Medical editing and automated speech recognition technology: The newest trend in medical transcription
~ What is it?~
Now there's a new category in the field of medical transcription called "medical editing" of "automated speech recognition (ASR)" dictation. This goes along with the rapidly growing trend of hospitals and physicians using voice recognition software to do their dictation. The national company I was working for was rapidly switching most of their accounts to this format about 2 years ago. I chose to train and do this work so I could know first-hand what it was all about and be able to report on it.
Well, the bottom line is, even though the companies are turning to this, in my opinion it is "not ready for prime time" to quote a famous TV show. :o) The word recognition is still VERY poor and a LOT of editing must be done by the transcriptionist turned editor. Unfortunately the national transcription companies look at editing as a step lower than regular transcription and don't think it takes as much skill (anybody can do it?) and therefore they are paying 50% to 70% of the typing line rate for editing work. I strongly disagree with this conclusion on their part (and voiced my opinion to my company with many others).
~ My personal experience with editing~
After doing almost nothing but editing work for 4 months, I saw that it takes even MORE skill because the word recognition is so poor. I saw the system may plug in real medical words that look okay at first glance, but an experienced MT would see right away that it didn't make sense, and would then listen carefully and make the necessary corrections. I'm not sure that "anybody off the street" could do that. I try to make my work as close to 100%accurate as is humanly possible, but I found myself missing small things in my ASR reports, especially punctuation or double words or misspellings, because as your eye scans the report while listening, you sort of get in a "zone" and don't pay as much attention as you should. I thought, if I found myself making more mistakes I can only assume others are too. This means the quality of the report is probably declining, not improving.
And what about increased production? It is claimed that editing a speech recognition report is supposed to increase your productivity by 20% to 30%. I found just the opposite! I've seen MTs claim this is true for them, but I've also talked to other MTs who found, just like me, that it did NOT increase their productivity. I found that it took me 3 to 4 times LONGER to edit a totally garbled report than if I had just typed it in the first place!
So my productivity was cut drastically. I was working much longer but still doing less work than before for 70% of my old line rate. Editing work looked like it was turning this career into less than a minimum wage job! Needless to say, this couldn't continue, so I started looking for an alternative, and I'm happy to say that I found a wonderful smaller regional company who is NOT switching to voice recognition, has no plans to switch to voice recognition in the future, and pays me a decent line rate. I said bye-bye to the big guys and that editing work and went back to liking my job again!
~ What do the dictators think of ASR? ~
How does this new voice recognition impact the doctors and other providers who are dictating? It doesn't really impact them at all! They never see the totally messed up and garbled voice recognition report. They only see a final product just like they are used to seeing, but which, unbeknown to them, an MT has labored long to fix! They're happy as oblivious little clams.
~Another down side to ASR work~
Now I'm seeing comments on the MT boards that those who have been editing for a while and then go back to typing are finding that their typing speed has gone down while they've "been away." I'm sure that would reverse with time. It's a matter of training the brain again, but what about those who are popping back and forth between editing and typing?? Again, God made the brain very resilient, and I'm sure it can adapt, but it may take more concentration and resolve to do it and frustration will probably be the result.
~ What do others have to say about ASR? ~
I'm not alone in my feelings about the downward trend in pay, skill requirements, etc., for medical editing. Here's a quote from the official website of the AHDI (Association for Healthcare Documentation Integrity--formerly known as American Association of Medical Transcription) who are the best known advocates for the traditional medical transcriptionist.
Quote:
Speech Recognition Editing
Performing SRT editing successfully requires a somewhat more specialized skill set than that involved in traditional, manual transcription. There is a different eye/ear/brain coordination dynamic at work in SRT editing compared to transcribing, which often makes it more challenging to identify errors in an SRT-draft document. It is more common in SRT editing for the brain to be "tricked" into thinking that the eye has seen what the ear has heard, due to the lack of the tactile component of the fingers manipulating the keyboard to make the text characters appear on the screen. It is a common misconception that SRT editing is somehow easier than manual transcription or requires less knowledge and skill; this is most certainly not the case. It is true that the physical demands are somewhat decreased with SRT editing, as it does not require as much keyboarding, but the mental demands of SRT editing are greater, requiring more intense focus and concentration.
Compensation for SRT Editors
The methods and rates of compensation for SRT editors vary greatly, as is true for medical transcriptionists in general. Some employers pay an hourly rate, with or without benefits; others pay on production, by the line or character or some other unit of measure, again with or without benefits. Compensation for SRT editors working on production is often less per unit than for transcribing, with the assumption being that editing SRT is faster than manual transcription and therefore editors can process a greater number of lines, characters, etc., in the same amount of time. While this maybe true to one degree or another, it is not unusual to find that the increase in productivity with SRT does not make up for the lower compensation rate, with the end result being that editing pays less than manual transcription. This is clearly inequitable, given that SRT editing is in some ways even more demanding than manual transcription. MTs should evaluate SRT editing positions very carefully before signing a long-term contract, since it may not be known until after the fact whether or not the rate of compensation for an editing position is adequate. Again, for an editing position that pays on production, the rate per unit itself is not the key factor; it is the level of productivity you achieve that will determine your actual compensation for a given period of time. If the compensation for SRT editing is half the rate for manual transcription, an MT must be able to process at least twice as many lines, characters, etc., in a given period of time in order to receive an equivalent compensation. Whether or not this is a realistic goal depends a great deal upon the accuracy of the speech recognition application and the user-friendliness of the transcription software and whether or not it allows the use of macros, text expanders and spell checkers, etc.
Unquote. See AHDI.org as source of this quote.
~ In Summary ~
As you can see, my experience with editing was not positive, and I am dismayed by this trend in transcription, but I've heard that there are some MTs out there who absolutely love it. Maybe some day, a few years from now, speech recognition's potential will be fully realized, but in my opinion we are a long way from that.
If the idea of editing scares you (but I hope it doesn't scare you away from transcription as a career), you might do like I did and find a local company, clinic or hospital to work for. Most likely they will not be turning to voice recognition anytime in the near future. And those companies, clinics, hospitals are always on the hunt for good US-based MTs.
If you have questions or concerns about editing or anything else in the MT field, feel free to
e-mail me (see "contact me" button above) and ask questions. Be informed!
