MTReviews of

Advance for Health Information Professionals

Advance Magazine 3/25/96
Review by Mary Morken

Highlights for MTs include an anonymous letter to the editor by an MT who describes a bad experience with an unnamed, national, long-distance MT company who didn't "deliver what they promised." Her list of woes includes taking her computer to a day's training, computer problems, communication problems, unexpected phone expenses, feeling confined at home, not getting enough work or QA feedback, not receiving faxed patient names, and abrupt treatment from technical support.

She also mentions what she considers false advertising of the promise that medical transcriptionists can make $25,000 working at home. "I know of no transcriptionist in my area of the country who is making that kind of money, especially at home. . .Maybe I am living in the wrong part of the country."

Letters to the editor can be addressed to advance@merion.com, with subject line: "Attention, Lisa Algeo, Editor." They are soon going to announce their new web site. Pat Forbis writes an article entitled, "Offshore Transcription is Real." She states that AAMT holds a neutral position on the subject of MTs from other countries transcribing American doctor's dictation, which is developing because of the shortage of MTs and the new digital telephone technology. She believes it is time to develop laws, policies and procedures regarding this, addressing the issues of security, confidentiality, informing the physicians and patients served, and the possible decline in American MT wages. She believes many American MTs are "living at poverty level or below."

New terms from Stedman's "Word Watcher" quarterly: Seradyn Color Vue, Accusway balance measurement system, Disten-U-Flo fluid system for hysteroscopy, Har-el phyarngeal tube, and PortSaver PercLoop device, a ligating loop.

There were 17 advertisements for medical transcription, including Silent Type Inc. in Northern New Jersey, 201, 346-5900.

2/26/96, "Keeping an eye on New Technology."
Brenda Hurley, an MT, writes about a subcommittee that is gathering information from digital vendors. They are asking about compatibilities, quality, type of phone lines used, compression ratios and security.

The lead article is about the Healthcare Open Systems and Trials (HOST) Program that is testing new equipment in medical records processing. They have test sites in West Virginia, New York and Texas.

HISB, the Healthcare Informatics Standards Board, is working on a global standard for medical records. Kaiser Permanente and Mayo Clinic are developing a standard clinical vocabulary based on SNOMED (Systematized Nomenclature of Medicine). There are now several health information networks such as Ameritech's Global Participant Index that are making patient records more accessible and cutting costs.

New terms are listed from Stedman's WordWatcher December Journal: acarbose (Precose), ketotifen (Zaditen), alpha2 anti-plasmin chromogenic assay, rapid Rh D genotyping, topodermatography, single tooth root form implant, Accellon Combi biosampler, Airprene hinged knee support, Durkan CTS gauge, Fine-Thornton scleral fixation ring, Wayfarer prosthesis and Z-Med catheter.

There are 26 medical transcriptionist positions advertised, including a new national company called Trans-Comp, 800-935-1100.

01/29/96: Semiannual Medical Transcription Issue
1. Salary vs Incentive Pay for MTs: the Controversy Continues. General statements about diversity of situations and pay programs. The author recommends doing whatever is good for the business and the MT.
2. Rerecording Digital Dictation for long-distance work. This will soon be obsolete as voice files can be downloaded to computers in a few minutes. (This is not yet available.)
3. Pat Forbis, Associate Executive Director of AAMT, writes an article on educating patients before they sign consents, and the difficulty of understanding medical language, especially by uneducated patients.
4. Profile of Bonnie Monico of Omaha, the new President of AAMT.
5. Catherine Baxter of MTIA writes on the importance of confidentiality and the Bennett Bill. She estimates there are over 60 billion lines of transcription per year in the USA.
6. A few new terms from Stedman's WordWatcher, August 1995.
7. ICD-9-CM Coding Changes.
8. MT predicted to be one of top 10 businesses for 1996 in "Business Start-Ups Magazine."
9. 31 advertisements for MTs.
12/11/95: This issue includes articles on:
--carpal tunnel syndrome, a complicated picture
--a letter from Carrie Boatman, an MT, suggesting MTs work where they are appreciated
--preferred Christmas gifts for people with too much
--how to prepare for CMT exam (self-assessment tapes available from AAMT)
--the president of a large health information management firm
--the Bennett Bill, Medical Records Confidentiality Act
--the diagnosis of Tiny Tim in Dicken's Christmas Carol
--OSHA's proposed ergonomic regulations
--Stedman's list of urology terms (blue dot sign, cecil urethroplasty, cystolithalopaxy, gastrocystoplasty, pyelovenous backflow)
--the uses of patient release of information, a test
--facility-wide confidentiality protection
--the legal importance of patient release of information
--Greater New York Hospital Association Consulting
--Process mapping of business procedures for making improvements
--a review of [sic] Humor by Diane Heath of AAMT
--a report of the American medical Informatics Association's Annual Symposium
11/27/95
This issue includes articles on:
--computerization of long-term care facility medical records.
--the Medical Records Confidentiality Act.
--the loneliness of working at home.
--the problem of finding a temporary supervisor.
--dealing with problem students.
--a survey of the 35,000 members of AHIMA.
--coding guidelines.
--the implications of cuts in Medicare and Medicaid.
--the division between the computer literate and illiterate.
--beta testing new software.
--the need for confidential email within health institutions.
--Anthony's Health Care Internet Alert, an email newsletter surveying medical web sites: 800, 632-0123, ext. 5861.
--Advance Job Hotline: 800,355-6504.
--14 advertisements for medical transcriptionists.
11/13/95
The cover story is on file storage systems; others are on confidentiality of records, chart tracking with computer, process mapping for efficiency, Sweden's health care system, etc.

A letter to the editor from AAMT defends the new rule of national membership being required for regional AAMT membership, as giving members more of a voice. It also rejects the notion of AHIMA representing MTs, as giving MTs less of a voice.

AAMT's Pat Forbis enumerates the obstacles against a computer-based patient record system, including disagreements and misinformation among groups studying CPR. She then enumerates the realities of the dictation-transcription process. She warns of "equipment errors... noise...interruptions...stress caused from unreasonable productivity expectations."

She concludes, "If...health information specialists address the needs of the information language specialists with the same degree of care given to designing the...computer, there will surely be a successful merger of minds and technology. This in turn will accommodate the needs of those whose mission is to provide quality patient care. In the meantime, it is business as usual for the medical language specialists, the medical transcriptionists."

Advance for Health Information Professionals, 10/16/95:
This issue featured the national conference last weekend where they expected 3,000 medical records people. An article by Pat Forbis encourages employers to practice fair hiring and promotion because MTs are very diverse. There is an article on Mediscribe in Pittsburgh. They use remote MTs. Joan Kolonay is Director of Operations (412, 242-7575). There are articles on management, AIDS data network, managed care, stress reduction and morale building.

Stedman's column with new terms has several new terms: Arie-Pitanguy operation (listed in Tessier as Aries-Pitanguy), Hynes pharyngoplasty, Schonbein's operation, and whitegraft reaction.

10/2/95, AHIMA National Convention Issue
The lead article is on using bar codes for medical records identification. Another article states that 16 hospitals closed last year, 40 went through mergers and cutbacks, and the trend continues. There are articles on integrating the whole system of medical records, from dictation to archiving.

An article and advertisment tell of Dictaphone's new ExpressNet which can send dictation over the phone "faster than real time. . .hours of dictation in minutes."

There are 19 advertisements for MTs nationwide, including hospitals, and Medscribe and Transcend Services.

9/18/95
The main article is on touchscreen technology where a lightpen or finger touch is used. Pat Forbis writes an article in which she reminds us not to forget the patient. An article on using on EDI (electronic data interchange) for insurance claims to speed reimbursements and save money states that this field is hindered by the need for standards, and the need for institutions to purchase new systems. Using Windows for hospital computers is explored; ways to benefit from user groups is discussed. A hand-held computer called "PalmVue" used at the bedside to access information is described; another article describes BioNet, the Red Cross' new computer network. HeartMate, the implantable, air-driven heart pump is discussed; a VLAD (left ventricular assistive device) is used until a donor organ is obtained. There is a report on the progress of telemedicine to benefit rural areas, an article encouraging exercise for weight loss and fitness, and an article about computer viruses.

New ophthalmology terms by Stedman's include Bruns' nystagmus, endophthalmodonesis, Grave's optic neuropathy, eye-closure pupil reaction, fluid retinopexy, gas retinopexy, lid crutch spectacles, jaw winking, laser corepraxy, mechanical corepraxy, optic ataxia, purse-string corepexy, pseudo-hemianopia, pupillary ruff, setting sun sign, solar maculopathy and tadpole-shaped pupil.

9/4/95
By Mary Morken
The theme is artificial intelligence. Many articles on new technologies. None on MT.
8/21/95
The theme of this issue is confidential versus anonymous HIV testing. States differ in their policies regarding HIV reporting, and it can be very confusing. Other articles describe a confidentiality lawsuit, confidentiality in a correctional institution and Vermont confidentiality law.

Of interest to MTs, an anonymous letter to the editor tells of the hard work of transcription and the pressure to produce. Diane Heath of AAMT writes an article on MT books, which really only began to be produced in 1973. Before that, MTs made their own notebooks filled with words. AAMT began in 1978 and many more books were published in the 1980s. Her minimum list includes a style book, an English dictionary, a medical dictionary, a laboratory and pathology book, a medication book and an abbreviations book. Then she mentions specialty books, spell-checkers and magazines, and online services are listed as part of the resources for MTs. The AAMT Resource Library is an up-to-date book list, $5, call 800-982-2182.

New terms listed from Stedman's: vowenoid cells (see Bowen's disease), bracyonycia (short nails), collagen injection (for deformities), crown of Venus (forehead lesions from syphilis), keratoelastoidosis marginalis (papules along line between palms and d orsal hand in elderly), localized pemphigoid of Brunsting-Perry, lupus erythematosus panniculitis, morsicatio (biting lips), pulsed dye laser (to treat children's hemangiomas) and subungual exostosis.

8/7/95: The major topic is optical imaging of medical records and its evolution over the last 10 years.

Letters to the Editor still discuss Pat Forbis' article on the Internet. One writer objects to AAMT closing their membership as AHIMA is opening theirs up more, and suggests AHIMA should add a section for MTs. The other writer objects to the comparison of computer networking with live medical lectures which she feels are much more beneficial, and obtaining medical terms from the computer that are not documented.

Past AAMT President, Marilyn Craddock, who died in July of a brain tumor, is remembered and honored; she received the Educator of the Year Award at the national convention.

There is an article on negotiating with vendors using teamwork, knowledge, competition and a winning attitude; an article on transferring medical records to CD-ROM; an article on job titles matching the job; an article on people abusing employee travel privileges when attending conventions; a professional profile on Dr. Melanie Brodnik who is an administrator at Ohio State University in the School of Allied Medical Professionals among other things; an article on job descriptions for disabled students; a report on the AAMT National Convention; an article on selecting filing equipment; an interview with Scott Griffith of Alpha Systems (document recovery, disaster recovery and file management); and an article with 10 positive opinions on the use of Internet.

There is also an announcement of Medical Records Institute's new WWW site:
http://www.medrecinst.com

7/24/95
(Advance can be reached at Internet:advance@merion.com)
Two more letters to the editor recommend computer networking, rejecting AAMT's negative stand on this issue. Alan Stancliff states: "It is true that rude things are occasionally posted online. A few people have left such cyberlocations in disgust or with hurt feelings, but sooner or later (and usually sooner) the participants in the particular cyperplace browbeat the miscreants out. Flame wars do occasionally rage, but they are rarer than one might suspect, and usually the embers die without much ash being left. Pamela Folmasoff states: "The Internet and computer networking are growing, beneficial, unlimited and rewarding. Let's not resist it like computers were resisted for transcribing (when MTs didn't want to give up their IBM Selectric IIs)."

An article by Jennifer Martin tells of the benefits of online communication with MTs, with instructions on how to get to the five boards: "One of the first people I met online was Debbie, another MT...I was delighted to find she lived right down the street."

There is an advertisement by MRC, Medical Records Corporation, a very large national company with 40 offices, hiring both in-house and at-home MTs. Phone: 1-800-dictate.

There is an interview with Stephanie Emond, President of CaTS, California Transcription Services in Fair Oaks, CA, with 42 MTs.

An article by Christ Jones of AAMT summarizes the results of the survey of MT employers. Of note, 82% paid hourly, 70% required MTs to answer a telephone, 48% said the CMT credential is not a factor in hiring, 47% described MT as professional work, and 49 % reported that some of their employees are members of AAMT. The sample included 6,727 employers.

"News Network" is the title of an article explaining two new databases available online. Call FORE at 312, 787-2672, ext. 275, for more information.

Linda Galbraith, MT, writes a guest editorial to encourage new MTs who are looking for their first position. She tells of her own beginnings and recommends that new MTs be very independently resourceful, since employers have very little time to train new MTs. After stating that starting from home is the exception, she gives this advice: "Begin pursuing your at-home career by talking to smaller doctors' offices who specialize in a certain area. If they are leery of your lack of experience, offer to transcribe one day's work of dictation for free so they can measure the quality of your work. Tell them you will attach a "fake" bill to your work so they can see what they'll be getting for their money."

New terminology: None of the terms were act ually new except endosonography and control release suture.

There were major articles on the issue of electronic signatures and a list of the proposed revisions to the Medicare Hospital inpatient prospective payment system, and other articles.

7/10/95: Advance will have an Email address by July 24th at advance@merion.com. You can subscribe to the California Health Information Association's email list by writing Email LIST-SERVE@FIONA.UMSMED.EDU, then type SUBSCRIBE HIM-L with your name. Or write Mary Miller at mfmiller@aol.com for information.

Items of interest regarding MT: Letters to the Editor by Michele Chavez and Doris Anderson address Pat Forbis' article of 05/29/95. Michele states the Internet is not anonymous--in fact, people get acquainted as persons apart from appearances. Both letters tell of the benefits of computer networking. One letter from Chris Jones, Marketing Coordinator of AAMT, defends Pat's article and states they were not speaking of the MT forums specifically, they were not trying to discourage individuals from going online, and they were not saying AAMT would not be online in the future. He states they cannot take risks as an organization that individuals can take. He ends by inviting suggestions. There is a "Professional Profile" of Mary Morken using voice recognition and abbreviation typing for doing MT.

There are statements by the four candidates for the AAMT 1995 Board of Directors to be voted on in September: Anne Donnelly, Clare Terrill, Garolyn Grimes and Susan Pierce. George Heymont writes of uses of digital dictation systems for estimating quantity of work and analyzing problem dictators. Pat Forbis tells of AAMT's involvement in establishing standards for computerized medical records in ongoing committee meetings of the "American Society of Testing and Materials (ASTM) E31.22: Health Information Transcription and Documentation." There are 19 advertisements for MT positions.

Other articles include the case for the lasting need for paper records; dealing with office romances; helping disabled students identify their strengths; the discovery of a gene that causes dwarfism (pseudoachondroplasia); the recommendation of relaxed deep breathing while working to lower stress; the announcement that Lanier has a new program "MedWord for Windows," an integrated system for MT; and the announcement by Sudbury of PC VoiceTransit to download voice files of dictation into a computer. To subscribe to this free magazine, call 610, 265-7812.

6/26/95: Letter to the Editor by George Heymont, MT, objects to Pat Forbis' article in May 29th issue where she called computer networking a fad and a place where people mistreat each other. He stated that the article was insulting to the MTs who are online, and mentioned the five MT forums and the cross posting between forums, and the web sites that are coming for MTs.

Pat Forbis responds that George missed the point of the article (and so did I!): ". . .that AAMT will undoubtedly participate in the on-line exchange of information about medical transcription, but will do so with the measure of quality for which it is known." She then states she is a pioneer in encouraging the use of technology.

An article on management deals with the question of dealing with medical coders who talk to each other too much on the job. They are asking for good questions for this Management Q&A column, and panelists who can answer the questions. An article on offi ce tensions describes physical exercises for relaxing while working. An article on computerized patient records discusses the c osts, technological changes, legal issues, lack of standards, software compatability, need for education and confidentiality for changing to CPR. It states that paper records will still be necessary as well.

An article on AHIMA's (American Health Information Management Association) Regional Team Talks describes the purpose of the meetings; more information on upcoming meetings is available at 312, 787-2672. There are articles on peer review (HealthInsight), improving paper filing systems for patient records, peer review of Medicare patient records, reports on regional AHIMA meetings, preparation for the medical coders examination, an interview of the President of Document Control Systems, a report on the increase of tobacco use among youths, a report on a managed care company, an interview with a health information manager who is going to law school, and an article on medication use and abuse among the elderly.

The list of the latest terminology (with definitions) includes the following: acupressure, cheesy abscess, chronic idiopathic xanthomatosis, cutaneous lupus erythematosus, esophageal spasm, euthyroid sick syndrome, focal metastatic disease, Gulf War syndrome (no evidence of specific syndrome, just informal term), impaired glucose tolerance, infantile beriberi, ketotic hyperglycinemia, multiple chemical sensitivity, Scwachman syndrome, starvation acidosis and tussive syncope.

There is an advertisement for Short Cut, an abbreviation system for MT. 800, 314-4295. Price $149. By Hawk Technologies in Marietta, Georgia. There are 17 advertisements for Medical Transcriptionists at hospitals and services.

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