Is There Any Alternative? There is another way, and it's called ASP. Application Service Providers are popping up in many markets, handling retail inventory and transactions and health insurance claims submissions and transactions. Some have the ability to record clinical observations, write prescriptions, order tests and capture charges, in a manner that supports the practice workflow. In medical transcription, we're talking about Transcription Application Service Providers. A TASP will have made the investment into the servers, firewalls, software and security technologies, as well as T1 voice and data connectivity that are necessary for transcription functions and "rents" its use based upon volume.

Some TASPS offer relatively little, such as toll-free dial-in dictation only, for a lower price. It is then up to the primary transcriptionist to obtain the voice files and distribute them as desired, as well as handle the delivery of documents. Other TASPS offer more complete functionality, including toll free dial-in as well as hand held dictation, automatic file routing, work pooling, word expanders, templates and more, delivering completed work via the web with SSL security. They'll count lines or pages in any number of ways, or allow keyboard customization at the preference of the transcriptionist. They'll keep track of job age and alert the administrator to jobs that are dangerously close to becoming late, or even send those jobs to another transcriptionist who is available to finish them.

Many TASPS are almost entirely web based. What this means to both transcriptionists and their clients is that work may be accessed from virtually anywhere there is an internet connection, with the ease of a web browser. Downloading functions may be limited to certain personnel or locations, and administrative functions, such as file routing automation and work load assignment, limited only to administrative personnel. Some TASPS require the transcriptionist to type directly into the TASP system, others may allow offline typing into the transcriptionist's own word processor. Some TASPS are geared more for the large hospital client, others toward the individual transcriptionist. Some require a large up-front investment, and most TASP rates fall somewhere in the 2 to 4 cents per line range.

What If? September 11 has taught us that disasters can occur in the most unspeakable proportions, and that none of us can ever consider ourselves immune. A transcription service as well as a TASP should have backup systems in place such as redundancy -- mirrored servers located in another facility that take over should failure occur, such as in a fire or flood. A "Plan B", if you will, of how transcription functions would be handled in case of disaster. Insurance is also a must.