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Our industry has changed over the years, evolving from a job performed in a doctor's office or hospital, to one that is performed in many cases at home. As practices grow, the need for space makes the choice of sending a worker home a wise one. This trend has helped to change medical transcription from what was once a cottage industry into very big business.

Why Change? Transcriptionists, of course, are for the most part quite content with this arrangement and those who are working independently are happy to make a few trips per week into their client offices for tape pickup and work delivery. Some hire additional help and find themselves orchestrating additional pickups and deliveries. But many are catching on to the fact that there are easier and more efficient ways of getting the job done, without the driving, arranging and meeting. Many are making the move to digital.

Quick Change Perhaps the simplest scenario of changing to digital is the transcriptionist's purchase of a dial-in system, into which the physician will phone and dictate. The residing codec (analog to digital converter) will create a digital sound file that the transcriptionist will play back later and transcribe. Once finished, the transcriptionist will e-mail the completed document back to the physician. Works fine, for the most part, until the doctor decides he'd prefer to use a hand held recorder. Or a toll fee applies to the call, and the physician prefers that the transcriptionist absorb the cost. Or the practice would now like a searchable database for delivered transcription. Or web access. Or the transcriptionist would like to take a vacation. Or the workload has increased to something more than one person can handle.

Also, dial-in systems can be expensive, pricier yet when you add additional features such as file routing. When sending work to other transcriptionists, one must also consider such factors as encryption, file transfer methods and connection speeds, as digital voice files can be quite large and can be cumbersome to download. Remote transcriptionists must have the correct player and footpedal in order to listen to the voice files. Policies need to be in place regarding the storage and delivery of the completed work for confidentiality compliance.

Hand helds? Now we're adding yet more factors into the mix: getting those voice files from the hand held into the physician's computer, and then getting those voice files from the physician's computer to the primary transcriptionist (who might then distribute them, with all of the above issues applied). And what about obsolescence of the equipment, which, after all, is computer based? Without careful planning and equipment choices, the cottage industry of medical transcription has the ability to become a mansion-sized headache.

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