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Transcriptionists may have worried about their jobs with the advent of speech recognition technology. But in the coming years, they may find their roles stronger than ever — increased by the same technology that once threatened to replace them.
The transcription profession is definitely going to change, says Claudia Tessier, CAE, chief executive officer of the American Association for Medical Transcription in Modesto, CA. "We anticipate the increased merging of new technologies with the talent and knowledge of medical transcriptionists. The change has already started, but it is going to accelerate and be more dramatic."
Speech recognition technology is no longer viewed as the ultimate solution to replace transcription, she says. "Vendors now are increasingly aware that if they take the technology of speech recognition and combine it with the knowledge of the medical transcriptionist, they can be much more effective and can be bigger players in the market," Tessier says.
When working with medical transcriptionists, the speech recognition system would do the first pass for the record, but that record is recognized as a draft, she explains. The transcriptionist preferably would immediately edit the record, recognizing and clarifying any inconsistencies or redundancies.
The transcriptionist would be able to make the document clearer, more complete, and more consistent than direct speech recognition, because medical transcription is not a verbatim process, Tessier says. "It’s an editorial process. Verbatim transcription can be a barrier to communication because people do not speak the way they communicate in writing."
Unfortunately, physicians who are happy about using speech recognition don’t always review their work before they sign it, she adds. "Since they thought they said what they intended to say, they assume that the document is accurate as dictated." Tessier says she has seen multiple demonstrations of how it takes almost no effort to quickly identify errors, some of which are minor. "Some, however, are medical errors. The wrong term was used, or the procedure started on the left side and ended up on the right side. It takes that attention to reviewing the document for completeness, accuracy, clarity, and consistency to assure that the information is what you want documented."
Tessier says she doesn’t think the person who dictated the record should also act as its editor. "Few people want to do that and can do that well for themselves."
Transcriptionists also can make contributions when data entry is structured, as with touch screens. "You often need the opportunity for free text," she says. "[The clinicians] may need to dictate information to the history or to add the reasoning behind a diagnosis, particularly with a differential diagnosis, and the transcriptionist would add this free text to the structured text."
Overall, Tessier says she sees an evolution of the transcription profession in which the editing skills, medical language, and content knowledge of the transcriptionist become more important. "The transcriptionists with the more sophisticated knowledge of medical care will have wonderful [career] opportunities."
The evolution of the transcriptionist role may not depend on direct relationships with physicians, though. Tessier expects that relationships between transcriptionists and physicians will continue to be as variable as they are now. "There will continue to be some direct relationships. There will also perhaps be an increase in the instances where transcriptionists and physicians will never see each other, because they might be on opposites sides of the country or the world."
Tessier says she hopes that new technology will improve transcriptionists’ opportunities to get clarification of confusing dictation or inconsistent content. For example, a physician may use a new term that is not familiar to the transcriptionist. The transcriptionist tries to research the term but cannot find it. He or she then leaves a blank in the document and asks the physician to fill it in as well as to provide feedback so the transcriptionist will know the term in the future.
"Unfortunately, the feedback too often never comes," Tessier says. "We hope there will be ways to reinforce the attention given to providing feedback about new technology and new techniques so the knowledge base of transcriptionists can increase faster than they could find the information on their own."
Transcriptionists may find that they are working on records dictated by staff other than physicians, too. Physicians are doing more documentation with dictation and transcription, but so are health care professionals of other disciplines, Tessier says. "It’s as though the development of the electronic patient record has stimulated a greater awareness and greater utilization of [dictation and transcription]."
The massive attention given to the electronic patient record has brought attention to dictation and transcription for data entry, especially because no alternative technologies have worked out to be the ultimate solution, Tessier says. "It has brought interest in it that all of our marketing efforts were not able to do."