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Aug 20, 2005

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Hot topics revisited...

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Dear Friends,

Here are some interesting excerpts from "Medical Transcription
Forum" - an editorial feature in Advance for Health Information
Professionals Newsletter, by Lisa A. Algeo.

<One of the biggest, and most controversial, topics surrounding
medical transcription today is offshore outsourcing. What are your
thoughts on this practice? Has it affected your job directly?

McSwain (Production MT): I guess you could say offshore outsourcing
has affected my job: I have actually worked in India, for an Indian
company, helping to upgrade their MTs' skills. Therefore, I am very
aware, on a personal level, of the talents, problems and life
stories of Indian MTs. In the context of that vast, crowded and
still poor country, I can't help but applaud those folks who put
out the time, trouble and money to become MTs. Their training,
intelligence and contact with the world outside India are good
things for India and the world.

None of which, arguably, has anything to do with the question of
whether Indian medical transcription is good for U.S. MTs or the
medical transcription profession. Except possibly this: in India I
learned that it is just as hard to find a good MT offshore as it is
in the United States, if not harder. They're there, but they're
rare and valuable. Furthermore, many people trying to do medical
transcription in India are not well trained and have a shaky
command of English. (Unfortunately this sometimes seems to be true
in the United States as well!) I don't believe that even full
acceptance of Indian MTs would lead to a glut of MTs: the number of
people willing and able to be excellent MTs will remain limited
globally.

Simpson CEO, Spheris: As a company that provides outsource services
and technology for medical transcription, we listen closely to our
clients and respond with solutions customized to their needs. The
health systems, hospitals and practices we work with are facing a
capacity issue: an escalating demand for digital clinical
documentation and a shortfall of MTs. That's the reality. They're
also asking for off-hours coverage and true around-the-clock
service. After 2 years of discovery, Spheris decided that providing
a global workforce-in addition to increasing our U.S.-based MTs-was
in the best interests of our clients. As a result, we immediately
increased our capacity by more than 1,000 MTs by acquiring a global
operation with a successful 10-year track record.

Frame (Manager at BryanLGH Medical Center): Whether we approve or
not, I believe offshore transcription is here to stay. Therefore,
the best thing we can offer the transcription profession/industry
is to assure the MTs in other countries receive the best training
possible. This, of course, takes time; and I don't believe the
offshore MTs have had enough time to be trained adequately. But
aside from all that, offshore companies are making pretty
compelling offers to employers in the United States. Just recently,
I had the opportunity to be involved in a presentation/demo from an
offshore company out of India, along with several of the larger
dictation/transcription vendors in the United States. In terms of
money, the offshore company won hands down. With the cost of health
care today and everyone needing to cut corners, offshore
transcription is very tempting.>

<What are your thoughts on SRT? How is it affecting the industry?

Cameron (Snr VP, MedQuist): SRT, as introduced years ago, was
largely still a technology being tested within health care. In
recent years, technology improvements have led to greater
adaptation and less frustration. We currently see a trend where
health care organizations are utilizing SRT as an alternative to
offshore transcription, in which they have better control over
their own destiny with regard to the security and turnaround of
transcription. Organizations are seeking a co-existence between
dictation, point-and-click, transcription and SRT to address the
increase in documentation as the health care needs of baby boomers
steadily increase.

Howe (Immediate-past president of AAMT): SRT is elevating the value
of medical transcription by shifting focus from a "typing"
mentality to one of the role of "editor." When health care
providers prove to themselves that their time is best utilized when
focused on patient care, documentation practices will shift toward
information processing and a rising need for expert language
specialists to edit, review and ensure clean data in our
information systems. There will always be the need for an expert MT
to partner in the documentation process and SRT validates that.>

<What type of measuring stick does your employer use to gauge
productivity and quality? Are there cases in which productivity
pressure compromise quality?

Iwinski (CEO, Acusis): At Acusis, productivity is never given
priority over quality; in fact, our MTs are compensated based on
the quality of the reports they transcribe rather than quantity.
Our Affinity Solution is a process that assigns MTs to focus
exclusively on one account after implementation, which greatly
improves familiarity, consistency and delivery. In the event an
increase in transcription volume occurs, buffer production capacity
is built in our system and due to a healthy pipeline maintained by
our recruitment department, any permanent increment in volume is
handled on a proactive basis.>

<How important is certification in the medical transcription
industry? Do you think credentials/licensure should be mandatory?

Cameron (Snr VP, MedQuist): We see the potential for certification
in the medical transcription industry to become necessary in the
near future, but it will be an effort that will require MTSOs and
AAMT to work together cooperatively. Universal acceptance of
certification within the industry will promote standardization and
convey a standard value level to prospective employers and clients.
At this time, we do not envision that licensure would be made
mandatory.>

To read the entire feature, go to:
http://health-information.advanceweb.com/common/Editorial/Editorial.aspx?CC=5762\
8&CP=1

Ciao!

Maj (Dr) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.mtindia.org
"The Community of MT Professionals"

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NEWS AND VIEWS :
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1) Medical transcription comes home

It's a daily ritual for thousands of homemakers across India. After
sending husbands to work and kids to school, they download voice
files and start transcribing medical illnesses of patients in the
US.

Slowly, medical transcription from home is becoming a phenomenon,
particularly in tier-II cities where the BPO boom hasn't yet caught
on and educated women are still not being encouraged to venture out
of home.

"Almost half of our 600 home employees are women. Working from home
allows them to spend more time with family," said Mr Rajiv Shetye,
VP, Spryance, a Boston-based medical transcription firm which now
has 1,200 employees in India.

According to estimates, India has about 100 medical transcription
companies and the big ones include Accusis, Spryance, Spheris and
Heartland. About 10,000 people work in the $120 million-strong
industry.

Still, there is a lot of untapped potential. The US market for
market transcription is about $12 bn per annum, which is more than
double the BPO exports of India. More than 700 million hospital
events need to be recorded every year. According to Nasscom, about
1.6 lakh such transcriptionists will be needed in India by 2008.

http://www.financialexpress.com/fe_full_story.php?content_id=99771

2) Why medical transcription is such a major draw

The medical transcription business is drawing people from other
sectors. That's because the income can be quite substantial.
Transcriptionists are paid anywhere between 60 paise to Rs 2.0 per
line. At a minimum of 6 hours and transcribing 800 lines per day,
transcriptionists can make around Rs 1,200 a day. Working 26 days a
month, they earn more than Rs 30,000 a month. They send their
reports to an editor for proof-reading who are paid upwards of Rs
40,000 per month.

As a result, hundreds of professionals are quitting their regular
jobs to assist US doctors in transcribing their conversation with
patients. X-ray, pathology, surgery and discharge reports of US
patients are also being transcribed out of India.

To be a transcriptionist, an aspirant has to acquire skills in
medical terminology. The next step is the editor. Level three is a
quality analyst (QA) who has to work out of the office of the MT
firm.

http://www.financialexpress.com/fe_full_story.php?content_id=99806

3) Outsourcing trend claims hospital jobs; Evergreen to save
$400,000 a year by contracting out transcription work to Spheris

Seventeen employees of Evergreen Hospital Medical Center in
Kirkland will lose their jobs, most by Aug. 31, victims of a trend
toward outsourcing the work of medical transcriptionists. Spheris,
a Franklin, Tenn.-based contract medical transcription company,
will begin today to take over the work of typing doctors' dictation
into Eastside patients' records, hospital spokeswoman Amy Gepner
confirmed Monday.

The taxpayer-supported hospital expects to save $400,000 a year
over its current costs for transcription services, including
salaries and benefits, Gepner said. But the move is also being made
because existing transcriptionists cannot keep up with the workload
without a $500,000 to $750,000 investment in equipment as well as
personnel. ``It doesn't make business sense to be significantly
increasing the cost,'' Gepner said.

The contract with Spheris also requires that no work be sent out of
the country and that all 17 Evergreen transcriptionists be offered
jobs, Gepner said. ``Three have chosen to go with Spheris,'' she
said.

Some employees complain, however, that the contractor is simply not
offering a living wage. Spheris offered 7.5 cents per line, said
one transcriptionist, who asked for anonymity for fear that a
``measly'' severance package would be withdrawn.An average Spheris
worker would make less than two-thirds that of an Evergreen
employee, according to the figures the transcriptionist provided.

Evergreen transcriptionists earn $13.50 to $19.62 per hour, plus a
7-cent per line bonus for more than 938 lines a day. At a
consistent day's work of 1,200 lines, the midrange Evergreen
employee would earn $150 a day, compared to $90 for the Spheris
worker. ``I have to pay a mortgage, pay bills,'' the
transcriptionist said. ``I can't live on that kind of wage. ... I'd
just be giving my expertise away.''

http://www.kingcountyjournal.com/sited/story/html/214991

4) MedQuist Announces Preliminary, Partial and Unaudited Financial
Results

Once the Company completes the financial assessment and review of
its billing practices disclosed in the Company's previous filings
with the SEC, the Company expects that an independent registered
public accounting firm will review and/or audit the Company's
financial statements, as appropriate. While, at this time, the
Company cannot estimate the total costs of (i) the billing review,
(ii) defense of the class action matters, (iii) the SEC
investigation, and (iv) compliance with the
Department of Justice investigation, all of which have been
previously disclosed in either the Company's filings with the SEC
or the Company's press releases,
the costs incurred to date by the Company in connection with the
foregoing have been included in the results set forth below.

http://www.prnewswire.com/cgi-bin/stories.pl?ACCT=104&STORY=/www/story/08-19-200\
5/0004091410&EDATE=

5) Transcend and MDI Founder Announce Stock Option Agreement

Transcend Services, Inc. announced that a co-founder of Medical
Dictation Inc. ("MDI"), Sue McGrogan, has agreed to invest $200,000
in Transcend as of August 15, 2005 through the purchase of 71,942
shares of common stock. This purchase is part of an overall option
agreement that provides four options to purchase $200,000 each that
could result in $800,000 of total investment over the next two
years. Half of the investment will be in cash and the other half in
the forgiveness of a note due to Sue McGrogan from her sale of MDI
to Transcend. These purchases will be made at a price of 110% of
the average market price for the ten trading days prior to said
purchase. The remaining three options are exercisable on the six-
month anniversary dates of the execution of the option agreement
and cannot be carried forward once the option date has passed.

http://www.tmcnet.com/usubmit/2005/aug/1174534.htm
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The MTIndia Team
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