MTIA / CDIA – The End of an Era

April 14th, 2013

The Clinical Documentation Industry Association (CDIA), formerly known as the Medical Transcription Industry Alliance (MTIA) has formally announced that they have ceased operations.  After many years of service to the medical transcription industry the CDIA / MTIA organization has conceded that it must close it’s doors, citing external factors relating to the contraction and consolidation of the medical transcription industry in  recent years and the financial ramifications of those transformations.

The past several decades has been characterized by significant industry consolidation fueled by mergers and acquisitions within the ranks of medical transcription service organizations.  These consolidations have helped the industry in some ways by allowing for economies of scale, resulting in a healthier, albeit smaller, group of growth oriented employers. However, with the consolidation of MTSO’s, the medical transcription industry has become less nimble and has clearly suffered the loss of some of the entrepreneurial dynamism that has allowed the industry to adapt to an ever changing technological and regulatory landscape. One of the other obvious casualties of this tsunami of consolidation unfortunately, was the Clinical Documentation Industry Association (CDIA) which has experienced a rapidly shrinking membership base as MTSO’s have merged and consolidated operations.

This is a regrettable announcement in light of the fact that the CDIA / MTIA has provided many years of forward thinking leadership and training to the industry. Additionally, it has provided valuable lobbying efforts on behalf of medical transcription service organizations as well as to medical transcription practitioners worldwide.

The industry will certainly move forward.  However, we will also miss attending the annual CDIA convention and expo with its insightful workshops, training, and networking opportunities.  We express our sincere appreciation to all those who were involved in providing these industry services over the years.  Their tireless efforts will be missed.  Below is a full transcript of the announcement posted by CDIA:

Dear CDIA Members and Supporters,

The Clinical Documentation Industry Association (CDIA) has weathered many financial challenges over the past few years from the significant contraction in the marketplace and overall unhealthy economic conditions. In response, we rebranded the association to expand our reach beyond medical transcription, editing, voice, and speech recognition to encompass every touch point in the clinical documentation continuum. Our flagship event, the CDIA Annual Conference, had broadened the educational program to bring together these complementary audiences.

Unfortunately, the external factors have become too strong for the association to overcome and this is why we are writing to you today. On behalf of the CDIA Board of Directors, we regret to inform you that the association is closing and the annual conference planned for April 2012 in Baltimore, MD has been cancelled.

This has been a very difficult decision that the Board did not take lightly. The association’s finances could no longer sustain the organization to serve the members and support the annual conference. Over the next several weeks, CDIA representatives will be winding down the association and information will be sent regarding recent payments made to the association.

Thank you for your support of CDIA and participation in the association. We encourage you to continue to promote the spirit of CDIA’s mission, values, and advocacy platform as you continue your involvement in other associations, including the Health Story Project ( and AHDI (


The Clinical Documentation Industry Association

2012 and Beyond: Divining the future of Medical Transcription and Clinical Documentation

January 7th, 2012

By Christopher Dunn

The dawn of a new year – 2012 – seems an appropriate time to take a fresh look at the future of the medical transcription and healthcare documentation industry. To be sure, the past several years have seen a steady if not accelerating encroachment of both technology and outsourcing on the traditional medical transcription model. In fact, if we are to be completely honest, the traditional medical transcription paradigm is fast becoming a relic of a bygone era.

The speech recognition movement has swept in with a vengeance and is gaining traction in the traditionally slow-to-adopt US healthcare industry. The factors that have delayed the penetration of speech recognition technology are numerous – with cost, entrenchment, bureaucracy, uncertainty, and a lack of standardization all contributing. However, one by one these issues have been resolved or mitigated and the industry now seems poised to accelerate the pace of SR adoption as the path to profitability and efficiency becomes more clear.

At the same time, the propensity toward overseas outsourcing of transcription has become commonplace, bringing its own set of benefits, and headaches to an increasingly fragile industry. However, the pace of outsourcing may decelerate slightly in the future as speech recognition technology continues to establish itself as the dominant production model. The cost efficiencies of SR will make it more palatable for healthcare operators to maintain a domestic production resource in the future.

MTSO’s have scrambled to redefine their role in the wake of a rapidly morphing space. Consolidation and scale have been the bywords of an industry badly shaken by these rapid global transformations. Most recently, MTSO’s, along with their armies of skilled medical transcriptionists have worked hard to adapt to the changing technological landscape. The conversion from a traditional medical transcription skill set to the more in-demand medical record editing role has been arduous and inefficient. Companies and transcriptionists alike have been forced to wear two hats as their healthcare partners lurched in fits and starts – transitioning away from a traditional medical transcription model in favor of speech recognition technology.

The MTSO survivors have done an admirable job of transitioning to the document editing role with a healthy dose of guidance, support, and cheerleading from AHDI (Association for Healthcare Documentation Integrity), the industry organization that astutely responded to the writing on the wall several years in advance of the sea change. Formerly known as the American Association for Medical Transcription, AHDI abruptly changed its name and its mission a number of years ago in a move calculated to ensure its own survival as well as the survival of the industry it served.

Looking to the future, many MTSO’s now appear well positioned to take advantage of the future demographic trends that will shape the future of the healthcare industry for several decades to come. Specifically, the volume of patient documentation will accelerate markedly in coming years due to a rapidly aging and long-lived US population. These trends have been on the radar screen threatening to overwhelm medical transcription budgets and capacity for a number of years now. However, 2011 marked the first official year of actual baby-boom retirements – setting the stage for far greater healthcare demand and patient documentation in the near future.

As a consequence, a healthier and newly retooled cadre of MTSO’s are now settling into the driver’s seat in what portends to be a remarkable future opportunity of profitable growth in healthcare documentation. Medical transcriptionists who have been successful in transitioning themselves to become competent and efficient medical record editors will also benefit from robust industry growth as they assume an increasingly important and visible role in the clinical documentation production process.

Looking in the rearview mirror, the first decade of the new millennium can best be characterized as a decade of disruption, transition, consolidation, and adaptation in the healthcare documentation industry – all of which have been extremely stressful and costly. The next decade should offer hope for smoother sailing and an opportunity to stabilize around a new model that will facilitate future growth, efficiency, and prosperity.

The QWERTY Keyboard Sham: Taking Inefficiency to New Heights

December 20th, 2011

By:  Christopher Dunn

Did you ever wonder how the ubiquitous qwerty keyboard configuration came into being?  For those not familiar with the term, Q-W-E-R-T-Y refers to the six alpha keys on the left side of the top lettered row of the standard keyboard. Coincidentally, these keys spell “QWERTY”, which, of course, has no specific meaning other than what has become a favorite reference to this specific keyboard layout. Over the years the term QWERTY has evolved into a shorthand descriptor of the most popular international keyboard layout of all time.

If you’re like most people, you undoubtedly assume that sometime in the distant past, a group of highly paid efficiency experts were corralled into a room and forced to come up with the most brilliant and efficient keyboard arrangement possible.  Surely the individuals would have been charged with the task of developing a keyboard configuration for the ages – one that would promise to yield absolutely the fastest keystrokes with the minimum amount of stress.

Guess again.  The qwerty keyboard design was actually a far less noble effort and has a much more insidious history than that.

A Short History of the Mechanical Typewriter

The mechanical typewriter certainly represented one of the most important inventions of its time.  It played a key role in ushering in a new and unrivaled age of enlightenment and information sharing.  Nevertheless, the invention of the manual mechanical typewriter in 1868 came with its own unique set of problems and challenges. Among the most notable of these problems related to the propensity of the mechanical character arms to frequently jam.

The earliest versions of the mechanical typewriter had characters which were mounted on metal arms. As the typewriter keys were depressed, the downward force of the typist’s fingers would cause the metal arms to swing forward and strike the back of an ink ribbon and impress the characters onto a sheet of paper which was inserted firmly into a mechanical roller.

The jamming problem was exacerbated when two or more keys were struck in rapid succession.  Unfortunately, the fastest typists tended to get ahead of the swinging action of the arms causing frequent jams and resulting in errors that were difficult and time consuming to fix. In fact, the fastest typists ended up spending most of their time untangling metal swing arms and fixing errors resulting from mechanical mistypes.  It just didn’t pay to type too rapidly.

Development of the QWERTY Solution

Consequently, the QWERTY keyboard arrangement was designed specifically to solve this jamming problem.  The QWERTY keyboard was designed by Christopher Latham Sholes in the 1870’s – just a few short years after the first mechanical typewriters came off the production line. The final version of the Qwerty keyboard came about through a great deal of trial and error in an attempt to overcome what was the most pressing problem of the new typing device: the jamming problem.  It was discovered that by arranging the keys in such a way as to reduce the possibility of typing keys in rapid succession, enough inefficiency could be created in the typing process to circumvent the problem of tangling the metal mechanical character arms. Problem solved. Unfortunately, the burden of inefficiency rested squarely on the shoulders of typists who suffered a tremendous loss of productivity, incurred measurable additional stress, and were plagued by serious physical maladies such as carpal tunnel syndrome.

QWERTY:  The Most Inefficient Keyboard Layout Possible

1.  The ten most frequently typed letters in English language literature are in order: E, T, A, O, I, N, S, H, R, and D.   Of the eight home keys of a traditional QWERTY keyboard – that is, the keys where the fingers rest and spend most of their time – only three of the top ten letters are represented:  A, S, and D.  The other seven of the top ten most common letters require a reach up or down from the home keys to strike the key.

2.  What is more, the three “common” letters (A,S, and D) that are found on the home row of keys are located to the far left side of the keyboard. That is to say, they must be typed by the middle, ring, and little (pinky) fingers of the LEFT hand.  Most people are right handed. By forcing typists to type the most commonly encountered letters by either reaching or by using the least dexterous fingers of their weakest hand, the QWERTY keyboard all but guarantees the most painful, tedious and slow typing experience possible.

Hope for Change?

So why are we still clinging to a keyboard arrangement that is hopelessly outdated, completely irrelevant, and in every way counterproductive to speed and efficiency in an age of computers and high speed printers?  Could it be the same reason the United States refuses to embrace the more efficient and intuitive metric system?  Perhaps we are simply too entrenched and invested in an inferior system.  Maybe we perceive that a change of this magnitude would be too costly or chaotic. Possibly we simply lack the foresight or the will to change.  Whatever the reasons, it appears the QWERTY keyboard will be with us for the duration. As they say, it is hard to teach an old dog new tricks…

When Will Social Security Go Broke?

May 14th, 2011

When will the Social Security system run out of money?  Well, the US Treasury Department announced recently that 2011 will mark the first tipping point for Social Security since we emerged from the last protracted recession in 1983.  That is, more benefits will be paid out in 2011 than will be collected by the Treasury Department.  Fortunately, this is expected to be a short-lived phenomenon (for now).  An ultra-high unemployment rate approaching 10% has resulted in a substantial reduction in wage tax collections in recent months.  The current shortfall is expected to last for a couple of years at which point the Treasury predicts we will return to a surplus situation for a few more years as the economy picks up some steam.

But beginning in 2015 and thereafter, an enormous wave of Baby Boom Retirees will push the Social Security plan into a permanent death spiral – where payouts to retirees will overwhelm incoming wage taxes to the point that the surplus that has been built up over decades of time will begin to be drawn down at an increasingly rapid rate.

So what is the end game?  For starters, if the most recent actuarial statistics are accurate, the Social Security surplus fund, which currently stands at about $2.5 Trillion will run out of money and be completely depleted by 2036 – a year sooner than earlier estimates.  Of course, this so-called $2.5 trillion dollar surplus is not real money mind you, but an IOU from Uncle Sam who has already spent the money with a promise to repay it.  Once the “surplus fund” is depleted, the Social Security system will rely completely on new tax revenues to pay for an increasing level of benefits.  Unfortunately, as the Administration looks into its crystal ball it expects that wage tax revenues will only generate enough to cover about 75% of the demand for benefits after 2036.  Someone will have to go without…

So how worried should you be? To some degree it depends on when you were born — and how long you expect to live.  With a retirement age currently set at 67 for the latest generation of baby boomers and assuming an average lifespan of approximately 78 years (based on latest published averages), if you were born in 1958 or before you are home free (assuming you have any faith at all in the current system).  For those born in 1959 and beyond, the outlook is murkier.  In all likelihood the Federal Government will make good on its commitments to Social Security beneficiaries – in the same way it will make good on its obligations to investors and foreign countries that fund our ongoing deficits by purchasing US Treasury Bonds.  Of course “making good” may come at a high cost in terms of potential inflation, which will serve to erode the real value and purchasing power of any benefits received.

Another thing to keep in mind is that there is a lot of attention focused on trying to fix the soon to be defunct social security system prior to D-day. This may mean some combination of increasing the retirement age for younger workers, reducing benefits to retirees, and increasing the social security wage tax rate in an effort to right the ship before it sinks.  Stay tuned!

Social Security Benefits: The Case Against Early Retirement

May 12th, 2011

The  United States Social Security Administration has posted a list of official retirement ages. The Full Retirement Age is important as it determines when an individual will qualify for full social security retirement benefits. The Full Retirement Age (FRA) for receiving Social Security Benefits has been increasing gradually since Social Security benefits became effective. The FRA – Full Social Security Retirement Age began at age 62 and has increased to age 67. It is virtually certain that the Social Security FRA will continue to creep up as financial resources continue to become strained under the burden of a rapidly growing elderly population. As it currently stands, those born in 1960 or later will have to wait till they reach the age of 67 before they qualify for a full social security retirement benefit.

Of course it is possible to qualify for an early retirement benefit at a younger age – and in truth, with the state of the economy, many individuals approaching retirement have been taking advantage of this opportunity to get benefits now rather than delaying them until they reach the full retirement age.  In fact, according to Social Security Administration statistics, about 70% of all individuals who qualified for early retirement benefits last year chose to take the early retirement benefit - settling for a likely overall reduction in total benefits paid over the course of their lifetime.

In a few cases taking less money now may make more sense than waiting for the higher payout.  For example, if you are in poor health and/or are stretched beyond your current financial means you may feel it advisable or even necessary to sacrifice future earnings potential for a lower payout beginning today.

Either way, there is no getting around the fact that by opting for an early benefit stream today, the total benefit you will receive over the balance of your life will most likely be substantially reduced. I say most likely because we never really know when it will be our time to go. Someone who delays taking benefits and then passes on unexpectedly before reaching the magic Full Retirement Age will be out of luck.  Of course it is always wise to keep in mind that a surviving spouse may be entitled to a higher survivors benefit the longer you wait.  But let’s look on the bright side and assume that you will live well past your Full Retirement Age – a pretty valid assumption in most cases.

From a purely financial perspective then, it is generally not advisable to begin drawing social security benefits at an early age – if it is at all possible to avoid it. By claiming your social security retirement benefits early you stand to forfeit thousands or even tens of thousands of dollars over the course of your remaining life.

According to the Social Security Administration you can expect to lose a whopping thirty percent of your monthly income by beginning to draw retirement benefits 5 years ahead of schedule. So, for example, if you are scheduled to draw retirement benefits at age 67 but choose instead to file for social security benefits at the age of 62, then you will receive benefits – but at a level that is 30% less than what you would have received by waiting till your FRA Full Retirement Age. If you file 4 years ahead of schedule you can plan to receive a 25% reduction in your benefits. A three year early retirement will cost you 20% of your income, and so on. It makes a lot of sense to wait till you reach your Full Retirement Age before you file for Social Security Benefits.

Conversely, if you are in a position to delay your filing for social security benefits until some years after you qualify for full benefits, you will enjoy an even higher level of monthly and yearly income for the balance of your life. Call it delayed gratification… For this reason, some retired individuals choose to continue to work past the age of 70 in order to make ends meet so they can delay filing for social security benefits past their Full Retirement Age.  By following this strategy, they ensure a higher level of social security income  and attendant standard of living through their remaining retirement years.  And as our health care expenses tend to increase over time, those later years may be the years we need that extra income the most.

Inpatient Medical Coding vs. Outpatient Medical Coding

May 9th, 2011

In the world of medical coding, there are two fairly distinct groups of medical coders Inpatient Medical Coders and Outpatient Medical Coders:

1. Those who perform medical coding for clinics, physicians offices, and hospital emergency rooms. These are typically referred to as “Outpatient Medical Coders”.
2. Those who perform medical coding in major hospitals. These are typically referred to as “Inpatient Medical Coders”.

If you are interested in a medical coding career, it will be important to understand the difference between outpatient medical coding and inpatient medical coding. This might be best understood through example. If you have a procedure performed that requires you to be admitted to the hospital and stay overnight, this medical coding activity will require the skills of an inpatient medical coder. If you have a procedure performed on a same-day basis and are not admitted to the hospital for an overnight stay then it is considered an outpatient event and is typically assigned to an outpatient medical coder.  A lot of surgeries and procedures that used to require admission to the hospital are now being performed routinely on an outpatient basis – which means you go in and have the surgery and come home the same day without ever being admitted to the hospital.

As you might expect, there is a significant difference in the skill set required to apply medical codes to complex inpatient operative reports vs. the skill set required to apply appropriate medical codes to a report for a laceration or a stubbed toe in a clinic or emergency room setting.

The reality is that most medical coding is outpatient medical coding. The trend is for physicians and hospitals to perform more and more of their procedures on an outpatient basis.

Most entry-level medical coders are going to begin their careers performing outpatient medical coding on outpatient medical records.

Inpatient medical coders are generally trained or mentored on the job and come from the ranks of outpatient medical coders. This creates plenty of opportunities for advancement in both career and income over time.

Making the Correct Medical Transcription Training Decision

April 23rd, 2011

A few words should be written about the state of the medical transcription industry today with respect to training. The industry has gone from one offering virtually no formal training options a couple of decades ago, to one that has attracted an increasing number of participants – not all of which are reputable. To be fair, many of these training programs are well meaning. However, some are simply ill prepared to deliver a training experience that will yield a positive career outcome.

Remember – you can spend just as much time and money (and in many cases much, much more) on a second or third rate program as you can on a first rate program. In my experience, I have found that most people who select one of these lesser options do so for one or more of the following reasons:

1. Effectiveness of their marketing messages
2. Perceived low price of the program
3. Lack of available information regarding alternative training options

When evaluating any MT training program, consider what your ultimate goals are. Many people who express an interest in the MT career field have two primary goals:

1. To get a good job upon graduation
2. To work from home as a medical transcriptionist upon graduation

Both of these goals depend on the ability of the training program you choose to deliver a marketable education and to facilitate a number of positive post-graduation employment opportunities.

So when you consider the cost of a program that is fundamentally incapable of delivering on either of your goals, then what initially seemed like a great value can quickly turn out to be one of the most expensive and frustrating options imaginable.

Ultimately you should do your homework and ask the hard questions. Look at the evidence of how existing transcription employers view the training program you are considering. Look at whether the program is approved by AHDI. In the end, there are few decisions you will make that will ultimately prove to be more important to the success of your career.

Keyboarding Introduction

April 20th, 2011

Many, if not most of us, spend a significant amount of time in front of a keyboard. Some of us rely on our typing skills (to one degree or another) to generate a living. And while point and click technology has made speed typing less of a requirement than it was a few decades ago, good communication increasingly demands solid typing skills.

A computer keyboard may seem like a simple and relatively unimportant tool, but the reality is that the keyboard interface has allowed information to be created and replicated in a way that has transformed the world. Think about it. What would a computer be without a keyboard? Certainly, the mouse and other innovations have reduced keystrokes. But there is simply no shortcut to entering vast quantities of raw information into a computer system. And like it or not, virtually every sentence, every word, every syllable, and every letter has had to be pounded out by a typist. It turns out that the lowly keyboard is one of the most important tools mankind has ever devised.

Standardized Keyboard Arrangement: The Key to Typing Productivity

The standard keyboard arrangement in Western countries is often referred to as QWERTY. Take a look at the top row of letters on a standard keyboard – moving from left to right – and you will understand why. All keyboards have a common placement of letters to ensure that any skilled typist can move seamlessly from one keyboard to another without losing anything in productivity. The current computer keyboard configuration may not seem all that intuitive at first glance, but it is elegantly designed to result in maximum typing speed and efficiency.

Most standard keyboards manufactured today have 101 keys. Increasingly, additional symbols and specialized applications are generating a lot of keyboard variations. However, the fundamental arrangement of the standard letters and numbers is generally never changed. This allows individuals to move from one keyboard to another without trying to figure out a new keyboard arrangement every time they type. Over time key positioning can be memorized and fingers can be trained to type keys without searching or even looking down at the keyboard. This is much the same concept as we see with the piano keyboard. Piano keys are arranged in a standard fashion, allowing play by touch rather than by sight. Of course, like sight reading on a piano, touch typing on a keyboard requires a lot of practice. With dedication, however, typing can become second nature and speed and efficiency can increase dramatically.

Medical Transcription Books and Resources

April 18th, 2011

Medical transcriptions are medical language specialists. The bulk of the transcription work in this country is performed by home-based professionals. As statutory or contract employees or subcontractors, it is generally up to the home based professional to develop and maintain their own library of professional industry resources. While there are a lot of options available, there are certain medical transcription books that should be considered mandatory for any home based MT professional.

A Basic home library should include at a minimum:

1. A Standard English language Dictionary – Try Webster’s.
2. A Comprehensive Medical Dictionary – Try Dorland’s Illustrated Medical Dictionary or Stedman’s Medical Dictionary
3. A Good Drug Reference Book – Try Stedman’s Quick Look Drug Book and/or American Drug Index by Facts and Comparisons
4. A Good Medical Abbreviations Book – Try Medical Abbreviations: 30000 Conveniences at the Expense of Communication and Safety by Neil M. Davis
5. A Good General Medical Word Book: Try Sloane’s Medical Word Book
6. A Solid Grammar and Style Guide – Try the Book of Style (AHDI), or the Chicago Book of Style.

In addition to general purpose resources most MT’s will rely from time to time on specialty resources. Every medical specialty has its own peculiar terminology and vocabulary. Radiologists will use an entirely different set of terms to describe their findings compared to an internal medicine specialist, for example. Stedmans offers an entire library of medical word books. These books average $40 a piece and are continually being revised and updated. You would be well advised to hold off on purchasing specific specialty word books until you have a need for them. If you are beginning a new transcription specialty account or expect to be assigned to a specialty work group then a good medical word book is not only invaluable, but should be considered essential. It will add immeasurably to your productivity as a transcriptionist.

Titles from the Stedmans library of Medical Word Books include:

- Cardiovascular & Pulmonary Words
- Dermatology & Immunology Words
- Emergency Medicine Words
- Medical & Surgical Equipment Words
- Neurology & Neurosurgery Words, 4th Edition
- OB-GYN & Pediatric Words, 5th Edition
- Endocrinology Words
- GI & GU Words
- Oncology Words
- Ophthalmology Words
- Pathology and Laboratory Medicine Words
- Orthopedic and Rehab Words
- Plastic Surgery, ENT, & Dentistry Words, 5th Edition
- Internal Medicine Words
- Radiology Words
- Surgery Words
- Organisms and Infectious Diseases Words
- Alternative and Complementary Medicine Words
- Psychiatric Words

As a medical transcription practitioner, you will be continually adding books and resources to your personal library over the years. Be aware that many books are available on CD and increasingly are available online. The ability to search electronically can add significantly to your medical transcription productivity.

Increase Your Typing Speed and Efficiency

April 15th, 2011

Typing speed and efficiency is one of the most crucial aspects of many careers such as medical transcription – where every keystroke counts – literally.  It turns out that typing form can be one of the most important determinants of ultimate typing speed and efficiency. Most of us are aware that the most effective method of typing is referred to as “touch” typing. With touch typing, the hands are placed over the keyboard with the fingers in a specific formation. The position of each key on the keyboard is memorized and typing occurs fluidly and without the requirement to continuously look at the keyboard. Typing keyboards have become standardized so that the keys are always organized in a specific way – arguably allowing for maximum efficiency. I say arguably because there are schools of thought that insist that there are actually more efficient ways of organizing a keyboard. Nevertheless, these schools of thought have not prevailed and the current keyboard arrangement that you see on almost all keyboards today in one variation or another has taken hold and become a ubiquitous standard.

Standardization has occurred for a very important reason. Consider the vast amount of information available in books, libraries and on the internet. All of that information has been hand typed by an army of skilled typists. Standardized computer keyboards have allowed a mechanization of the typing process resulting in incredible advances in typing speed and efficiency.

Touch Typing Technique

The old method of typing (and sadly, a method still in widespread use) is the “hunt and peck” methodology of keyboarding. This is an extremely tedious and inefficient method of typing. People who use this style of typing are either incapable, unwilling, or possibly have just never considered that it was worth their time to memorize the position of the keys on a keyboard and to adopt standard finger positioning techniques. Unless you are a person who truly only interacts with a keyboard once or twice a year you will profit from the efficiency that can be generated through keyboard memorization and touch typing techniques.

Speed Typing Checklist

In addition to learning to “touch” type, many people find that they can incrementally increase their typing speed through a combination of:

1. Maintaining a correct typing posture: this means sitting erect with elbows to your sides and fingers neither hovering above nor pressing down, but rather resting gently on the keys in a standard finger position – more about this below.

2. Ensuring that the keyboard is at the proper height. Most desks and keyboard trays are set at a standard height. Be aware that if you are shorter or taller than average you will need to adjust your chair to establish comfortable positioning.  Speaking of chairs, if you make your living interfacing with a keyboard as medical transcriptionists, data entry specialists and computer programmers do, then a chair is simply not a place to skimp.  You  need a chair that will provide excellent support and facilitate a healthy typing posture. Additionally, your chair selection should consider the maneuverability – both in terms of vertical adjustment to set the chair to the exact height and the ability to move from side to side or swivel depending on the need.  Further, you should not forget about comfort and circulation. I have personally had seats that restrict the flow of blood to my legs because of the way they were designed.  You need to be careful and pay attention to the chair you select. Realize that it can have a measurable and long term impact on your health.  If you type a lot, you need to care for your spine, your arms,wrists, and fingers, and pay attention to ensure that you get adequate circulation through your legs.

3. Typing with finesse – type fluidly with fingers resting gently on the keyboard.  Every ounce of extra effort will add up. Poor technique can contribute to carpal tunnel and other repetitive injuries.

4. Refraining from overworking yourself. Take periodic respites from your typing routine. Gluing yourself to a keyboard for hours of uninterrupted typing will lead to problems and fatigue and render you less productive in the long run.  It will also jeopardize your health, possibly taking you permanently from your career.

5. Monitoring your typing speed and accuracy by returning frequently to the free speed typing test available at can motivate you toward higher levels of speed and accuracy as you see the results of your efforts.

6.  Making proper and generous use of macros and keyboard efficiency tools.  With a modest amount of setup and a relatively minor investment, you can increase your typing speed, efficiency and productivity substantially by taking advantage of productivity software.  Macros basically allow you to substitute words, word strings, or even entire repetitive paragraphs with a few keystrokes.  Again, even if you feel that the typing macros don’t speed up your typing significantly, it may still make sense to utilize them as much as possible to minimize the volume of repetitive physical keystroke activity you are subjecting your body to on a daily basis. At the very least it will result in less repetitive stress on your fingers and wrists.

7.  Fixing typing errors in real time.  Taking the time to stop and correct each mistake at the moment that you notice it is one of the biggest time drags on your overall keyboarding speed and efficiency.  By continuing past a mistake even when you realize you have made it you will maintain a continuous uninterrupted typing rhythm, yielding huge benefits over the course of a typing session.  Correcting errors at the conclusion of a completed report with the assistance of automated spell and grammar check software will in the long run be far more efficient.  Don’t underestimate the need for a final proof read to catch mistakes that are not caught by spell check software, which is notorious for missing obvious contextual problems.

8.  Determining the proper auto-correct setting for your circumstances.  Depending on the sophistication of your auto-correct software capability, you may want to avail yourself of an auto-correct feature, which basically corrects problems as they happen. However, this can also become  your worst productivity nightmare as auto-correct programs are notorious for thinking they have you outsmarted and correcting a lot of things that do not need correcting – requiring you to go back and fix the problems.  What is worse, these problems will not be caught by spell check and will have to be discovered manually.  The right option for your specific circumstance will likely be discovered after one or two typing sessions.Often out of sheer frustration you will turn the silly feature off after a paragraph or two.  Use your judgment on this one.

9.  Practicing short bursts of high-speed typing.  By typing as fast as you can for relatively short periods of time you will begin to acclimate your fingers and your mind to the notion that you can type faster than you believed possible.  This is important and will eventually result in a higher rate of average typing speed for most people. Your brain and fingers will typically cooperate to allow you to type at a comfort level rate of typing speed.  Most people are capable of typing much faster than this comfort level rate.  It requires practice and effort and a basic mind adjustment to accomplish it – but it will pay big dividends if you keep after it.

With proper attention to some of these details you will be surprised at how quickly you can improve your typing speed and efficiency.  The speed typing test will allow you to monitor your typing speed and efficiency and measure your progress toward your goals.