Email to Dr Chassin - President and CEO, The Joint Comission

Dear Dr. Chassin:

My name is Debbie Schwarm. I am the creator of an online community for medical transcriptionists. We currently represent, as of today, 4146 participants on our Facebook page with a subset of participants more actively participating in an actual website community and have 933 signatures on a petition asking for Joint Commission support for dictation/transcription standards. You can find links to all of these efforts in the attached proposal. There is a lot of information in various places. I would suggest, on reading this email, to launch the attached Word document which will lead you through our activities in an organized manner.

I am writing to you at this time because I have been unsuccessful in obtaining a meaningful response from this team, Ms Mary Brockway, Dr Castillo, and Ms Panagopolous. In brief, I contacted the standards department in June 2013 to discuss our concerns. A brief phone meeting took placed, where I was given a few minutes to relay my concerns. I also provided the team with a lengthy report, and the meeting was wrapped up with some general comments that committees were in place looking at safety issues. I was asked to provide data about my concerns, and though I already had done this in the report provided, I did then set out to solicit even more information from others in the form of an online petition. Of note, It was very apparent to me, from that discussion, that the dictation/transcription was not well understood by these Joint Commission Officers. For instance, Dr Castillo was not aware that there is a human interface/editor between voice recognition software and the text product. Ms Brockway seemed unclear about what exactly we even do. This was concerning to me.

In March 2014, I followed up with the team, providing the attached report/proposal. Ms Brockway replied, essentially stating that there were standards in place addressing my concerns. No discussion was offered, however, and I replied to her email indicating that the current medical record standards she referenced did NOT, in fact, address the many concerns outlined. She then stated she would contact me again in June, and did not, and upon following up, Ms Brockway refuses to reply.

Dr Chassin, I have spent at least 5 years and my own personal money, of which I have very little, to gather a community of medical transcriptionists, build a website, use survey tools, and develop this petition because I am passionate about the notion that our healthcare documentation processes are an entire mess and unsafe to the American people. I believed I had something to offer this industry, having done hospital quality activities for over 20 years. I saw few doing anything about the issues, few in this industry understanding CQI processes. I am not backed by big monies of any large corporation or a political stage. Maybe I don't do things entirely according to political correctness, and I don't have a large title that might get me through the right corridors. I am simply a private party who believes in speaking up and taking action when things matter.

I respectfully am requesting the respect of The Joint Commission to give our work a thorough evaluation and to really and truly with interest speak to the community I have gathered. It is an outrageously abusive industry, its practices largely affecting patient safety, and I believe the first step in righting the many wrongs would be realized in documentation standards that are enforceable.

I am attempting to use The Joint Commission QI standards, already employed in clinical departments, that these very Joint Commission QA processes would be useful in managing and monitoring the quality and appropriateness of the medical documentation services rendered. I am unclear why this is not something that would interest your staff.

I respectfully await your reply.

Debbie Schwarm www.mymt.me 971-226-8258