Taking note: Medical transcriptionists use skills to keep hospital records and information in hand

Paula Allen, medical transcriptionist, shows off her fast fingers as she transcribes medical notes from the Centralized Transcription Services computerized Dictaphone system. Photo by Kirk Murray.

Osborn is the supervisor of Centralized Transcription Services, located on the lower level of the hospital’s Pomerantz Family Pavilion. The “special people” are the approximately 70 medical transcriptionists who spend their days (and in some cases, their nights) wearing headsets and typing medical notes laden with specialized terminology at dizzying speeds. Every time a physician anywhere in the hospital dictates notes about a patient visit or procedure, Osborn and her staff are the ones responsible for transcribing those notes into printed medical records.

Paula Allen is one of the transcriptionists. When she took the job, she had to take a typing test. Her speed came to 85 words per minute.

“I’ve sped up since then,” Allen says.

Surprisingly, Allen and her fellow transcriptionists say the job is full of variety. Like the physicians whose notes they type, each transcriptionist has medical specialties, areas of terminological expertise.

“I type seven or eight departments,” Allen says. “General medicine is a world away from cardiothoracic surgery. I’m also a pre-nursing student. I learn something new all the time.”

Allen also enjoys the camaraderie that develops among the transcriptionists. “We have a really great bunch of people,” she said. “I learn a lot from the people I work with.”

Centralized Transcription Services was formed in November of 1997. Prior to that, every department of the hospital had its own system of transcribing notes. Some had full-time transcriptionists, while others relied on secretaries who had other duties as well. The transition to a centralized system took place gradually and was completed last year. Tammi Craft, senior associate director of health information management, says that the centralization has been a great benefit to the hospital. For one thing, with two shifts of dedicated transcriptionists covering from 6 a.m. to 1 a.m. seven days a week, the department is able to make much more efficient use of equipment purchased.

“If there are four transcriptionists in one department and two leave, it devastates them,” Craft adds. “Here, if someone quits, it doesn’t devastate us.”

Daniel Fick (right), associate professor of family medicine, demonstrates dictating into a Walkabout in his office. Photo by Kirk Murray.

The technology of medical transcription has evolved. Physicians used to use a variety of media to record their notes, including cassettes and their own handwriting. Now they can call a phone number, punch in their unique ID and a patient ID, and start dictating straight into the phone from their office or home. The audio is recorded in digital format and stored on a central computer system. Physicians also can dictate into the built-in microphone of a personal computer and have the audio files save directly onto the same network accessed by the transcriptionists.

There’s also a third way that’s growing in popularity, a hand-held device called a Walkabout. Looking like a television remote control, each Walkabout contains a microphone and a computer chip that stores audio files. Depending on the size of the chip, the Walkabout can store between 30 and 100 minutes of dictation. Once the dictation is complete, the device is plugged into a docking port, which can be located in a departmental office, and the audio is copied straight onto the network. The Walkabouts can be purchased by departments or rented from the University’s rental pool. For information about acquiring one, contact Osborn at (35)6-4469.

It takes a high level of commitment to become a medical transcriptionist. Generally a candidate for the job has to demonstrate a previous knowledge of medical terminology, good computer skills, and fast, accurate typing. Once they’re hired, they enter a six-month period of on-the-job training to determine if they really have the aptitude for the job. A trainer works closely with the new hire to correct and explain their errors. Even after the official trial period is over, the training goes on far longer.

For wellness reasons, the department encourages all the transcriptionists to spend at least five minutes of every hour out of their chairs and walking around. And as an added perk, the chairs themselves are top-of-the-line Aerons, which come in three sizes to fit the user and adjust in every imaginable way.

Once through the training process, transcriptionists tend to grow highly attached to their jobs.

“A really good transcriptionist just flat out loves it,” Craft says. “Finds it relaxing.”

Robyn Klein, one of Allen’s co-workers, is a case in point. She’s been a medical transcriptionist at St. Luke’s Hospital, in her home business, and at UIHC for a total of 20 years.

“It’s what I do,” Klein says.

Article by Sam Samuels