We Have a Dead Moose
Okay, today I’m going to ask that you stick with me on this discussion because it’s one I think we need to start having and one that I think we’ve kind of avoided in our industry for awhile. So grab your coffee, take a deep breath, hang in there to the end, and then I want to hear your thoughts.
First let me tell you a story. Several years ago when I was on the (then) AAMT Board of Directors, our CEO told us a story about what we came to refer to as the “dead moose on the table.” It went (paraphrased) like this: There’s a big dead moose on the table. Everyone knows it’s there. Yet, nobody talks about it. And the longer no one talks about it, the more it stinks. Yet we continue to ignore it, hoping that both the moose and the stench will go away. Today we might even get out the Fabreze and try to do away with it like that. But in the end, there’s a dead moose, right there in the middle of the table, and unless somebody finally speaks up, the stink is only going to get worse. I believe we have a moose on the table.
Let’s look at some of the things that have happened over the last few weeks in our industry. First, we saw the announcement of the purchase of WebMedx, a medical transcription company, by Nuance, a technology vendor who is very active in the EHR world. The next thing I noticed was that Medquist, a transcription company, purchased M-Modal, a technology vendor. That was followed by the announcement that Transcend, yet another transcription company, purchased Salar, an EHR company. Along with that I saw a couple of other things. In the Medquist press release, the new CEO spoke of rebranding the company and assiting their clients with the move to the EHR. In a webinar sponsored by HIMSS, a representative of Nuance spoke of their plans to work with the IBM Watson technology and also described the “vision” of how documentation would be done by running it through an SRT engine, using natural language processing, which would also attach data tags so that the structured data could be immediately put into the EHR. And, no, transcription was not mentioned in that talk at all.
Now let’s look at what’s happening to the people in our world. In the past two weeks, I have heard more stories than I can even count about good, seasoned, well experienced MTs being laid off from their jobs. Why? Technology means companies can do more with less. And yes, sometimes it’s also because the company is outsourcing more of its work. I hear the stories from MTs who are small business owners of their workload being half of what it was a year ago because of the electronic health record. Schools are challenged with what to do to best prepare their students for sustainable future employment. How do you teach everything we teach now and yet still teach the new technologies that are emerging? Students in programs and who are new professionals in our industry are asking what the future looks like for them as well.
What we hear in the professional associations related to medical transcription is the mantra of the narrative. Now let me first say I think there’s value to the narrative in a medical record. It tells the patient’s story. Both associations are focused on promoting the idea of retaining the narrative as a way to “preserve” the profession, and industry, and perhaps even the organizations themselves. And yet in the background, the EHR is being implemented as the health care industry marches to the beat of meeting things like meaningful use and EHR adoption that, unlike the SRT technology of 10 years ago, isn’t just a nice improvement in productivity, but a mandate from the Federal government. AHIMA has a workgroup working on transcription roles and the EHR, and I imagine we’ll see a report when that’s done. Still, that’s the HIM world deciding for us what we will be and where we might fit. I really wish the transcription associations were this focused on the future and defining new roles.
So for the moose. Here’s what I think the moose is. The EHR is much like the rush we all saw with speech recognition technologies. Some said it would never happen, some said “not in my lifetime, I’ll retire first,” and some just waited for it to happen to them. A few learned the technology early on and that’s probably the group who has done the best with it. Remember, though, this technology was only a “nice productivity enhancer” or “something so you can do the same work with fewer people.” It was not mandated by the government. In 2016, as of right now, healthcare providers will be penalized for not having an EHR and meeting these requirements. Penalized means less money. It will force the stragglers to finally get on board.
I think the moose on the table is that everything points to traditional transcription going away more and more, perhaps until there is very little or none left. Okay, I said it. That means if we only have those skills that we’ve relied on for so many years, the future is going to get pretty scary. The EHR is here today, it’s not going away, and it’s critically important that we address the moose on the table and start figuring out how to do something with it. No amount of “narrative-scented Fabreze” is going to take care of this one.
This post is long. We’re going to do a series of discussions this week about this moose and how we can address it and be better prepared. I’ve watched our industry for a long time and too many times MTs have just let someone else decide their fate. I think it’s time to stop that and start doing something for ourselves. Without some honest, brutal dialogue, that will be tough to do.
So let’s chat. I want to hear your reaction so far. This isn’t a one day discussion so let’s get started!
Related posts:
- The Other Moose on the Table
- The Best of 2011
- Are You Getting Ready?
- Transitioning to the EHR Webinar Report
- Job Search Skills in the Electronic Health Record
Tagged with: electronic health record • future of medical transcription • HITECH Act
Filed under: Challenges in Medical Transcription • Continuing Education • Future of Medical Transcription • Technology
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Same thing happening to others: cashiers, bank tellers, etc. Pretty soon computers will be running the world and there will be no need for humans!
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Gotta admit, I don’t like talking about this issue or even thinking about it. Too stressful. I feel there is nothing I can do anyway, so why worry about it. I am just going to keep on working and see what happens in the future. I am willing to make whatever changes I need to and get whatever training I need to make myself marketable in the future, but until I know where things are going to go, there is really nothing I can do at this moment.
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Deb Reply:
August 8th, 2011 at 8:12 am
Pam, why do you feel like there is nothing you can do? Medical transcription is going away. MT is the “dead moose.”
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Kathy Reply:
August 8th, 2011 at 8:30 am
Pam, I really don’t think anyone likes talking about tough issues. At the same time, I think it’s important so that we’re not left wondering what to do. Someone said to me recently “people don’t want to hear bad news, they can’t handle it.” My take on it is that people can indeed handle bad news and would rather put it on the table than pretend it doesn’t exist. Unless our profession starts having some of those bold conversations, I’m really afraid a lot of folks are going to be left behind. And I DO think there are things we can do, which is part of why I wanted to start this conversation.
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Sarah Reply:
August 9th, 2011 at 11:36 am
I think there is a lot you can do, actually. You can seek training in the EHR or you can begin to train for a different profession entirely. Knowing what is ahead, I think right now is the perfect time to prepare. By 2016 physicians will have adopted the EHR. If I were still transcribing, and I still am a few days a week, I would set that year as my goal to have skills to either move forward with the EHR or skills to move into a new profession. All of our life circumstances are different though. I’m only 34 and have plenty of time ahead to establish myself in a new career. Another though is that there is so much aide available right now for going to college. You have to be a matriculated student to qualify for a Pell grant, but Pell grants are currently $5,500 a year which is usually enough to pay books and tuition at public universities. A lot of people don’t even realize they qualify for these grants. There are ways to make furthering your education possible without going eyeball deep into debt.
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The moose isn’t quite dead yet. It’s being bled and the meat carved up.
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I think that now is the time to take the bull by the horns and start getting the training and make the changes that need to be done before the moose is just a pile of bones. Since we already know that by 2016 everything will have to be changed to EHR why wait until the last minute to start making the changes necessary for us to fit into the new job market.
I think there will always be a need for a real person to do some of the work with the EHR so start finding out now what role we want to work towards.
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Kathy Reply:
August 8th, 2011 at 8:31 am
Linda’ you’re right. It’s past time. And yes, there will be need for a real person to do things in the EHR. Todays’ MT Inner Circle post by Sarah Barton talks about her first two weeks on her new job. There will be new roles, it will just depend on whether people are ready to get what they need to do them and step out of their box a bit.
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Same thing happened with my husband’s printing industry job 10 years ago or more. He considered himself an artist, and everything was done manually. Digital printing was on the forefront, and printers were losing their jobs. He didn’t return to school to educate himself but did take a good look at his talents and where he could put them to use. We had a couple of scary years where he was self-employed and there was no money coming in, but now he is employed by one of the largest health systems in the Northwest with great benefits.
It’s time to see how our MT skills will benefit the moose, or it’s time to get re-educated and leave the moose to die. I was one of those who thought speech wreck was going to go away, and of course it didn’t. The EHR is here to stay, and this is the perfect time for MTs to get in on the ground floor opportunities.
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I also can’t understand why this was done. I went to a pain management Dr. a few weeks ago and he spent more time with his little black box complaining he hates this but has to do it and I see patient care going way way down, because they have to fill out the computer. An exam was really never done.
Another Dr I have said in the past he would rather retire than convert.
When I was practicing yesterday on EMR, I thought, wow all my history is online, ready for anyone to take. How many of you heard of offices being broken into with patient’s charts being stolen (the chances of that was slim).
I am totally against this. I work from home. I do NOT want to go work in a doctor’s office and be an MT, but only work from home.
However, sometimes in this case, we need to think out of the box and try and adjust to the changing times, as we have no choice. I still am going to find a way to work from home.
By taking this course, I am not as scared of EMR as I was before. I also have heard of lots of MT’s losing their jobs.
I have one account now that purchased EMR software. Am I concerned – YES.
Debbie
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Kathy Reply:
August 8th, 2011 at 8:51 am
Debbie, no doubt there are a lot of challenges these days with how to make the EHR work in ways that benefits everyone, starting with the patient. As for records being stolen, there are a lot of real life examples of that happening with paper records. I’m not convinced that every work at home opportunity will disappear, although I do think there will be some different doors open there. It will, as you said, mean that we have to think out of the box!
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I am willing to change and fit in with whatever the end result of this EHR transition is, but do we really know what that will be yet? What exactly should we be training for? Specifically. I want to do something, just not sure WHAT to do?
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Kathy Reply:
August 8th, 2011 at 9:47 am
Pam, in these discussions this week I hope we can flush some of that out. There is training available related to the EHR and I think it’s important to figure out what a good path might be. We’ll share some things along the way and explore some options. I’m also planning a webinar to talk about it in the next couple of weeks so stay tuned!
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I have a certificate in medical coding, but have never actually worked in that area and would need classes to brush up on that, plus now they are instituting ICD-10, so that is more training. Also most coding jobs require a year or two of experience.
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We have EMR at our hospital and clinics too and I agree with a previous post that the quality of care is no longer there. When you go in for a physical you are in the room with the nurse who is staring at the computer asking you questions filling out the vital signs she had taken and asking you about your allergies, previous history, etc; never once looking at the patient. Then the doc comes in, sits down at the computer repeats the same questions about your symptoms and types in the computer not looking at the patient. Then he does his quick 5 minute exam, sits back down at the computer typing, not saying a word and we are suppose to be quiet while he types his report. We ask questions and they get frustrated because they are busy with their document. I might as well walk up to a computer put in my information myself and let it tell me what my to take for meds, what my diagnosis is and not have doctors either. Before we know it we will be putting our arm in a box that takes pictures and it will pop out a piece of paper that tells us where it is broken, stick it in another box that will wrap it and cast it and we will go on our way. So sad that humans don’t interact like they used to and treat each other with dignity and respect with all these stupid computers taking over.
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Kathy Reply:
August 8th, 2011 at 9:49 am
Holly, that’s one of the frustrations often heard from patients about the EHR. Sometimes I think it’s part of the bugs that we have to get worked out just like when we deploy any new technology. I do agree with you that technology should not be impacting patient care and believe that’s something we need to continue to stress. As patients, we also need to speak out about it and figure out how we can work with those physicians in a participatory manner so that we are also getting what we need in our health care.
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Sherry Evans Reply:
August 8th, 2011 at 10:53 am
OMG…this sounds like the Jetsons! Remember the TV cartoon? Get up in the morning….well, you are basically “ejected” from your bed, taken to the shower where you were “done unto” and then popped into your clothing. You shot through a tube onto the level where your “space-car” was parked, and you shot off to wherever your work was. Even the maid was an intelligent robot! If we’re not careful, that old doom and gloom folksong “In the Year 2525″ (or whatever it was named)is going to come true. Every time we rely on computers, we are giving up a little bit more of our brain’s necessity to do something…pretty soon our brains and bodies will have no need to do anything anymore!
It’s too scary to sit by and do NOTHING about!
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I am another MT whose was put on part time because of lack of work. I need to work from home because I am also a caregiver. Should I spend the money and do a course in voice editing? I thought of coding but don’t think coding is a work at home job. Is voice editing going to be around for a long time. The future of MT seems so uncertain right now.
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Kathy Reply:
August 8th, 2011 at 12:30 pm
Ramona, there are at-home coding jobs and several companies who hire for that. I’m a believer that a good MT doesn’t have to have a special course that teaches a particular system for SRT editing, but you do need the editing skills. You’re right that things seem very uncertain. I think the best thing for us to do is explore what we can do that we are also interested in and can use our skill set and then go for the new things. It’s doable if someone is willing to step outside of their comfort zone a bit.
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Linda K. Reply:
August 8th, 2011 at 2:55 pm
Ramona, I also need to work at home due to health issues and just started a course on editing skills so I can expand what I am able to do. Things do seem very uncertain right now for MTs so I wanted to add to my skill set as an MT and editing appealed to me more than coding.
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>>>>>Both associations are focused on promoting the idea of retaining the narrative as a way to “preserve” the profession, and industry, and perhaps even the organizations themselves. And yet in the background, the EHR is being implemented as the health care industry marches to the beat of meeting things like meaningful use and EHR adoption <<<<<<<
Kathy, you comment speaks to the heart of the Health Story Project. HSP has made terrific progress in the last few months in getting DOCUMENTS, not just narrative, but DOCUMENTS with narrative into the standards and specifications that meet meaningful use requirements. Last December, the ONC became involved in the harmonization of HSP templates and those of IHE. This is HUGE! This means the ONC believes in the value of narrative documents and believes they are a credible path to documenting care and meeting meaningful use. They key is that these documents are standardized using Clinical Document Architecture, which the ONC (just a couple of weeks ago) recommended be THE standard for clinical information. The H&P template created by HSP is already mentioned in certification criteria and the remainder of the HSP templates are a very few steps away from being recommended as standards for meeting meaningful use stage 2.
I will admit that there is a strange dichotomy in the industry. If you talk to the techies that are designing and programming the EHR–the ones doing the real nitty-gritty work, they *are* including coding and standards for narrative, but "on the street" we still hear a lot about point-and-click. I hope it is not pie-in-the-sky-thinking that having the HSP templates included in meaningful use stage 2 will be ignored by the industry and that transcription will go away anyway.
HSP is focused on narrative text, but the HSP/CDA standards do not say *how* that text is captured. There will be some EHR systems that continue to capture that information using transcription, but many will also use FESR or direct-entry (ie, doctors typing). Our efforts should be focused on promoting those eight traditional document types that HSP has templated (H&P, Progress Notes, Op Notes, Consults, etc) and advocating for the increased efficiencies and quality controls that come with a dictation-and-transcription partnership.
The moose definitely stinks!
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Kathy Reply:
August 8th, 2011 at 12:32 pm
Laura, I know you’ve done a lot of work on the Health Story Project and it’s a good one. What I am hearing in the IT world isn’t that the narrative will go away, but that it will be created with a combination of SRT and natural language processing that will allow for both the narrative and the tagging for structured data. Indeed the real issue is the “how” the data is captured. Well, one of the issues anyway. The other is how to verify that the data that gets entered really is correct (which is one of the courses I’m taking right now and that discussion is sure interesting!). Thanks for adding to the discussion here.
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>>>>The other is how to verify that the data that gets entered really is correct <<<
How do we communicate to the EHR/HIT community that *we* can be the ones to do that? Do we need to be talking to the HIT community or to providers/administrators? Certainly we could talk to both, but the question in my mind is where do we focus our efforts?
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Kathy Reply:
August 8th, 2011 at 2:44 pm
In today’s post at the MT Inner Circle, I believe we see an example of just that thing happening. I think it’s pretty exciting. I do think, however, as Sarah points out in that post that it means MTs have to step outside of their box and get the right education to be prepared for these roles. http://mtinnercircle.com/2011/08/08/the-first-two-weeks/
Until we are ready to let go of some of the things we’ve always believed were important or valued, I’m afraid this industry is going to move on without us. I think those who recognize that and work to find new things will be fine. Just this weekend, I saw a similar kind of job posting right here in my own town. It also included the ability to train staff. I’m really hoping that all of this HIT training that folks are doing now will position them for some of these great opportunities.
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I have thought that doctor’s office and clinic work was on its way out for several years. But do you think that the front-end speech rec engine and “Watson”‘s natural language processing will also do away with complicated acute care transcription?
And moreover, won’t natural language processing also affect the medical coders? After all, there is no reason that documentation couldn’t also be coded simultaneously with its processing and tagging.
You NEVER hear anyone in AHIMA or AAPC say medical coding is going away. In fact, what you do hear is how organizations need to plan to have more and more coders because productivity will lag when ICD-10 is instituted. Could this be because the organizations AHIMA and AAPC are more powerful and have more members and more clout than AHDI? Or am I too cynical?
Is the fact that coding is linked to reimbursement, thus causing an error in coding to lead to legal accusation of fraud, one of the reasons for its apparent invincibility?
If so, why is it more important that my medical history is accurately coded than if it is accurately recorded?
My father’s doctor’s EHR (or the idiot pointing and clicking in it) gave him a history of prostate cancer and atrial fibrillation. He’s under treatment for the atrial fibrillation and has no symptoms. We can’t figure out where the diagnosis came from. (He has had blood clots in the past so the Pradaxa treatment was warranted for that in lieu of Coumadin.) He has never had prostate cancer.
To my mind, the career of coding is at just as big a risk as transcription. Why is coding considered safe from the onslaught of technology?
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Kathy Reply:
August 8th, 2011 at 3:17 pm
Susan you’ve asked a ton of good questions. First, do I think technology is going to mean major changes for transcription in acute care? A resounding yes. Here’s one of my reasons for that. No company spends millions of dollars to buy another company unless they see a clear return on investment. When I look at just the Nuance purchase of a major transcription company, they in effect (no matter how much we hate these terms) bought two things–customers and employees. With a majority of customers being acute care facilities, why would we think they don’t intend to apply that technology? It’s sure what they are saying when they speak at workshops.
Yes, I think there will be an impact on coding with NLP. I’ve said for years there has to be a way that the document is created and coded at the same time. Enter these new technologies and that will be a certainty some day. One thing I’m hearing about the anticipated coding shortage is that many coders are now saying they don’t want to learn ICD-10, which in addition to the slow down for those who are learning will create a shortage. It reminds me very much of the early days of SRT when so many MTs said they’d rather retire than learn the new technology. Coders are a bit where we were then, an aging workforce who doesn’t want to learn the new stuff. That will create more jobs. What I do think will happen with coding is because of the potential for fraud issues there will be more quality checks to the computer-assisted coding to be sure it has it right and covers everything.
You are right that the two organizations you mention are bigger than AHDI and have more clout, although in some ways I see HIM folks having some of those same struggles for relevancy and trying to be sure that the IT folks don’t take over healthcare documentation. I think our own profession is struggling to find relevance, dealing with an ever-diminishing membership, which means less revenue to accomplish things, and really trying to not only keep the profession relevant, but also the organization. A daunting task. In that process, I think we get afraid to stand up and really have these kind of discussions because of the potential to create fear. I’m just a believer that you do away with fear by acknowledging the moose on the table and doing something about it.
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Nae Reply:
August 8th, 2011 at 4:38 pm
I don’t know about anyone else, but for me, right now I think it is more case of information overload than anything else. I am so busy taking classes in all sorts of thing, EHR, SR editing, IT-related subjects, both here and through college level courses there simply is not time to worry about change. Yet, despite cramming all sorts of new technology, new ways to do things into my brain, I can’t seem to make any of that fit a paying job in a facet of healthcare documentation that actually interests me. I have always relished the challenge of learning new things, but here, in my area of the country it is almost like the job market has not caught up with the hype of the technology or the legislation. Primarily the need seems to be for upper management/IT developers/trainers right now. I don’t mind paying the price to learn new ways … but it sure would be nice to be able to narrow down my energies into one specific avenue instead of spreading myself so thin trying to cover every possible scenario the pundits keep coming up with as the path to the future.
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Kathy Reply:
August 8th, 2011 at 6:13 pm
Nae, I think a lot of folks are in this same boat. Many people are saying okay, I need something extra, but what. It’s really only by exploring the possibilities that we can figure out what some of that is. It’s also true that some of these roles aren’t even developed yet and will be things that come up as we move along. I do think there are some good basic things people can arm themselves with to prepare for that part of the future.
Linda K. Reply:
August 8th, 2011 at 8:27 pm
I am with you Nae, my brain is on overload trying to take classes and improve my skill sets for the future. I think that there are more of us that are getting the message that we need to start revamping our roles now, but it is so difficult to decide what to work on first, second, or third because we really do not have a clear blueprint for the future except for the fact that MTs as they exist now will not have as many options in the future.
Sarah Reply:
August 9th, 2011 at 12:24 pm
Nae, Even though I have a job right now I feel the same way. I have about 2347823498 things I want to take classes in and they would probably all benefit me but I’d like to be more sure of that before jumping in. I’d like to take the EHR classes but I’m not sure they’re going to teach me anything I’m not learning on the job. RHIA certification seems to be a good idea but the university near my hospital also offers a health management certificate that employers around here are wild about. What I’d really love to do is return to sports medicine work but, believe it or not, I make more money doing what I am doing right now than I would doing that! Go figure.
Susanne, In my work environment the EHR is not replacing transcription of operative reports and things of that nature. Those are going to India to be transcribed.
I wonder the same thing about coding, whether the EHR will impact it a lot and how stable the future is. I wandered into the medical records office where the coders work a few days ago. You couldn’t pay me enough to do that job. I just got out of my basement suffering as I transcribed. I just couldn’t stand the idea of going into that office and coding all day. I guess we all also have to consider what we’ll enjoy doing.
There’s still something niggling at me. I’m not knocking education–am a believer it in for sure. I would happily jump into the classroom if I was not currently paying tuition and R&B for both my son and my daughter. But are we asking MTs to build on what they already know? or are we saying it’s time to start over with a new field of endeavor? Granted, we are saying “you can stay in health care,” but are we really building on an MT’s fundamental skills of medical terminology, pathology, and pharmacology along with an eye for detail and an understanding of language? (In the spirit of full disclosure, I will say that I have made the transition between two seemingly unrelated healthcare professions, that being Medical Technology to Medical Transcription).
I applaud Sarah for her accomplishments, and I have no bad feelings for her at all. But, she is not the typical MT. Her background and education are not typical of MTs. Is it inspiring? Yes! But does this give the majority of MTs a platform to work from? I’m not sure.
The association has been talking about the EHR since Peter came on board in 2004. As a board member and staff member, I heard his mantra ad nausea. It’s not a new topic (at least to me anyway). Peter tried desperately to get people to hear him. But, even for those of us who “heard”, we still have no clear path to take–or even a fuzzy one for that matter. I see lots of my friends enrolling in HIM programs, but I’m not clear what they will do with those certificates and degrees. I guess I’m saying that the whole EHR thing has the entire medical profession in a state of such flux that NO ONE knows which way to go—doctors, nurses, or HIM people.
I still get the sense that the message is “abandon ship, find another ship to sail on.” Maybe that was the dead moose’s dying words, but those words stink too!
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Kathy Reply:
August 8th, 2011 at 6:12 pm
Laura, I really don’t think you have understood Sarah’s post at all. She’s been really clear that her MT background has been vital in this new role. And yes, I do think there is a platform for MTs to work from. This discussion really is about figuring out how to leverage the skill set to do things within the EHR. I think that’s a much better option than doing what we have traditionally done which is waiting to see what happens to us and who does what to us so someone else can tell us where we fit, or not.
If you take some time to browse the job boards, the roles related to the certificates and degrees you are seeing people do are starting to pop up and there are quite a few of them. HIMSS has devoted a job board to the 6 roles identified by ONC as well. One thing that is happening is that everything is so new that many of those roles are being created. I think those folks who are doing this now are doing themselves a favor by getting that education so they have it as those roles come into play in the healthcare arena. If by “find another ship to sail on” you mean traditional transcription/SRT, then maybe that is part of this discussion because I believe we are missing a subtle message that there will be less and less of that until very little opportunities exist there. It’s easy to say those things are there now, and yet in being complacent, we aren’t preparing for the time when they’re not.
You’re also correct that Peter talked a lot about the EHR. I only wish we would do more to explore future roles and not always leave that to someone else to do for us. Today I had a conversation with an HR manager. In that conversation, I took the opportunity to explain why my background did indeed fit with the needs of the position she had, but we have to have the information and be informed to do that. We also have to speak the language of the EHR, which isn’t the same as what we’re used to. I’m sure you get that from your involvement with things in the industry.
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Sarah Reply:
August 9th, 2011 at 12:06 pm
Laura, you’re right and to some degree I’ve regretted saying that what I am doing “any MT” could do. That was a pretty heavy statement to make. I tend to assume we’re all the same and see MTs as being like me. The first week on the job I had to read patient’s reports and realized that not all MTs are created equally. The errors were horrifying. On the other hand I’m not sure there is a “typical” MT. I can think of one MT I know who has a higher degree in math or maybe physics. I knew an MT in school who actually had the same background I had in sports medicine and the same board certifications. I know another who has a PhD in music somethingoranother. I have no idea if there is an average theme for who MTs are or not.
We’re also all in different circumstances and plenty of us cannot work outside of the home, so what I am doing would not work for many of you. I came into MT because I was in that situation myself. I was facing a divorce and I had 4 children ranging in ages from under 2 to 9. I would have needed to make $25 an hour to pay for childcare and still make any profit at all. At the time, that wasn’t going to happen. I asked a friend who had been an MT for a few years where I should go to MT school and that afternoon I gave Linda Andrews a call. I enrolled in Andrews a few days later and the rest is history.
There are a couple of things unique for my situation. One is that my children’s father is a disabled veteran and can stay at home with them. I don’t have to worry about needing childcare when I leave the house at 6:00 in the morning. My state has a fantastic public transportation system so I am able to take a train and spend only $9 a week getting to work so my profit from working is much greater than it would be if I was driving. I’ve also been transcribing for what is widely considered the best pediatrics hospital in the world. To go from that to EHR work with another pediatrics hospital was very fluid. Would they have even interviewed me without pediatrics experience that many MTs do not have? I don’t know.
I’ve shared my experience with everyone not to try to tell you all that you can find a similar job, but to give you a little bit of hope that we can take our MT skills and use them to qualify for other positions. I found something wonderful and I am very happy doing it. It is a fantastic fit for me, but wouldn’t be for everyone. I used my skills as an MT and marketed them to an employer so they would know I had the skills to do the job. That part, any of us can do if we find a job opening.
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I have read all the comments here. I am not seeing any solid direction. It is as if people are saying take classes and get degrees and certificates, but do we know where we are going with them? Are we taking classes and it may be the one we need for what we get into as time goes on or it may not be? Are we just to take some editing skill classes, get an HIM degree if you can afford it, and hope for the best? All education is great but I think there needs to be more of a plan of action here. Maybe I’m not quite getting it but I really do want to understand. I want a solid plan of where I’m going before I start taking any classes for anything.
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Kathy Reply:
August 9th, 2011 at 5:14 am
Becky, this post is only the start of dialogue. You’re right that it doesn’t outline a plan. What I think is important is that we start the dialogue that is missing in our industry and explore the options. I do think there are options out there and I think it’s important that we start now being sure we have the education necessary to step into those as they come up.
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Sarah Reply:
August 9th, 2011 at 1:16 pm
I’ve wondered the same thing though. What exactly is that education? I don’t know the answer. I don’t think anyone does at this point. A few months ago an AHDI president elect was publicly crucified for saying MTs should get degrees. I think she had the right idea though. My grandparent’s generation did very well if they attained a high school graduation. My parents generation could get jobs without a degree but the degree helped. My generation absolutely has to have a degree or advanced training and many jobs are moving to requiring a master’s. If I wanted to go back to sports medicine I would really have to get my master’s because in the 10+ years I’ve been away from that work the master’s has become the standard expected. You cannot go wrong with education, but in this line of work it just is not clear at all what that education should be in. It confuses me too. Would I benefit more from focusing on business with perhaps an MBA with certifications in health management? Would I do better to focus on EHR management training? I don’t know. I know I don’t want to waste time or money. We want to prepare to step into new roles, but what should that education be in? It is frustrating because no one has those answers yet.
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