Evolution in Workforce Development through Technology Uptake

The need for skilled healthcare workers working in close tandem with clinicians has never been greater than this. A lot of demands have been placed on healthcare facilities and enterprises to meet measurable goals, report core measures, and implement quality data metrics for HIE.

A properly prepared and educated workforce aids the dynamics within the healthcare industry to achieve organizational goals for meeting meaningful use objectives. A combined team of diverse leadership, including clinical and non-clinical roles, IT, project management, analysts, and support services, enable change management to occur between both the informatics team and the business side of the organization combining common vision, mission, and goals.

New regulations in healthcare change the dynamics of an enterprise to focus on adoption of technologies, centered with attainment of meaningful use objectives, achieved on time. One such attribute, combining efficiencies, is the development of the nation's first online medical scribe program with instructor facilitation. Both ScribeAmerica and TRSi Corporation recognized a timely need to bridge the gap from traditional roles and enable online educational outreach to prospective students and facilities. In the past, medical scribe training programs typically included an application process, followed by a screening process selecting pre-medical students, second year and above. Today an innovative curriculum has been co-developed with Chief Medical Officer, Luis Moreno, MD, of ScribeAmerica in tandem with Director of Curriculum Development, Kristin Hagen, CPEHR, CPHIT, CPHIE, of TRSi. Both companies share unique perspective to supply the industry with long-term quality educated scribes to sustain healthcare systems, multi-specialty clinics, and rural or urban practices.

Obtaining the appropriate education, skill set, and credentials are a necessity to fully develop and participate in best practices for the organization, increase patient safety, and ensure risk management mitigation is taking place within the US Healthcare System. Standards must be adopted and met to ensure the right solution in stepwise fashion for health information exchange partnered with the communities. Technology adoption is moving at a faster pace, and it is imperative allied healthcare workers understand the opportunities in front them.

Below is a shared link from social media networking regarding medical scribes and their inherent value as a professional career or stepping stone. With solid education, medical scribes add yet another dimension to the healthcare delivery model to aid physicians, promote patient safety, and aid overarching goals of real-time documentation delivered at the point of care.

The self-paced online curriculum is provides the allied healthcare student with broad-based education and understanding in HIT through simulations aiding clinical understanding. Coursework includes anatomy & physiology, pathophysiology, human disease processes, pharmacology, medical terminology, diagnostics and radiology, alongside non-clinical instruction which includes industry understanding of billing and coding levels, case studies, and data entry input methods into an EHR system. TRSi is focused on building the next-generation workforce and deems its mission on equipping "work-ready graduates" to successfully transition to industry scribe positions for physicians, facilities, and staff.

Emergency Medical Scribes & Other Allied Healthcare Scribe Opportunities.

AHDI Series: "Let's Talk About...Quality from a Patient's Perspective"

The latest in a series of open letters to the medical transcription industry, entitled, "Let's Talk About...Quality," has been authored by Susan Lucci, RHIT, CMT, AHDI-F, and Kristin Hagen, CPHIT, CPEHR, CPHIE, AHDI-F. In this article, Susan and Kristin approach the topic of quality from the patient's perspective, in the context of the push toward electronic health records and greater patient participation in the healthcare delivery process. They point out the value of the Healthcare Documentation Quality Assessment and Management Best Practices Tool Kit, developed jointly by AHDI, CDIA, and AHIMA, in helping to promote quality in healthcare documentation. The authors also point out that even though it may seem that quality is of lesser value than pricing to some clients, the importance of accurate medical records is of great concern to consumers of healthcare services. Furthermore, as experts in the field of healthcare documentation, medical transcriptionists bring added value to the documentation process.


"Let's Talk About...Quality" is the second in a series of four articles specifically intended to lead in to an online AHDI Town Hall meeting on the topic of "The Value of Association" to be held Tuesday, April 19 at 4 p.m. Pacific/7 p.m. Eastern, hosted by Barb Marques and Ava George.

--Jay Vance
AHDI Lounge Moderator

AHDI Series: "Let's Talk About...Medical Scribes"

Recently TRSi partnered with ScribeAmerica to jointly form an online distance learning educational training program for the allied healthcare documentation sector.  The partnership is an industry's first, complimenting the greater healthcare system in tandem with other healthcare professionals.  I have included some common questions and answers to better understand the quickly emerging and developing career opportunity geared to evolving and transitioning medical transcriptionists, pre-medical students, seekers of second careers, the unemployed, and those interested in working clinically alongside a physician through the mainstream of healthcare. You will see a preview into this growing career field.  Enclosed is the open letter, "Let's Talk About...Medical Scribes," authored by myself.

What is the background of a medical scribe?

Scribes have been around since the early biblical days. Today scribes are commonly referred to as Clinical Information Managers. The primary function of a scribe is the creation and maintenance of the patient’s medical record, which is created under the supervision of the attending physician. The scribe documents the patient’s history and story through the physician’s interaction with the patient, procedures performed, the results of laboratory studies, and other ancillary information gathered at the point of care. Scribes follow the workflow of the patient(s) under the direct care of the physician.

What are current scribing trends and models?

Medical scribes have commonly been deployed into emergency departments to provide real-time supportive services to busy emergency room physicians by documenting clinical patient encounters as they occur through direct data entry into the EHR. They serve as a right hand to the ER physician in capturing the care encounter while also coordinating the presentation of diagnostic data to assist the physician with clinical decision-making.

There are various levels of scribe training programs from local to national organizations, designed to create efficiencies within the US healthcare system. The demand has traditionally been filled with eager pre-medical students, learning first-hand about the workflow patterns and patient care they will deliver in the future. As a medical scribe, the role is focused on creating comprehensive and complete medical records and eliminating some duplication of tests. The base education has been set around medical scenarios, case management, disease processes, medical terminology, anatomy and physiology, coding, and other biological processes. Scribes are pre-screened for the selection process.

What are the skill set requirements and training required to become a medical scribe?

Medical scribes may be trained on site or through affordable online distance education programs. Skill sets include strong English grammar, a compelling interest in healthcare and patient improvement, a strong desire to work in a clinical setting, superior analytical and resource skills, understanding and training in enabling technologies (with computer and keyboarding skills), an understanding of information workflow, attention to detail, keen listening skills, and strong multi-tasking abilities. A scribe, by design, is a self-starter who works well in a variety of different settings and paces and follows directions well. The medical scribe is the physician’s assistant and is continuously utilizing a strategic thought process. The individual also has a desire to work within a team of allied healthcare personnel. Together the physician and the scribe partner to create a comprehensive and meaningful care encounter record. Scribes are also expected to be well-versed in HIPAA and regulatory compliance, and like MTs, scribes have a steep learning curve, with clinical shadowing required in the post training phase.

How does medical scribing connect to the broader documentation spectrum and other health information management (HIM) roles?

Medical scribes are a central liaison within any healthcare facility, surgical center, or emergency department. They uniquely interact and collaborate with other members of the healthcare team, tracking patient information, including ancillary departments of laboratory and radiology departments. Medical scribes adapt to technological needs of the facility, understand the basis of electronic record systems, coding practices and levels, medical decision-making, and the disposition of the patient. Medical scribes fill a need identified by market demands. Physicians focus on the patient, documentation is tracked and delivered in real time, and documentation is available at the point of care, as defined by our healthcare system.

Could this be a stepping stone for medical transcriptionists and others in the medical transcription field? Is this an alternate career path for medical transcriptionists?

There are similarities and distinct differences between medical transcriptionist and medical scribes, as are there in comparing these roles with any other health information management role. Just as medical scribes would need additional training to transition to the unique application of a traditional transcription skill, with some additional training in specialized applications, medical transcriptionists would also be uniquely qualified to fill the roles open in the emerging and growing field of scribes. One thing is certain. National mandates and incentives will increase the adoption of electronic medical records. Healthcare will need professionals who have a flexible resume of contributory skills applicable to an EHR-centric documentation setting. Scribing is a potential alternate documentation setting for medical transcriptionists. All allied healthcare personnel and career fields will continue to adapt, evolve, and emerge alongside medical transcriptionists, medical insurance specialists, health information managers, medical informatics, and other quality documentation analysts to blend roles and skill sets forming a sophisticated electronic network globally. Like all medical professions, continuing education is imperative for the well-being of the allied healthcare system.

Similar to medical transcription, medical scribing provides another career pathway, or stepping stone, to the broader healthcare system. Utilizing knowledge and skill sets through a variety of roles, the medical scribe is focused clinically, observing the patient’s encounter, documenting alongside a team on site under the physician’s care. Healthcare career opportunities are anticipated to grow, and these career fields offer a springboarding opportunity to other roles, as desired. The market will continue to adapt, evolve, and innovate, and we need to be prepared to do the same.

As a close observer of the scribe profession through new training programs, I can tell you that transcribing and scribing are neither competing nor complementary. They are quite unique, with some overlapping fundamental training but with divergent connection to technology and practical application. They are simply two of many current and evolving roles for those who desire a role in documenting healthcare encounters. It’s a matter of choice and options – and depend greatly on the individual in terms of personal choice for role, setting, and training.

The AHDI Lounge has setup a place for positive discussion and welcomes all to attend the Town Hall series to discuss emerging roles and other top-of-the-mind industry topics in greater detail.

Appreciating Where We Are Going...

The holidays are upon us and many traditions in families will be repeated with some new additions created to bring holiday cheer. The spirit of friendship, football, cooking, and decorating is inevitably in the air. This holiday season there are many things to look forward to warming our hearts: Christmas tree decorating, snow sledding, hot cocoa making, sitting beside the fireplace, singing holiday hymns, dressing Christmas cookies, attending social gatherings, watching holiday movies, and stringing up Christmas lights in the cool weather to name a few.

Reflecting back on 2010, there are many blessings and this is a time to step back and reflect on what we have and those being built. It is also important in our lives to recognize the changes we have endured, and continue to adapt to, managing our lifestyles and livelihoods, staying ahead of the curves in life. Though we are progressing ahead with some uncertainties and hopes for our nation to restore its economic vitality, we must keep moving ahead to see the light that reaches beyond the next bend.

Like many of you, this year I made an important decision in my life to blend my education and skills into the industry. I am employed as the Director of Curriculum Development, focused on building allied healthcare workforce development. It is a blessing to see my healthcare business expand into the industry, serving my client's needs, solving complexities in healthcare, and enabling our skills to meld into new goals together.

The healthcare industry is certainly on the minds of many Americans, as are the health professionals who serve in this line of work. Refined medical procedures, treatment modalities, and technological advancements will reshape our healthcare out of necessity to further solve complex medical problems plaguing our nation. There is a true appreciation, walking an evolving career path, similar to all of you to building patient safety modalities into model curriculums, ensuring standards of practice are instituted into the medical record process.

Through government incentives, electronic medical records will become a fluid part of medical practices. Structured, encoded speech recognition, enabled through natural language speech processing, will allow physician-preferred workflow practices to ensue. The human knowledge worker, trained and skilled through formal education and speech recognition editing course curriculums, will be prepared and equipped to remain the benchmark of physician-dictation workflow processes. One must prepare ahead of the curve for best positioning.

Similarly, the medical coding and billing profession is also experiencing dynamic and rapid change with technologies of computer-assisted coding. Together medical language specialists and medical insurance specialists have similarities in documentation collaboration, creation, and delivery to the end point. Both allied health professionals will remain vital components to documentation creation and the art and science to establish a complete medical record workflow process, telling a patients' complete medical records story.

Regardless of data entry input method, the key will be to ensure the workforce follows the trend and enters the profession to create opportunities of delivering medical records at the point-of-care for the patient. Sophisticated developments in cell phones, digital recorders, computer entry, personal health records, GPS entry, and telemedicine will have its place and increase market share in the foreseeable future. Continuing education is necessary to keep up with the trends, laws, and regulations affecting medical data specialists.

The career opportunities today are very diverse with new paths being created and opened every day. Distance learning opportunities through approved partnered healthcare associations will open the doors to your future and allow transition in our healthcare system during this vital moment in time .

If you have been contemplating adding to your skill set, retooling, or learning a second trade with your skills established, the time is now to begin additional career training. This is an investment made in yourself. Our nation, healthcare industry, and communities (rural or urban) need your expertise to bridge the gaps in preparation for medical records implementation and established health information exchange systems. Healthcare will undergo significant change over the course of the next 4 years, transitioning, and reshaping itself.

I encourage everyone to consider an allied health professional career, where interest is deemed. The opportunities are endless long term - use your background, experience, prior education, and resources you have to evolve into a hybrid career that bridges the gaps in professional workplaces. Data analysts, registrars, educators, health information managers, information technologists, information exchange collaborators, community leaders, and regional extension center implementers are in demand with new enroads in the future.

As this New Year approaches, reach out and make some important choices in yourself that will continue to grow your knowledge and education for the benefit of continued patient safety, medical records administrators and physicians, hospitals transitioning to integrated electronic medical records to the envisioned National Health Information Network. It is a journey together that will branch into multiple new directions.

From a service leadership standpoint, I look forward to celebrating with you this holiday season for many areas of life, and the contribution and difference you make. Take time with your families building holiday memories and have a very blessed season, giving thanks. Enjoy your Christmas celebration and New Year's resolution. Bless you all!

The Evolvement of our Profession Through Meaningful Use

As we head into the Association for Healthcare Documentation Integrity (AHDI) Annual Conference and Exposition (ACE), I cannot help but wonder how many professionals are analyzing the effects meaningful use will have on our evolving career path. New rules and regulations have been put before our sector for practices to meet the requirements of a comprehensive electronic health records (EHR) system.

Many disparate systems and data silos make up a large percentage of information that cannot be reused, repurposed and analyzed for higher-level patient care. New technologies in the transcription sector bring natural language processing to the forefront, allowing structured, narrative, encoded data to directly input into electronic medical record systems and health information exchanges, including Health Story Project. Through government fund allocation, Regional Extension Centers (RECs) have formed in geographic locations to include key stakeholder participants that are helping states adopt, implement, upgrade or demonstrate meaningful use EHR technology. Community-wide focus of data sharing is at the epicenter. The Centers for Medicare and Medicaid Services (CMS) have allocated funds for eligible physicians and hospitals who meet "meaningful use" criteria through electronic records to receive incentive payments for years 2011-2015. A stringent set of minimum requirements must be met by the provider following its 90-day request to access the funds for eligibility of stage 1.

RECs are in the process of making recommendations of current and future needs for their respective communities. Once complete, health informatics technicians will be needed to assist and deploy the technology investments. We are at a tipping point of seeing many changes occur within healthcare and its respective careers.

The National Health Information Network (NHIN) is vital to the evolvement of patient care coordination and health services in the United States. As a country, there are a multitude of areas where benefits will be seen, including saving lives, disease control, community wellness screening, reduction of duplicated services, and an overall cost savings to enable efficiencies through real-time data, at the point of care, for decision-making. Patients' contribution of their personal health record (PHR) will help level communication with their caregiver, thus ensuring treatment, referrals and transport mechanisms stay within reasonable cost to the system.

How does the evolving medical language specialist and HIMs fit into these changing roles? First and foremost is understanding the medical record process and enrolling in a school approved by the Approval Committee for Certificate Programs (ACCP). Second, earn the credential and market yourself and your skill set. AHDI has partnered with Health IT Certification through its Vendor Affiliate Program to offer specialty credentials, (i.e. CPHIT, CPEHR, CPHIE, Privacy and Security credentials) at a discounted rate to AHDI members. Formalize education and training to evolve with the cyclical change we are facing over the next several years. Together we must recognize this and work collectively to be a part of the complex solution that lies ahead.

Highly trained medical language specialists and HIMs are well suited for evolving roles through their experience with their knowledge, understanding, eye for evaluating patient errors, and critical analysis skills for a quality and cost-effective healthcare system. Clinical decision support software is an enabler. The people with the technology must remain a part of the system throughout the document lifecycle, furthering job creation to a sustainable workforce. Many challenges bring new opportunities: understand the technology, develop workforce-ready graduates, bridge communication, participate in stakeholder collaboration groups, and ensure technology vendors meet the goals and objectives to meaningful use criteria within the specified timelines to place the building blocks for successful adoption and inclusion.

The NHIN brings many possibilities to the U.S. healthcare system. Pre-hospital care and 9-1-1 ambulance transport systems combined with primary care physicians have the ability to work together to triage patients into the appropriate level of care (i.e., ambulatory, acute care, primary health, non-transport) through effective planning. We may do the same. This mainstream is here to stay within the revolution of the information technology age.

So take one step at a time. Chart some new goals where you would like to be and how you intend to get there. Be flexible and stay informed through industry associations. Make your plan and succeed. Pursue additional education that will open new doors in the world of medical transcription. We are in this journey together to stay a vital part of the healthcare system. It is a process formed together, through many hands, volunteers and professionals, to enable our craft to move mountains and sail to the other side!

Boost Productivity & Elevate the Profession into the Future

“Times are a Changing” in this evolution-revolution of our profession. Intelligent speech recognition, redesigned workflow processes, electronic medical record implementation, new rules and regulations are all colliding and impacting the way we do business. The Association for Healthcare Documentation Integrity is an organization that promotes and focuses the integrity of data capture, sets the standards of care in our profession, and produces best practices and industry white papers.

What opportunities are available for medical language specialists to stay informed, increase productivity, and elevate our profession? First and foremost are industry awareness and knowledge. Connecting and advocating for our profession at the local, state/regional, and national levels are imperative to our future. Change is cyclically occurring at a rapid rate. From a personal and professional investment perspective, earning credentials are key to staying informed and networking with allied peers. Consider an investment in the developed speech recognition training curriculum developed through TRSi and 3M, now offered through AHDI or partnered companies. Additionally, BenchMark Knowledge Base is another great tool that enables HIMs an associate membership to AHDI, provides a console of industry information happenings, maintains accurate databases, and showcases quality standards of care.  As you take a look back at National MLS week, celebrate the investment in yourself combined with quality education as helpful “next steps” to drive a successful and rewarding career journey.

The time is now to prepare for networking with allied health professionals, vendors, and involving yourself to attend the 2011 Annual Convention and Expo (ACE) in Austin, Texas. This year’s theme “No Limits” will be hosted at the Hilton Austin, August 4-7. Plan to listen about industry trends and drivers, learn new technologies entering the market space, and ways to additionally prepare for increased security through national incentives of health information exchange and health reform –now on the horizon.

Through our national associations, board of directors, leadership committees, and staff, we are readily available to help “you.” Get connected, prepare for our future together, and work to sustain and advance our place in healthcare documentation. With multiple ways to input information into an electronic medical records system, come understand the modalities to place the information privately and securely. AHDI meets those needs to help sustain viability of our profession, support meaningful use requirements, and promote higher education within ourselves and our profession. Collaboratively the makeup of the leadership team, diverse professions, new professionals, students, and peers, are all here to support “you.”

Walking Through Change in the Healthcare World!

The healthcare documentation profession is making significant strides in deliverance of quality patient medical records. Through its transformation, members, past and present, can recount the stages Annual Convention and Expo (ACE), of technological advancement now leading us into today’s breakthroughs. Numerous challenges exist today in the healthcare delivery system, our sector is not excluded. Understanding and welcoming change is the next positive step in our professional career. Attending this year's Advocacy Summit and it is clear we are on the right path to our future. Respective members of Congress and health information management professionals are preparing for this evolution in time. There will be obstacles individually and collectively to face, overcome, and persevere as we begin this journey together. How might students and professionals stay informed, educated, and relevant to the future, planning for success?

Association for Healthcare Documentation Integrity (AHDI) has defined a clear vision of that mission. Industry specific communication is distributed electronically through publications and social media networking sites. Timely webinars and workgroup initiatives further the efforts to maintain relevance to the member. Local, State/Regional, or Online component associations offer additional ways of building support. Individuals should examine their career goals and aspirations and plan to become a part of the solution to the evolving healthcare system.

Change is also a necessary part of our future and promotes the growth and repositioning this sector needs to stay vibrant. The Power of 10 is one such initiative designed to increase the individual’s voice of advocacy to legislators in Washington DC. This campaign has set an ambitious goal of collecting $10 by 10,000 MTs by 2010 to support standard-setting bodies of data capture in the EHR, educate lawmakers to allied health workforce development, and work to enable additional efficiencies in the healthcare system.

Furthering the walk, the Health Story Project is a targeted program designed to expand software capabilities and enable greater flexibility to physicians, utilizing structured narrative documentation methods of choice for data capture. Establishing effective and clear workflow are another important step through health information management to ensure proper document routing is electronically distributed.

As professionals, we are fortunate to have an environmentally friendly, portable high-technology career available to us. AHDI offers credentials with introduction of TRSi/3M Speech Recognition Technology curriculum to further the skill set. Discounts are also offered through the Vendor Affiliate program in specialty credentials offering additional pathways through health information technology, electronic health records, health information exchange, and privacy and security compliance (http://www.healthitcertification.com/).

AHDI is committed to working hard to ensure the tools are available to the members. We are in position to make a difference in deliverance of healthcare documentation. It is important we recognize and seize diverse opportunities. Staying engaged, connected to associations, and educated of national goals will help ensure you are on the path of success to carve a niche into the healthcare delivery system.