You are absolutely correct that RMTs who took their exams during the Beta phase of the exam did not receive notification of their scores until October 2006. As you know, the purpose of the Beta was to ensure the quality and usability of the testing process and we were extremely fortunate to have people like you contribute to the Beta! One of the integral purposes of the Beta was also to establish a clear scoring method and this required having enough people test to be able to fairly establish the criteria. Once this data was finalized all test takers were contacted with their scores. Although I was not involved in the Beta process I was able to pull a copy of the document that was sent to all Beta testers to inform them of their scores and that document states that “your RMT credential will be good for 3 years from your exam date. In order to maintain your credential after the 3-year period, you will need to complete an RMT recertification course and pass the final exam”.

With the RMT Recredentialing Course policies recently being finalized AHDI’s Credentialing and Education Department in conjunction with the Credentialing Development Team discussed the proposed deadlines at length. The parties involved agreed that in the light of the fact that all RMTs have been given proper notification of their recredentialing deadline, as well as what the recredentialing process would be, the 2 month extension on the deadlines would provide adequate time to prepare to complete the course.

AHDI is committed to supporting continued excellence in the MT industry and is fortunate to have the support of credentialed individuals like yourself! If you or anyone else has any further questions please feel free to contact me via email at cuber@ahdionline.org.

- Cassie Uber, Credentialing and Education Specialist, AHDI

“Your recertification deadline is June 30, 2009. You must complete the RMT Recertification course no later than September 30, 2009.”

Interestingly enough, I did not receive my RMT until October 2009. Now I see they say recert is due June 2009 but have graciously extended it to September 2009.

No respone to email and this is not right. You want us to value the cert, but give only 3 months to take a new course and exam at a cost that may not be possible in this economy with such short notice. This recert course is a year overdue and now you want us to do it under AHDI timeframe.

“The cost of the RMT Recredentialing Course is $100. RMTs can take the RMT Recredentialing Course any month after receiving their 6 month reminder but must complete the course before their deadline”

I did not recieve a 6 month reminder. Shame!

Hopefully staff will reply with answers. Thank you,

Let’s make two additional assumptions about quality for our model:

– credentialed MTs produce higher quality reports than do non-credentialed MTs
– reports prepared by non-credentialed MTs must be proofed 1.3 times to raise the level of quality equal to the quality of an un-proofed credentialed MT report

If the cost of credentialing is to be justified, then the cost of credentialing must be less than the cost of the additional proofing required to make the reports equal in quality.

Even if credentialing is determined to be justified in our model, the relative availability of credentialed MTs, non-credentialed MTs, and proofers will additionally determine the workforce mix.

No one ever said (or at least they shouldn’t have) that CMTs produce higher quality reports than noncredentialed MTs. The only way we could possibly measure that is if every MT was required to take the exam, so that you could make a correlation between the quality of those who passed versus those who didn’t. Right now, there are just too many high quality MTs out there who have opted out of the credential. It’s little wonder (to Julie’s earlier point) that employers haven’t required it. I should reiterate here that, in my opinion, AAMT made a huge mistake early on in promoting the CMT exam by touting it as an “elite credential,” marketing it as something so prestigious that only a few had it. That was the wrong way to get the profession credentialed.

This is one of the reasons why I said early on that unless the credential is mandatory, the best way to push credentialing into a profession is for MTs to self-regulate and not leave it up to the employers (though, as I said, we may sadly have reached the point where only the employers can make it happen). If we wanted to set standards for our own profession and determine who can enter our profession and who can’t, we’d embrace credentialing voluntarily. If every highly skilled MT stepped across the line and registered their skills through the exam process (whether employers required it or not), we would have organically demonstrated to employers that CMT = skilled. The marketing message of AAMT should have been something akin to Uncle Sam saying “We Need You.” The CMT (and now the RMT) will only mean something when every skilled MT capable of earning it has embraced it, not the other way around. That’s the only way you shape the thinking and understanding of industry employers about our skillset. You have to reach a tipping point with the credential where more MTs who are capable of having it actually do have it.

http://tinyurl.com/qe5l4q

What I found most interesting was the specific pointing of a finger at CBay – who recently acquired a large share of MQ.

A more diverse skill set will be essential in the MT of today and tomorrow, to include more technical skills, a greater understanding of natural language processing, discrete data, coding, a truly functional EHR, and SRT editing. There is a career lattice and our current credentials are a beginning. RMT does set the stage for broad-based knowledge. CMT embraces an even broader set of skills to include much learned on the job. An associate’s degree shows some capacity for broader world knowledge. We also need master’s and PhDs for research and development.

I agree a new compensation model is crucial and oftentimes unpopular. If MTs, whether ICs or employees, are going to evolve into the skill sets required, they must have the opportunity of “profit” and have greater incentives to stay in, start in or innovate within the industry. Granted, current economic times are restrictive, but this is temporary, capitalism will prevail.

Truly though, this is a very diverse group discussion, with opposing views and historic disassociation. Here’s my true ask . . . and I beg your indulgence for my impatience. When are we going to start working together in collaboration and become truly innovative in what the industry of the future could be? We continue to have dialogue about how to survive in the now. While I know everything in this thread is a real topic, MTs of 20+ years ago figured out how to be progressive by offering outsourcing as an option. Many did well. Some still do. We marginalized ourselves by showing the customers we could beat their in-house costs and gained many opportunities in the process; we continue to marginalize ourselves now – some of this is the “American” way. Now we have vendors doing more than talking about once-and-done and beating the entire cost cycle of text-based documentation. They ARE selling it. EMRs are replacing narrative text. Are the customers happy about the product? Well, it depends who you ask.

As smart business folk, I contend we need to rearrange our thoughts regarding our customer base. What is going to happen when the patients start seeing the inconsistencies, dare I say medical errors? The insurance companies are already asking the questions. Google and Microsoft see something there.

I do think we need an entry into practice and for me in my short tenure with the industry it has always been about certification. I know nothing else. For my students, they want certification and they assume industry adoption. RMTs were getting the jobs sooner than non-RMTs to such a degree we had to revise the apprentice program. My CMT shows my commitment to lifelong learning, and I would take it to the next level that someday we actually re-test to quantify that knowledge every re-certification cycle.

Any of the certification ideas I can think of all cost money, to the developers (so far AHDI), the users (the MTs or healthcare documentation specialists), the employers (MTSOs and facilities), the customers (stakeholders); they also save money, and someday I hope to see more research studies that put bite into our anecdotal claims. How about a certification in the privacy and security realm, are we willing to place our stake in the ground on that one?

My point here is this. Is there any consensus that can be built within the MT community that takes us past our internal historic differences of opinion and catapults us into collaboration of tomorrow so we are not continuing to de-fragment our own sector today?

Credit goes to Sean Carroll for his analogy to Horton Hears a Who; but I truly think the story rings true. How did the citizens of Whoville get off the dust speck? On the very same day, at the very same time, in unison they hollered . . . we’re here, we’re here, we’re here.

The window is closing on our dust speck. Can we turn our autonomy to collaboration? Our adversity into synergy? Move the debate to innovation? Agree on some stake and rally around it?

For AHDI, it is credentialing and a few other things. For MTIA, hopefully it will be DRT-enabled EHR and the Health Story Project and a few other things. For ATA, consider advocating with us to get our legislators to support funding for educating or re-training our domestic workforce. For individuals, what’s our next business plan? For retirees, promote the next generation rather than wilt their fire. For customers (as yet to be re-defined) perhaps actual authenticated accuracy? The prospects are endless and that’s why I’m here. To ask us to find common ground that includes the entire MT base, the MTSOs, the facilities, software vendors, patients, clinicians (stakeholders) and every single person on this thread to rally TOGETHER, creating some type of innovative success for all.

Nae

• Low Price – Credentialing costs money. Who will pay?
– MTSO – Gross margin for MTSOs range from 30 to 40 percent compared to over 50 percent for the business service sector in general. Lower margins will not attract sufficient capital for MTSOs.
– MTSO MTs – MT wages have been stagnate or worse for years. MTs will not accept the additional cost of mandatory credentialing.
– MTSO Customers – Providers expect quality reports although as noted below quality is inconsistently defined and measured. Purchasers of MTSO services generally want lower prices not increased prices.

• Turnaround Time (TAT) – Mandatory credentialing would increase the barrier for MTs entering the workforce. Increases in productivity using speech recognition and increased acceptance of non-US MTs have created a temporary excess supply of MTs. When saturation of speech recognition and acceptance of non-US production is reached, the demand for MTs will again exceed supply. The demographics of an aging US population and aging US MT workforce have not changed. MTSOs will need to reduce barriers such as credentialing to secure sufficient MTs to meet demand. Workforce predictions by McColl Partners are:

Demographic and healthcare-related growth trends will likely continue to drive attractive market forces for the healthcare documentation sector, including demand for healthcare documentation professionals. Employment in the domestic healthcare documentation sector is expected to increase by 16.4% from 268,000 professionals in 2006 to 312,000 professionals in 2016.2 Employment in this sector is expected to grow 6.2% faster than the national average. INDUSTRY UPDATE – Medical Coding, Transcription, and Billing by McColl Partners http://www.mccollpartners.com/assets/files/Q4%202008%20Industry%20Updates/Healthcare%20Update(1).pdf

• Quality – I have not seen evidence that credentialed MTs produce better quality reports than non-credentialed MTS. There is even less clarity when one considers the lack of industry standards on the definition and measurement of quality. Reports are generally contractually required to be returned to the customer with acceptable quality. A MTSO may need to use lower skilled MTs with more proofing or higher skilled MTs with less proofing. The skills of the available workforce will dictate the appropriate approach applied by a particular MTSO.

While the idea of mandatory MT credentialing may today look like a plum to some, it will in my opinion become a prune that, although edible, will be less palatable when MT demand exceeds MT supply.

As much as it is a nice thought about CMTs being able to command a higher salary and all, I am sorry, I just do not see that happening. I purposely work as an independent so as to avoid the annoyance of lack of work and subpar wages that I experienced while working at a national company. Even as an IC, I do not see how being a CMT could allow me to charge a physician more for my services. It still comes down to cost and more than likely if an MD found my rate to be too high, he/she will choose someone with a lower rate, especially considering the economy right now. Even thought I am not a CMT, I most definitely take the nature of my work very seriously. I’m not just typing up any old record, I am making a person’s medical record. I always think about what if it was my record? How could an error in my medical record seriously affect my life?

With 36-1/2 years of experience under my belt I took the RMT a few months ago, only because the company paid for the exam and offered a half cent per line raise for passing. I finished the entire test in just under an hour and walked out muttering that I’ve done harder work than that in my SLEEP…. So I would agree that the RMT at the very least should be a strong recommendation, if not a requirement, to get into the profession. (Frankly I thought the test was far too easy. But that’s just me.)