MT India Newsletter - http://groups.yahoo.com/group/MTIndia

28 Dec 2002

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Analyzing Quality Control (part II)
~Suresh Gonsalves

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ANNOUNCEMENT
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A happy New Year 2003 to all!

The MTIndia Team
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Dear Friends,

This is a continuation from Suresh's article, published in the last
issue. To read earlier MT India Newsletters, see the archives at:
http://groups.yahoo.com/group/MTIndia

Enjoy !
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Continued from last issue...

For entry-level medical transcriptionists or new employees or
beginners, it is absolutely necessary to listen to the dictation as
their work is reviewed. No history of quality levels for these
individuals exists. Every medical transcriptionist has a different
pace, but at the end of a 60-day or a 90-day period, the quality
department or the quality assurance transcriptionist will have a
clear picture of the current and potential quality of that
individual's transcription ability and inherent skill. Once the
medical transcriptionist has established credibility in quality
production, proofing automatically on the screen instead of the
printed report is the most cost-effective way to assure quality.
Printer ribbon waste, unnecessary paper waste, and subsequent
reprints are eliminated, and the listening time is also greatly
reduced. The quality controller or the quality assurance
department will then listen only for garbled dictation doubts,
flagged blanks, hypertexted words, specific doubts, or for
clarification. The quality control department will then provide
useful and constructive suggestions to the medical
transcriptionists for ways and means for improving their quality in
every aspect of medical transcription.

There is another way of maintaining quality at the highest levels
and that is by periodic internal audit checks of all the medical
transcriptionists in the organization or company. They could be
evaluated for errors and a suitable score of 85 to 100 could be
established to ascertain their prowess. This internal audit will
help to become a significant part of the medical transcriptionist's
evaluation process. This procedure will also add greatly and very
significantly to the credibility of your transcription department
or organization which will prove to be a boon in the long run in
earning goodwill and new clients, and hence, subsequently greater
profits.

These individual audits will prove to be a definite indicator of
the individual medical transcriptionist's quality, skill, and
ability to cope with the daily rigors of medical transcription.
Collectively, they are a significant, full, and a complete measure
by which the quality of a transcription department or organization
or company is gauged.

The expertise of medical transcriptionists is unmatched when it
comes to the dictation/transcription process for patient care
documentation. An ultimate goal should be to establish fair and
achievable standards for the employees of an organization.
Everyone would be more satisfied with the results if the standards
that are developed were based upon the experience and
characteristics within a particular department fixed as a model so
as to gauge the various standards existing within that department.
In the process of developing the standards for this model
department, one can come across several conclusions which could
shape and redefine the goal more clearly. The following are some
of the more pertinent conclusions that can have a more direct
bearing on the quality assessment and quality control:

1. The method that is used to capture and record productivity data
should be consistent and completely reliable. The more automated
the process, the less likely the results would be questioned.

2. Performance standards should balance quantity and quality.
While timeliness is important, the integrity of a medical document
is established by the accuracy of its content, not by the speed
with which it is produced.

3. Quality assessment should be based upon specific criteria and
accepted sources of reference and should always be carried out by
experienced medical transcriptionists with extensive knowledge of
the work being evaluated.

4. The process of designing an acceptable method for evaluating
quality and accuracy is a much more complex method. One can
realize that it would be impossible to examine every page of
transcription produced in the department, but one should take a
sample size that would give a reasonably accurate picture of
individual work quality.

5. As much as is practically possible, performance comparisons
among medical transcriptionists from different work environments
should be avoided. Significant variances in employee experience
and training, the nature and content of dictation, the age and
functionality of equipment, and the physical environment in which
employees function all have a significant effect on their ability
to process information and transcribe it into text.

6. Standards should reflect current working conditions and levels
of individual ability and should be reviewed periodically to assure
continued applicability.

7. An ideal and practical quality analysis plan should be one that
evaluates a full day's work, once a month, for each individual, for
a total of 12 samples annually. The samples are randomly selected,
varying the primary work assignment and the day of the week.

........to be continued.
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Cheers, and Happy New Year - 2003 !!!

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

"It takes years to become an overnight success."

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NEWS AND VIEWS :
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1) Kalam to open Mysore IT.Com

The President, A.P.J. Abdul Kalam, will inaugurate "Mysore IT.Com
2002." Addressing presspersons today, the President of Mysore IT
Forum, Shivaram, said the most important event during the four-day
mega expo would be the "CEOs' Conclave" in which Chief Executive
Officers of various IT companies would participate in a
videoconference with their counterparts in Mysore.

Prof. Shivaram said the "Theme Pavilion" would be the interface
between IT businesses and the common man. It would showcase IT
applications that had made an impact on the common man. The
applications to be showcased included mapping, satellite imagery,
Geographic Information System (GIS), animation, 3-D modelling, walk
through applications, BPO sector comprising a mock call centre,
transcription services, digital printing products, telemedicine,
smart commerce applications, technology enabled education,
e-banking, and use of Sanskrit in computing applications.

http://in.news.yahoo.com/021225/16/1zhcd.html

2) It's the strategy that counts

Strategy is about the 'Where' or 'Which' to commit resources in
terms of time, people and money to meet an objective. Creating
wealth involves exploiting imbalances or disequilibrium in the
market. Organisations can either create disequilibrium or exploit
existing disequilibrium.

One way to exploit a developmental disequilibrium is by
manufacturing or providing services from the less-developed
societies to the more developed. The garment exporters of India did
just this during the export boom of the 1970s and 1980s. Today,
software giants Infosys, Wipro and TCS are doing something similar.
They produce goods (or software) here because production costs are
cheaper here than in developed societies. This holds true for
services such as medical transcription and call centre operations
as well.

The danger inherent in this disequilibrium is that sooner or later
lower cost producers will emerge in other less developed regions of
the world. For instance, garment exports took a beating following
the migration of orders to lower cost producers in China, Sri
Lanka, Bangladesh, or Nigeria.

To overcome this problem, there needs to be a move up the value
chain. The Indian software giants are trying to do just this when
they say they want to move from being service providers to
consulting and finally to product development. In other words,
eventually the move has to be from a developmental disequilibrium
to creating a technological disequilibrium.

http://in.biz.yahoo.com/021222/17/1zez9.html

3) Training institute ordered to refund fees

District Consumer Disputes Redressal Forum has ordered Mr. P.S.
Jayakumaran Nair, former director of the Lakhotia Computer Centre
(LCC) here and the managing director, Jay Info Systems, Technopark,
to refund the course fee of Rs. 10,000 and to pay Rs. 7,000 as
compensation to Ms. Lekha Mohan, one of the students, who had
approached the forum as the defendant refused to refund the course
fee despite his failure to give her a placement.

http://www.hinduonnet.com/thehindu/2001/05/05/stories/0405404n.htm

4) They work when others sleep

All said and done, life in a call-centre is certainly not as rosy
as it appears to be.

The first cue has to be taken from the fact that people here adhere
to Jawaharlal Nehru's theory of becoming great for "they toil when
others sleep". Well, not really. As most of their business dealings
concerns people on the other side of the globe, they are under
professional compulsions to work when others have retired and
fallen fast asleep in the snug comfort of their house. "Believe me,
there's nothing great about the job that we do. Initially, although
the job appears to be interesting, over a period of time it just
turns out to be very routine and stereotype. It is just because of
the money they pay that most people are sticking around," says GE
call associate C.K. Praveen forbiddingly. "But that is how a
back-end office job is supposed to be - mundane and monotonous and
that is why these odd jobs have been outsourced from the cash rich
countries," ponders ICFAI Research Associate P Vijeender Reddy.

"If you tell me that anybody's aim in life was to work in a call
centre or back-end office, you are either lying or relating to me
the blasest person's ambitions," says a top manager in the Hong
Kong Shanghai Banking Corporation (HSBC), requesting anonymity.
"Indeed such a job happens by chance or is very incidental to the
point of being an opportune job," he adds.

GE Quality Call Instructor Beena Menon says, "At times, receiving
calls and answering queries of the customer becomes so draining
that our voice gets choked. Add to it, the unparliamentary phrases
that you have to take in from the client at times without the least
show of annoyance."

http://www.hinduonnet.com/thehindu/mp/2002/07/15/stories/2002071500
950100.htm

5) Healthcare software: Many imponderables

Thanks to the IT-expertise which India has, healthcare software is
fast becoming one of the hot IT segments for Indian companies.
Valued between $20 and $40 billion, the Health Insurance
Portability and Accountability compliance programme (HIPAA) segment
is expected to grow to $60 billion with a CAGR of 12-13 per cent by
2004, according to Gartner estimates.

Unless healthcare software providers take heed of these concerns
voiced by leading healthcare software players, the burgeoning
HIPAA/healthcare industry might be a repeat of the medical
transcription segment which witnessed a bust and consequent
consolidation.

http://www.hinduonnet.com/thehindu/biz/2002/06/03/stories/200206030
0080200.htm

6) Computers replace doctors' scrawls

Like other hospitals in the country, the Children's Hospital of
Pittsburgh recognizes that potentially deadly errors can be caused
by indecipherable handwriting, a memory lapse or other mistakes.

So, the hospital has joined a small percentage of the nation's
medical centers in installing a computerized system for doctors to
prescribe medication, order a blood test or check a patient's
weight.

The system, known as a computerized provider order entry and
electronic medical records system, could replace many paper forms,
such as prescription pads, said Dr. Eugene Wiener, the hospital's
medical director.

The Leapfrog Group, a coalition of more than 100 organizations that
provide health care benefits, has identified this kind of system as
a key way hospitals can reduce medical errors and prevent deaths
caused by mistakes.

http://www.poconorecord.com/local/tdo62546.htm

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The MTIndia Team
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