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Quality Assessment Scores for Medical Transcriptionists

The Association for Healthcare Documentation Integrity (AHDI) offers the following system for grading medical transcriptionists on the quality of their transcription.

Analyzing documents for accuracy and coming up with a definitive number like 98 percent is no easy thing. For starters, all errors are not equal: Inserting an unnecessary hyphen is trivial in comparison to transcribing a medication name incorrectly. Similarly, using there instead of their may not endanger a patient, but it’s still an error. Factoring all that into generating a consistent and meaningful final score can get tricky fast.

AHDI took on the challenge and developed a recommended quality-scoring framework. The initial version, in place since about 2005, was replaced with a shiny new system in 2010. The 2010 revision greatly simplified the system. It also takes the sting out of minor punctuation issues.

Key points of the AHDI scoring system include the following:

  • Every transcribed document starts with a score of 100. Points are then deducted to derive a final score.

  • Errors are assigned to one of three categories. The categories are: critical (3-point deduction), noncritical (1-point deduction), or feedback and educational opportunities (no deduction).

  • If the same error is repeated multiple times in a document, it’s counted only once.

Thus:

100 – (# of critical errors x points) – (# of noncritical errors x 1 point) = score

A score of 98 or better is considered passing. Because a critical error results in a 3-point deduction, a report containing a critical error automatically fails (100 – 3 = 97).

The AHDI provides detailed guidelines for this system in a whitepaper available in the “Best Practices and Standard Guidelines” section of its website. The whitepaper provides examples of critical versus noncritical errors, along with a list of items that should not result in point deductions. It also includes example worksheets for QA use.

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