Unit of Measure

Medical Transcription counting methodology has been a 'hot topic' within the HIM industry. During 2006 and 2007, a joint task force between AHIMA, the American Healthcare Information Management Association and MTIA, now CDIA, the Medical Transcription Industry Association, met to suggest a standard measurement that could be used with in-house transcription and by transcription service providers. Fifteen highly-credentialed healthcare professionals representing hospitals and transcription service providers came to a unanimous conclusion that the Visible Black Character (VBC) method should serve as the standard unit of measure. The task force stated that VBC was selected based on being so simply understood, easily verified, and technically feasible for all involved in the measurement. The committee reviewed many current and previous methods, including ASCII line counting, 65 character line counting, Gross (Sylvan) line counting and per minute pricing. Based on the support by AHIMA and MTIA for the VBC method, AAI added the VBC method of counting to the TA+ platform in 2007. The TA+ software suite and Transcribe+, the word processing component offer the VBC method, which is defined below.


A visible black character is any printed letter, number, symbol and or punctuation mark you can see with the naked eye when viewing electronically or on a printed page including header and footer. Spaces, carriage returns and hidden formatting instructions such as bolding, underlining, text boxes and spell checking are not counted in the total character count. Blank lines are not counted.


Healthcare facilities can verify the counting totals with Reporting+, the analysis module of TA+. This system is configurable for date range, transcriptionist or editor, report type and department with detail and summary reports. Additionally, facilities may manually count the number of black characters on the printed version of a transcribed report for verification. Reporting+ can be used to verify invoices from transcription outsourcing providers.


In addition to the VBC method above, the TA+ system can be programmed for an ASCII 65 character line that counts characters and spaces, Sylvan line counting and document counting. It is not necessary to change a facility's unit of measure with TA+. The ASCII method counts any ASCII character (black and white) between 32 and 126 in the formatted document, but not more than two consecutive spaces. Sylvan counting is defined as any letter or character on a line equals one line. TA+ accommodates pricing and counting by report, which is sometimes preferred by radiology departments.


The characters contained within the header and footer of each transcribed report may be included or excluded when the TA+ system calculates the character or line count. Options are to include or exclude all of the headers and footers in a multi-page document or count only first page headers or first page headers and first page footers. Additionally, if a facility desires to exclude a set number of characters (such as the hospital name) from the header or footer, this can be configured into the calculations. For example, if a facility desires to count the first page header and footer, minus the name of the hospital, but exclude the subsequent page header and footer completely, the TA+ system can be set up to automatically calculate in this way. AAI trains facility supervisors to accurately set up counting methods and all exclusions during the installation process.


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