them at this critical point in our survival. It is frustrating that this is the topic that comes up now when speaking with members when we should be talking about leveraging MGMA to get our message out, retooling for EHR opportunities, and… well.. to be frank fight for our survival in an industry that is trying so hard to discard us. If you think that is not what is really happening, come to MGMA this year and pretend to be a physician. Your jaw will hit the floor and the “EHR vendors as partners with transcription” will cease to be a part of your message.

Are you a medical transcriptionist who wishes to remain a medical transcriptionist? Sign our petition and be heard.  



Topics: Industry Issues