ASMART is very new and getting off the ground. We are looking for new members as well as board of director members. Currently we have consultants, health care professionals and service owners interested in being on our board of directors. Because we are so new, we are still working out the appointments. ASMART is the culmination of ideas from Jeremy Wells, who currently works as a MIS/Systems Analyst for a medical transcription company. He originally founded ASMART after seeing the unethical practices that go on with transcription billing. Coming from the high tech industry, Jeremy found that word processing file formats are an inefficient end-product that the client is buying. He believes that a transcription service client is buying data, not word processing. This is because data is inherently more valuable than word processing. Because important data is being supplied, a clear statement is being made that medical transcriptionists are making an active effort to organize and literally "translate" doctors dictation. All medical transcriptionists know that if they were to transcribe exactly what the doctor was saying, the result would be a mess that would be hard to decipher. Getting clients to realize this is part of what ASMART is trying to do. ASMART's interest at this point is to disseminate information and to get a public forum going about the merits of billing by and providing ASCII text as the end product of transcribing.
Is ASMART part of another company?
No, ASMART is an independent organization that does not have an alliance to any pre-existing companies. The theories and concepts behind ASMART have been gleaned from transcriptionists, service owners and health care professionals who believe that there's a big problem in this industry that needs to be fixed.
There are very few things that are as confusing to pay for as transcription--i.e., from the client's perspective. Everything can be bought for the most part by easily definable standards. Like the number of nails, number of bandages, number of hours, etc. The problem with transcription service billing is that it makes the artificial assumption (again from the client's perspective) that a "line" is a standard. But it's not. Clients can't compare which transcription service is cheaper than another, or worse make a mistake a switch to a different service and actually pay more because they didn't know that 14 cents a gross line will cost them a whole lot more than 15 cents a 65 character line. Or that one vendor who charges 14 cents a 65 character line can actually cost more than another vendor who charges the same amount. This is because a "character line" can be defined as the vendor wishes to include or not include certain characters.
In addition, the method used for counting lines (especially gross lines) is still firmly rooted in the days of the typewriter. There are better ways that are more compatible with today's information technology.
No. The whole purpose behind ASMART is to promote ethical billing and payroll practices in the medical transcription industry. ASMART's purpose is to give away free information and tools to promote this goal.
What does ASMART mean that transcriptionists do data entry and not word processing?
This statement does not mean that transcriptionists ARE data entry people and should be classified with the same skill set as those who, for instance, do order entry. Far from it, ASMART realizes that medical transcriptionists are highly qualified professionals that need to understand medical terminology, have excellent English skills, and have a good ear. Not anyone can do this. Medical transcription "data entry" requires far more than the basic skills required by most people who do data entry!
You can't enter the data unless you understand it. In the business world, you pay people more if the job they do requires more skills. Anyone can enter raw numbers or text into a computer. That's why for normal clerical data entry (say order entry), people don't get paid very much. But if you need to enter medical dictation, the person doing the "data entry" has to be highly qualified and understand medical terminology. By this very virtue, this person would have to be paid more than what typical clerical data entry people get paid to do (and along with that comes the added respect of that position).
According to Websters dictionary, "data" is defined as: "Individual facts, statistics, or items of information".
"Entry" is "the act of entering or recording something, as in a book register or list".
Does this not describe what a medical transcriptionist does? I.e., recording individual facts, statistics, or items of information from a patient visit?
What ASMART is trying do is not to demean transcriptionists, but to elevate in status what they do. In the modern world, data is extremely valuable. Companies are willing to pay large amounts of money to get the right data. And transcriptionists are producing this data.
Health care organizations need the data from a patient visit so that they can improve the care of that individual, bill from the data, and have a legal record of what transpired. This is extremely important information. Therefore, it is very important data.
Hence, what transcriptionists are doing is highly accurate data entry--as well as "translating" what a doctor is saying (the transcriptionists out there should know what this means).
A transcriptionist or transcription service provides DATA to their clients. And not any kind of data. This data has to be extremely accurate as patient's lives can be on the line--literally.
The idea is simple: Clients are paying for data and NOT word processing.
Is ASMART a clearing house for networking and education for the standardization and dissemination of medical language?
ASMART's goal is not the dissemination of medical language. Where ASMART is coming from could just as well apply to any other transcription-related business that requires highly accurate data such as the legal profession.
What billing unit does ASMART promote?
ASMART recommends using the kilobyte as a billing unit (derived from the number of bytes in an ASCII text file). The kilobyte is an undisputed standard definition in the computer world, and every computer has the native ability to do billing and payroll counts of transcription without any additional software.
How do I convert a standard billing rate per line (such as a character or gross line) into a rate per kilobyte (the standard unit for billing using the ASMART standard)?
How does ASCII text fit into the HL7 specification?
For the portions of the HL7 specification where there is free form text, it is specified that is be in ASCII text format. These free form text areas are typically the bulk of a patient visit.
How can ASCII text accommodate other aspects of the electronic patient record such as graphical data like x-rays, MRI images, etc?
ASCII text will only be used for written patient documentation and can be incorporated into databases containing the additional information you describe much easier than a word processing file. The HL7 specification, for instance, essentially specs out ASCII text as the format for patient documentation.
This is why ASCII text makes much more sense than word processing files which would, for instance, have to be converted to ASCII text before doing an upload to an HL7 compliant system.
Perhaps a question should be asked about what the AAMT or the AMA "sells"? They sell information. However, ASMART is not selling anything. If you want to use an economic basis for a description of what ASMART does, then it would have to be that it gives away information promoting understandable transcription billing standards for the health care industry. There is no "product" as such.
ASMART is an association and membership is free to individuals, health care organizations, and transcription services. Who are ASMART members? Anyone who wants to be and is in the health care industry.
What are ASMART membership benefits?
The primary benefit from being an ASMART member is knowledge. Using the information provided by ASMART, you can run your business more efficiently and honestly. ASMART will be disseminating information to our members dealing with all aspects that we cover. The second benefit is that ASMART will be providing a list of transcription services that will bill and provide ASCII text files per the specification that ASMART promotes.
Does ASMART advocate not paying for the space character (space bar)?
No, space characters ARE counted. What ASMART proposes is that billing be based on the number of characters in an ASCII text file. The space character by its very definition is a character and certainly would be included in the total character count. When you press the spacebar on your computer, it generates ASCII character #32 and therefore is included in the character count. The beauty in this system is that a character count can be taken directly from the size of the file because a byte is the same thing as a character. This also makes it easy for a client to know that they're not being ripped off by their service because it is so easy to verify what they're being billed for. The transcriptionist can get the same benefit too.
If a service were to pay their transcriptionists on the ASMART promoted standard, would they get less pay?
No, for transcriptionists, this is not a pay-related issue. Instead, it is an attempt to promote an ethical, common billing standard that does away with all the confusion over existing line definitions. Ideally, such a standard should make transcriptionist's lives easier because of the simplified file formats required for ASCII text. Complex formatting in a document takes time--time transcriptionists don't get paid for.
The whole idea is that less is being typed, and less is being formatted. If a transcriptionist were to be paid by the same method (i.e., by the number of ASCII characters in a document), she would be paid less for a particular report because not as much would be typed. However, the report would be typed in less time so that more reports would be done during the same period of time. The net result is the same pay, same number of keystrokes, but more reports.
This is a win-win situation for everybody. Transcriptionists have to deal with less overhead they don't get paid for, service owners get higher efficiency, and clients get an easy to understand and verifiable billing method.
Does ASMART standardize the amounts vendors should charge their clients? Isn't this price fixing, and if so, isn't it illegal?
ASMART does not advocate a certain amount of money that companies should charge. Instead, it advocates a standard method for defining what is being billed for.
Why would doctors be willing to part with their favorite formatting even if it does cost more?
This is a good point. The main push here will be from organizations that are interested in cutting costs and will mandate the requirement. Or the push could come from the computer people who want data that can more easily be interchanged between systems. However, since one of the primary goals of the health care industry is to reduce cost, it would be more difficult for an organization or physician to justify paying extra for superfluous formatting when no extra data is conveyed.