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One of the most challenging aspects of a transcription program can be working with vendors. In the final installment of the Journal's four-part series on transcription, learn how to lay the foundation for a strong, enduring relationship with your transcription vendor.

You may be struggling with contract issues with a vendor. Or maybe you're contemplating the pros and cons of working with outsource, at-home, or overseas transcriptionists. It's a fact: if transcription processes aren't working efficiently, the entire HIM department may be adversely affected. Factor in additional concerns such as data capture for electronic health records, compliance, and patient safety, and the importance of ensuring quality and cost-efficient transcription becomes even more apparent. To help you answer some of these questions, the Journal of AHIMA is launching a four-part series dedicated to transcription issues from the HIM professional's point of view. In this issue, we begin with MTIA president Scott Faulkner's overview of the industry and where it's going next. In upcoming issues, other experts will look at controlling cost and monitoring quality, navigating new technologies, and dealing with contract-related issues.

The hybrid record--both paper and electronic--is a cumbersome byproduct of the evolution to the computer-based patient record. Nancy Walker describes how William Beaumont Hospital managed its information services with this mixed media record. Her article provides practical solutions for health information managers including downtime procedures, report distribution plans, release of information steps, and audit procedures for maintaining confidentiality.

Virtually there. Natural language or textual data in the patient record plays a critical role in medicine. Read about the innovative system LDS Hospital has implemented to integrate textual data into the computerized patient record.

The results of the concentrated transcription program provided objective information that gives credibility to both sides of the transcriptionist training debate. In addition, the results provided the objective data needed to support changes in the curriculum. Students who are exposed to solid classroom teaching, coupled with enough opportunities to develop and practice transcription skills, have a better chance for success than those who rely solely on classroom instruction or solely on experience or on-the-job training. It is clear that increasing the number of hours of actual transcription results in an increase in the productivity and accuracy of the student's medical transcription.

We have seen document preparation systems evolve from basic line editors through powerful, sophisticated desktop publishing programs. This component of the application layer is probably one of the most used, and most readily identifiable. Ask grade school children nowadays, and many will tell you that they have written a paper on a computer. Next month will be a "fun" tour through a number of other application programs we find useful. They will range from a simple notebook reminder to a sophisticated photograph processor. Application layer: Software targeted for the end user, focusing on a specific application area, and typically residing in the computer system as distinct components on top of the OS. Desktop publishing: A document preparation program that begins with the text features of a word processor, then adds the ability for a user to incorporate outputs from a variety of graphic programs, spreadsheets, and other applications. Line editor: A document preparation program that manipulates text in a file on the basis of numbered lines. Word processor: A document preparation program that can, among other things, reformat sections of documents, move and replace blocks of text, use multiple character fonts, automatically create a table of contents and index, create complex tables, and combine text and graphics.

This study serves to evaluate the effects of computer monitoring on the performance of medical transcriptionists. The results of the study show that performance increases in the monitored state but that perceived levels of stress decrease in the monitored state. Previous studies are discussed in light of health information managers' use of monitoring technology to increase the effectiveness of medical transcriptionists.

A transcription service must be able to access the dictation system and other systems in transcribing a client's medical dictation. Hence, connectivity and compatibility are vital considerations.

Health information managers must be more aggressive in defining the technology and standards for dictation and transcription equipment and services. The author offers many ideas on how to tame the technology jungle out there!

A fascination with telecommunications and technology has enabled this author and her corporate information systems department to achieve system integration and simple functionality in a comprehensive and diverse medical transcription unit.

Because of the demand for accountability and the necessity that the medical transcription department function as a revenue-generating entity within the hospital structure. HIM professionals are rejecting inadequate solutions and looking for long-term improvements in medical transcription quality and productivity. It has been our experience that many hospitals and clinics are opting to train in-house. This is a cost-effective solution which can quickly provide a return on investment if managed properly. Many HIM professionals choose this solution because it ultimately affords the highest level of control in areas of quality assurance and turnaround time. It is also seen as a long-term solution to continuing staffing shortages, particularly in areas where medical transcription courses offered by local educational facilities are inadequate or nonexistent. Thus, strategic planning to guarantee both quality medical transcription and revenue-generating levels of productivity may involve implementation of an in-house training program. Such a solution will undoubtedly factor into balancing the equation of supply and demand as it pertains to medical transcription staffing in the future.

Technology is great, but people make the systems work. This is an example of what can go wrong when the users are not involved in decision making. But working as a team, the transcription and management staffs can create a happy ending!

Understanding what transcription costs and controlling the costs are two interrelated subjects, yet two very different subjects. Understanding what it costs is critical for your budgeting activity. Controlling the cost is essential for your management effectiveness.