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The Importance of Medical Terminology In Medical Transcription

Close-up Photo of a Stethoscope on top of patient medical records Close-up Photo of a Stethoscope on top of patient medical records

Transcription is an important part of medical care. Healthcare professionals can save time and money and enjoy other benefits by using outsourced transcription services. However, accurate documentation is a critical factor here, and some transcription providers are better at understanding medical terminology and ensuring accuracy than others. 

In this article, we’ll learn how: 

  • Understanding the significance of medical transcription is important. Medical professionals rely on accurate medical terminology to communicate and understand patient conditions, symptoms, and treatment plans effectively. 
  • Highly accurate medical records improve and ensure quality patient care.
  • Healthcare professionals like medical transcribers and medical assistants can learn the terminology in the healthcare field through experience, study, and research. 
  • Healthcare providers and other healthcare industry members need to consider accuracy and costs in transcription to ensure cost-efficiency and quality. Ditto Transcripts delivers both with its industry-leading service. 

A Brief Overview of Medical Transcription

Medical transcription converts medical dictations into written text, electronic health records, or electronic medical records. With this seemingly simple process, physicians, nurses, and other healthcare practitioners can dictate or record their patients’ medical records, and a transcriber can take over the recording and create a detailed report based on the information gathered from the recording. This can save the medical professional a lot of time, money, and effort. 

Transcription can be applied to numerous medical situations, such as the following records of patient encounters: 

Medical InstanceDescription
Patient Medical RecordsAccurate transcription of a patient’s medical history, including previous illnesses, surgeries, and family history.
Clinical Notes and SummariesNotes summarizing patient visits, observations, and treatment plans dictated by healthcare providers.
Operative ReportsDetails of surgical procedures dictated and transcribed for reference and future care.
Discharge SummariesSummaries of patient’s admission, complete medical information, treatment, and follow-up care instructions. Includes all information needed when preparing to discharge a patient. 
Diagnostic Imaging ReportsFindings from X-rays, MRIs, CT scans, and other imaging modalities dictated by specialists.
Pathology ReportsPathologists’ findings about diseases from tissue samples for diagnosis and treatment planning.
Consultation NotesDetailed notes on findings and recommendations by specialists for complete patient care.
Medical CorrespondenceTranscription of professional communications between healthcare providers for record-keeping.
Research and Clinical TrialsDocumentation of patient observations and outcomes in clinical research and trials for analysis.
Telemedicine EncountersDocumentation of virtual consultations to maintain comprehensive patient records.

Precise medical transcription services are crucial to ensuring patient safety and providing quality healthcare. Furthermore, effective transcription and communication of medical terms save healthcare organizations an average of $300,000 annually in reduced errors and improved efficiency.

Importance Of Medical Terminology In The Healthcare Field

Have you ever come across the words dysphagia and dysphasia? How about CXR, BS, c/o, and CRF? Do you know the difference between the two? Or does it look like doctors are just using fancy words and weird abbreviations for no particular reason at all? 

Medical terminology is important, and it can be a difficult concept for aspiring healthcare professionals, including transcribers. It’s filled with abbreviations and terms, intricate and complex words, not to mention the inclusion of medical coding and medical billing in some record types. 

However, this is all necessary. Healthcare personnel use medical terminology to ensure everyone understands all the information in different patients’ medical records. Standardizing medical terminology helps facilitate effective healthcare communication among healthcare providers globally. 

Furthermore, medical abbreviations make it faster for physicians to dictate or note important details for histories and medical procedures. Furthermore, understanding medical terminology is essential for medical research.

Medical practitioners and employees in the healthcare industry, including those who work in transcription, must learn medical terminology in order to operate as safely and efficiently as possible. 

How Do Transcribers Learn Medical Terminology?

Learning medical terminology, all the acronyms, and all the different abbreviations can be difficult. A trusted transcription service provider like Ditto Transcripts, which specializes in medical transcription, ensures 99% accuracy in all transcription projects. Our professional medical transcriptionists have undergone rigorous training and certification, including: 

Specialized Experience

Healthcare professionals understand certain medical procedures and terminology because of specialized training. This training and daily exposure can help them avoid making mistakes. 

Transcriptionists also specialize in different fields, just as doctors work in different practices. Specialization also allows transcriptionists to transcribe specific content and recordings accurately. Like doctors, transcription experts can ensure accuracy in medical transcription through daily exposure to industry terminology. They’re more familiar with commonly used medical phrases, abbreviations, and terms than your usual general transcribers. 

Certification

Unlike most transcription specializations, medical transcriptionists can undertake certification courses to establish their skills and experience in the field. The Association for Healthcare Documentation Integrity or AHDI (formerly the American Association for Medical Transcription) also offers two options for medical transcription certifications: a Registered Medical Transcriptionist (RMT) certificate and a Certified Medical Transcriptionist (CMT) certificate. 

Both certifications for transcriptionists and medical coders require them to pass several tests, including the Registered Healthcare Documentation Specialist (RHDS) certification exam. This examination includes medical coding and billing details. 

To keep their certification, they must either re-test or pass a re-credentialing course every three years. The CMT is the highest certificate a medical transcriptionist can earn as it requires the most education and work experience. 

Research Skills

Working in healthcare is a continuous learning process. Understanding medical terminology also requires research. Medical transcriptionists need to keep up with the latest developments in the healthcare field. They also must be able to research new terms and techniques and utilize their working knowledge in the field to contextualize recordings correctly. 

Consequences Of Inaccuracy in Medical Transcription

Let’s look at the consequences of inaccurate transcription and why being familiar with medical terminology is important. 

RiskDescription
Miscommunication of Medical TermsThe whole point of outsourcing medical transcription is to assign the work of documenting patient encounters to an accurate transcriber so that you can concentrate on patient care and help you perform your job better. Working with inaccurate transcripts can significantly increase your workload and impact your performance and patients’ well-being.
Poor Patient ExperienceIncorrectly transcribed medical terms account for an estimated 3% of medical errors. Inaccurate transcriptions can also lead to poor continuity of care, misunderstandings among healthcare providers, and delays in treatment. 
Increased Workload and StressThe whole point of outsourcing medical transcription is to assign the work of documenting patient encounters to an accurate transcriber so that you can concentrate on patient care and help you perform your job better. Working with inaccurate transcripts can significantly increase your workload and impact your performance, and patients’ well-being.
Increased Healthcare CostsCorrecting errors caused by incorrect transcription can lead to additional tests, treatments, and prolonged hospital stays—all of which increase healthcare costs. Additionally, errors can result in fines, penalties, or lawsuits, damaging the reputation and financial stability of the healthcare provider.
Legal and Compliance IssuesDespite being rich with medical phrases and complicated medical abbreviations, medical records are critical legal documents. Inaccuracies can lead to non-compliance with regulations like HIPAA. 
Loss of TrustWith so many things hanging in the balance, it’s no surprise that patients and their loved ones can lose trust in healthcare professionals due to incorrect transcription. This significant loss of trust can have long-term implications for the patient-provider relationship and the institution’s or medical personnel’s reputation.Physicians and nurses put in years to finish med school, gain the requisite knowledge, and increase their professional standing to make it in the medical field. 

Why You Shouldn’t Depend on AI For Transcribing Accurate Medical Terms And Abbreviations

Unfortunately, not all transcription companies offer the same level of advantage or quality of service. As a healthcare facility or provider, you must be able to find a professional medical transcription company that meets accuracy requirements without compromising on other matters. 

As the most common example, automated transcription uses voice recognition software to transcribe recordings of medical procedures and various dictations. They’re mostly easy to set up and use, and they’re cheap. 

However, they’re only about 86% accurate. This can be lower if we consider the complexity of spoken medical terminology. Actually, it goes lower  if you use uncommon phrases or abbreviations if the AI isn’t trained with these terms. 

This is unacceptable. Remember, accuracy is non-negotiable in medical transcription

Want Accurate Medical Terminology In Healthcare Transcription?

Every patient record requires precision. Look no further than Ditto Transcripts to ensure accurate transcription and improved patient care. Transcribing complex medical terms is a breeze with our experienced transcriptionists. Every transcription project is guaranteed to reach a minimum of more than 99% accuracy. 

We also offer medical organizations fast turnaround times, affordable pricing starting at $0.07 per line, unmatched customer service, and unparalleled flexibility. We work with healthcare professionals daily, so we know what you need. 

Ditto Transcripts is a HIPAA-compliant Denver, Colorado-based transcription services company that provides fast, accurate, and affordable transcripts for individuals and companies of all sizes. Call (720) 287-3710 today for a free quote, and ask about our free five-day trial.

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