Pros and Cons to Online Medical Transcription Services

To understand if online medical transcription services are a good choice for your practice, it’s first important to understand how online transcription companies work, what services they offer, and how much they cost to employ.

How do online medical transcription services work?

Transcription, or transcribing, is the process of turning thoughts, speech, or recorded information into a written text document. It’s a practice that’s been around for millenia, commonly used in judicial proceedings and in scientific research, where a transcriptionist produces a complete written document from whatever external information source that is provided to them.

While transcription has existed in the medical field for a very long time, it is only really since the advent of the electronic health record has its use grown to such heights. In today’s healthcare setting, medical transcriptionists use a provider's speech to produce complete medical notes and clinical documentation.

While these medical transcriptionists are sometimes employed directly by a clinic or larger care organization, it is becoming increasingly popular for medical transcriptionists to offer their services through an online platform. Online medical transcription services are usually leveraged by healthcare providers in one of two ways, either by extracting medically relevant information from an audio recording of an entire patient encounter, or by transcribing a dictation recording that the provider sends to the transcriptionist after the patient leaves.

Transcribing an Entire Visit

Of the two listed above, the former option of sending an audio recording of a patient’s visit in its entirety is decreasing in popularity, though it is still employed sporadically across the country. Healthcare professionals often use medical transcription in this capacity by using a recording device like a smartphone to record an entire patient encounter. The provider usually places the device between them and the patient, and when the encounter is complete, they send the recording to an online medical transcription service who extract all of the medically relevant information and only extract and log the medically relevant information that is necessary for the patient's chart.

The main reason this approach is becoming less and less common is because most online medical transcription services charge by the length of the recording, either by the line, the minute, or the word. The length of an entire patient visit, pleasantries included, makes for a recording that is far too long to send to an online medical transcriptionist. Instead, providers aim to shorten the length of their recordings by dictating the encounter after the patient leaves, or after hours.

Dictating a Visit

Using this method, providers significantly shorten the length of their final recording, but, they end up doing more of the heavy lifting in order to prepare the audio file for transcription. Instead of relying on the transcriptionist to extract the medically relevant information, the provider must do it prior to sending. It’s a tradeoff, but what it means is that providers must sit down after the patient leaves and dissect all of the information they gathered during a visit, package it nicely into a dictation recording, then send it off to the online service to be transcribed where they still will pay by the line, minute or word.

The end result is that providers must still work grueling hours to complete their own medical documentation, only instead of typing the information into their EHR, they are substituting their voice and using dictation and transcription. For many providers, it’s easier to dictate their documentation, but for many others, the cost-benefit isn’t always there.

Recommended Reading: Understanding the Differences Between Dictation and Transcription in the Medical Field


As mentioned briefly above, online medical transcription services usually charge by the minute, line, or word.

Charging by the minute means that a provider is charged a flat rate based on the length of the recording. While online services differ greatly, usually cost-per-minute rates are between $0.75 and $1.50 per minute.

Charging by the line means that a provider pays for each line of text that the finished transcription ends up being. Again, the costs differ based on which service a provider uses, but is generally between 7 and 12 cents per line.

Charging by the word is when a provider is charged for each word in the final transcription. The range here is around 5 cents.

But because almost all outsourced medical transcriptionists are paid at comparable hourly rates, the cost discrepancies are not that significant, regardless of payment method. Any way you slice it, these services cost about the same regardless of how they charge. Understanding and weighing these hard costs is a critical step for any provider considering using an online medical transcription service, but there are also other drawbacks and risks to consider.

Documentation Turnaround Times 

How long are you willing to wait to receive your completed documentation from the transcription company? 3 hours? 6? 12? Industry wide, transcription companies claim that their turnaround time is around 24 hours. If a provider opts for dictating their notes after a patient leaves or after clinical hours, this means that transcription won’t be completed and returned until the next business day, also likely after hours. By the time those transcriptions are imported into an EHR, reviewed, and signed off on, it can easily be 36+ hours after the initial visit.

Most online medical transcription companies offer expedited turnaround times for providers that pay to be pushed to the front of the line, but because almost all providers prefer to have their documentation within 24 hours, most end up paying the fee to move up the queue. An unproductive cycle often ensues, and providers often end up handicapped by costs and turnaround times. For the most part, however, these costs and drawbacks are communicated by the transcription service, as it is often in their best interest to be upfront and honest about costs. Though what is less discussed and recognized by the transcription industry is data security risks associated with transmitting sensitive information through online channels. 

Data Security

While there have always been data security risks of patient PHI, the stakes today are higher than they’ve ever been due to both the pandemic and the growing popularity and lucrativeness of cyberattacks. In 2020, 34% of all data breaches that occurred in the United States were in the healthcare industry, up significantly from the year before. This means that now it is more important than ever to ensure patient health records are safe, and the platforms they reside on and the online channels they transfer through are highly secure. Unfortunately, many online medical transcription services can’t guarantee the level of security needed to protect patient information.

While many online transcription companies are based in the US, the transcription work itself is often outsourced to countries overseas where labor costs are lower. While this may mean a slightly lower usage cost for the provider, it also means that sensitive information is likely more exposed, less regulated, and the companies held less-liable in the case of a breach. While HIPAA normally holds data holders (the transcription companies in this case) responsible for a data breach, there have been breakthrough judicial cases over the last few years that have actually held healthcare organizations accountable even if the breach is not directly their fault, citing a failure to properly vett the company they employed to house their data.

Recommended Reading: Is Medical Transcription Worth It?

To Conclude

In conclusion, when considering costs, turnaround times, and data risks, are online medical transcription services really a good option? It depends on who you ask. For many providers, it is – despite the reasons listed above. But, what if there was a better solution? One that took the idea of a medical transcriptionist, and ratcheted it up a few notches?

Well, at DeepScribe we’ve developed a solution that does just that. Our AI powered system operates like the best medical transcriptionist, the best medical scribe, the best speech-to-text software, all in one.

Rather than having to dictate an encounter, DeepScribe listens in on a patient encounter and naturally extracts the medically relevant information. But rather than sending that back to the provider as a transcription, DeepScribe produces a finished medical note that integrates directly into a provider's EHR. With DeepScribe care providers can return their focus to the patient, without having to worry about the documentation that awaits them after the patient leaves the exam room. 

Interested in joining us as we bring the joy of care back to medicine? Learn more here or watch a demo.

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