Archive for the ‘medical transcription’ Category

MTIA / CDIA – The End of an Era

Sunday, 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

The QWERTY Keyboard Sham: Taking Inefficiency to New Heights

Tuesday, 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…

Medical Transcription At Home: Finding the Right Balance

Thursday, April 14th, 2011

The Medical Transcription work at home trend has gained significant momentum in the past decade or so. It is a production model that has now all but replaced the traditional employment arrangement for medical transcriptionists. Most transcription is now outsourced to large MT service providers who employ hundreds and sometimes even thousands of home based specialists.

The benefits of a medical transcription at home career are obvious and compelling. They include things like:

  • Avoiding tedious commutes
  • Minimizing daycare expenses
  • Eliminating the need for expensive wardrobe upgrades
  • Enjoying the freedom and flexibility of working from home
  • Creating a personalized, comfortable home office environment
  • Finding time for daily life errands during work breaks
  • Having access to your own living areas for comfortable, stress free breaks

 However, as you take stock of the benefits of a home based medical transcription career, it is also wise to maintain some perspective on the potential drawbacks. In my personal experience, the positive benefits of working from home far outweigh the negatives. Nevertheless, it is important to approach any new career opportunity with your eyes open.

Working as a home based transcriptionist can have certain challenges. For example:

  • It requires careful planning to manage your work from home schedule around unexpected family or household emergencies.
  • You may be tempted to schedule parent teacher conferences, shopping, trips to the gym, or other errands during prime production hours.
  • A work at home environment can be distracting if you are not focused and motivated.
  • Well meaning friends, family, and neighbors can assume that because you are home you are available to chat or interact.
  • Friends or family may incorrectly assume that it is o.k. to drop off their kids for you to watch as they run their own errands.
  • Working at home can leave you feeling isolated.

 To succeed in any home based work environment you need to treat your work activities the same way you would treat a real job.  This is definitely true of the medical transcription career.  This means allocating specific chunks of time to uninterrupted MT work to ensure that you consistently meet your production, quality, and turnaround targets. You should plan to schedule breaks, errands, and any other non-work activities around your transcription work. If you allow these non-productive activities to encroach on your transcription time you will find that the stay at home opportunity that looked so appealing will quickly become frustrating, chaotic, and unprofitable - exactly the opposite of your work at home dream.

The time to assert yourself is at the outset of your new career. You should begin by developing a rigid schedule and post it for all to see – particularly family and others who may have a tendency to take your responsibilities lightly. Don’t be timid. Let people know that your top priority must be a commitment to earning a living and fulfilling obligations to your employer. As a medical transcription at home professional, this is never something you should find yourself apologizing for.  As you establish proper boundaries, you will discover that the benefits of a work at home career in medical transcription will far exceed the hassles and drawbacks.  With a little discipline, you will find that you will have the flexibility you desire when you need it most, while still protecting your professional turf.  It will be a win-win-win for you, your family, and your employer.

Whither Medical Transcription Growth? MT Growth Drivers for the Coming Decades

Tuesday, April 12th, 2011

Historically medical transcription employment has enjoyed above average growth – surpassing the average growth rate for most occupations.  In recent years, however, technology advances and offshoring trends have contributed to  a moderation of growth in the medical transcription industry.  The question is rightly posed as to what the future holds for the medical transcription and healthcare documentation industry.

The following facts exist:

1. The most recent statistics from the Bureau of Labor Statistics suggest that there are in excess of 105,000 medical transcriptionists currently operating on a full time or part time basis in the United States – this doesn’t count any overseas medical transcription employment.  Some estimates put the count at a figure almost double the 105,000 medical transcriptionist government estimate. The BLS expects the overall industry job growth to continue to keep pace with or exceed that of most other occupations – particularly non-healthcare occupations.

2.  The BLS projects medical transcription to post an 11% overall growth over the coming decade.  An expansion of the active medical transcription workforce of 11% would equate to approximately 12,000 new jobs – at a bare minimum.  However, with natural attrition that figure could be far higher.   It is noteworthy to bear in mind that a high percentage of the most seasoned and productive medical transcriptionists will be retiring in coming years – consistent with broader demographic trends seen in the United States.  One of the most important things that the BLS statistics miss is the fact that it takes years of experience for a transcriptionist to achieve a peak level of productive capacity.  In other words, it is not possible to replace the production of a highly productive and efficient retiring MT with the capacity of a single new graduate.  The reality is that the BLS statistics likely underestimate the overall demand for medical transcriptionists in the coming decade.  This is good news for prospective MT’s and harder news for healthcare managers who will continue to struggle to keep up with surging demand and a persistent capacity imbalance.

In addition to the raw statistical projections discussed above, consider the following demographic, legal, political and social trends that will all converge to shape the medical transcription industry over the next several decades – primarily driving demand for healthcare documentation to higher and higher levels – at least until the end of the current baby boom cycle – at least another 25-30 years.

  • A continuously growing population – the population of the United States and the world continues to expand relatively unabated.  This US population growth rate may be significantly understated as a consequence of the rapid growth of undocumented workers entering the country each year.
  • A rapidly aging population attributable to an upcoming and ongoing wave of elderly baby boomers and advances in healthcare treatments designed to extend life spans.
  • Increasing pressure on healthcare systems and processes to continue to extend life spans and provide quality of life to the elderly and other segments of the population.
  • A rapid increase in chronic and age and lifestyle related infirmities requiring acute care and non-acute but continuous care.
  • A significant increase in the quantity of malpractice lawsuits targeted at the healthcare industry and its practitioners. The healthcare industry will continue to respond with more inclusive and detailed medical documentation reports to reduce liability and provide an important legal papertrail.  (Translation: longer reports, more documentation – not less, more reports – not fewer, higher volumes of line counts, etc. etc.)
  • A continuation of the current trend toward medical specialization. This will result in a single patient being seen by multiple specialists instead of a single general practitioner with each visit requiring an additional layer of documentation.
  • An acceleration of the movement toward electronic information documentation as a means of enhancing both the quality of patient care and the accessibility of patient healthcare information.
  • An increasing ability to successfully treat conditions and prolong life in previously terminal patients.

While it is true that some of the projected future demand will be siphoned off by offshoring organizations or mitigated by technology,  it seems clear that the supply-demand conundrum that has existed for many decades will only be accentuated in coming years.  The need for quality medical transcription practitioners should begin to accelerate again after a brief respite.