Macro building 102

The AutoCorrect feature in Word is my bread and butter.  I literally type in shorthand.  The best way to use this feature is to make your entry something easy to remember:

pnt = patient

The next step is to build on this foundation:

pnts = patients
pnts’ = patient’s
attpnt = according to the patient

Notice I put the apostrophe at the end of the shortcut… that is because my brain will type the shortcut first, then remember to add the apostrophe for the possessive afterward the fact.  Any commonly used phrases should definitely be included in your shortcuts.

Another building trick is to “stack” the shortcuts:

rt = right
lt = left
br = breast
ch = chest

rtbr = right breast
ltbr = left breast
rtch = right chest
ltch = left chest

I also utilize numbers in with the shortcuts:

1deg = first-degree
2deg = second-degree
3deg = third-degree   ….and so on….

th4 = therefore
no4 = notable for

Next, I build on macros that have different endings:

xfm = transform
xfmd = transformed
xfmg = transforming
xfmn = transformation
xfmns = transformations

Make sure to include any acronyms to avoid the shift and caps lock keys, and then add “x” to expand:

cabg = CABG
cabgx = coronary artery bypass graft

aaa = AAA
aaax = abdominal aortic aneurysm

Something else I do… I shorten some words with their “phonetic” spelling:

cof = cough
flem = phlegm
cud = could
wud = would
shud = should

It takes some time to build your shortcut database, but once you do, be sure to BACKUP your macros at least once a week!  Trust me on this, I speak from experience (a day I shall long remember).

MT Daily used to have an entire list of ready-made shortcuts that you could import into your AutoCorrect, but I can no longer find it… perhaps they took it down?  In that case, I will attempt to have one on here that is accessible, but that may take me a bit.

Until then, the best shortcuts are the ones you create for yourself.  Be sure to:

• Include any commonly misspelled words in your AutoCorrect so you don’t waste time changing them constantly.
• Include brand name drugs with the capitalization already set up to avoid pressing the shift key so much (or trying to remember whether or not that weird name was brand or generic)
• Include any hyphenated words.
• Set up any homonyms like so:  ileum/ilium for both words — to double check that you’ve transcribed the right body part.
• Set up any commonly transposed words like “to” typed as “ot” as ot****.  Since OT is a legitimate acronym, your spell check may not catch it.  The stars will flag you to double check yourself.

Have fun macro-building!

Macro building 101

Okay, so they’re not really “macros” in the sense of “hot keys” to perform functions like the tilde macro from earlier, they’re really more like typing in shorthand. I have over 3000 shortcuts in AutoCorrect and AutoText in Word myself.

As I’ve said before, I have never used an “outside” word expander program because, when I started transcribing, the platform I worked on did not have the capability to use them. So, I learned to do without, but I think I’ve done quite well without one, averaging 250-300 lines per hour. If you use a word expander program, I’d like to hear your input on how it enhances your production, and if it’s any better than utilizing AutoText and AutoCorrect using the techniques I describe below.

The first company I worked for did provide a sort of “standard” shortcuts already embedded in the program. If you don’t want to be bothered taking the time to build your own shortcuts, MT Daily has a list already made up that can be accessed here and copied into your word expander program or into MS Word AutoCorrect.  This can be a good starting point if you need some inspiration.

However… my opinion is, if you don’t have a system that works for you, you’re not going to remember the shortcuts someone else has made.

Word is the most common platform currently in use, and it’s the one I’ve worked with the most, so for the remainder of my “macro training”, I’ll be referring to Word and the features of AutoText and AutoCorrect.

One of the first things you have to realize is that AutoText and AutoCorrect differ in two ways: One is how the shorcuts are generated and the second is how they are applied across programs.

AutoCorrect is a “quick shortcut” as a default (plain text option). It only has a limited amount of characters available and will not carry over any formatting (i.e. bold, italic, underline). However, once an entry has been made in AutoCorrect as “plain text”, that shortcut is available in ALL Office programs — Excel, PowerPoint, Outlook, etc. This can be very helpful as once you get used to typing in shorthand, it will eventually aggravate you to have to type things out longhand in other programs.  The shortcut is also able to be edited easily through the AutoCorrect window.

AutoCorrect will expand a shortcut as soon as the space bar is pressed or punctuation is provided after a shortcut that Word recognizes. For example: If my shortcut in AutoCorrect for “musculoskeletal” is “msk”, then every time I type “msk” then press space or punctuate, the word “musculoskeletal” will appear. The formatted AutoCorrect entries have no character limitations and will carry over any formatting assigned. The “Replace text as you type” box must be checked in the AutoCorrect window to use this feature (Tools, Autocorrect).

AutoText entries are actually templates that are saved in “normal.dot” in Word. These entries (along with formatted AutoCorrect entries) are NOT compatible across Word Programs.  Also, because AutoText entries are considered templates, they are not as easily edited as AutoCorrect, but this can have its advantages. AutoText also has no character limit and is saved with all formatting assigned.

An advantage of having templates AutoText is that it’s more difficult to “overwrite” them by accident.  A second advantage to using AutoText is that Word will give you a “flag” with the first few words of your template to allow you choose whether or not to insert that particular template, provided the “Show AutoComplete suggestions” box is checked in the AutoText screen (Tools, Autocorrect, then Ctrl-Tab to move between tabs to get to AutoText).   AutoCorrect does not have this feature, requiring you to remember more macros by heart.

When I type a physician’s dictation for the first time, I store that note as a template in AutoCorrect.  I highlight the body of the  note, press Alt-F3, then name the note so I can remember it.  For example, if it was a followup note for John Smith, M.D., I would name it smithjfup, an initial consult - smithjcons.  Then, the next time I need to type a note for that physician, before I even start transcribing the note at hand, I type in smithjfup.  The ”flag” will pop up with the first few words of his followup, and to accept that template suggested I simply press “enter”.

One thing to note: the AutoText flag may pop up every time I start typing “Smith” in a note… if I don’t need the template, I just keep typing and ignore it – and it goes away. I have complete control over whether I want to insert the template or not.

To re-make that saved AutoText template for Dr. Smith as a “generic”, I’ll take the time before transcribing the new note to read through the template I have just entered and replace any gender specific items, any vitals or lab test values, and any patient-specific information that will change constantly with a tilde.  I then save it like I would a new one, giving it the same name as before. I’m then prompted to choose whether or not to overwrite the existing template – this helps prevent boo boos. Once I have my generic Dr. Smith template, I can do more reading and less typing by moving around in the note using my tilde hot key to insert the needed information while keeping all his “usual” blather. It takes a little time to build up generics for each physician, but it pays big in the long run.

If you would like to read more about AutoText and AutoCorrect, check out this link: http://word.mvps.org/FAQs/Customization/AutoText.htm

I’ll be telling you all how I build macros in AutoCorrect next… so stay tuned!

Optimizing production – De-mousing

Before I get going into how I build macros so I can remember them (I have thousands), the first thing a new MT MUST do is learn to de-mouse yourself.

“But why?” you ask?

Because of this very important rule:

In this business, every time you take your hands off the keyboard, you are losing money.

Once learned, you will find that using keyboard shortcuts is a heck-of-a-lot faster than grabbing the mouse.  One of the first things you will definitely want to do is learn to use your Alt and Ctrl keys.  Also, find out what function keys are specific to your transcription platform program — write them down on a 3 x 5 card if you need to until you get familiar with them.

Remember that, in nearly every program out there (at least all the ones I’ve ever worked with), when you see a drop-down list, a letter will be underlined… that letter is set up to work with your Alt key (you can try it now… Press Alt+F to see the File menu drop down — the press Esc twice to exit the menu).  Once the menu has “dropped down”, you no longer need to continue pressing the Alt key to activate the items on the menu, just be sure to notice what other letters are underlined because, while that drop down menu is open, those letters are “hot keys” to the function you want to use.   Also, many of those functions will have the corresponding Ctrl key listed next to it, usually saving you a keystroke.  I cannot stress enough how important it is that you learn the Alt and Ctrl functions for the menu items you use every day.

The next thing you will want to do is learn how to move around in your documents without ever touching the mouse.  Such as: Ctrl+End will take you to the end of the document, Ctrl+Home will take you to the beginning of the document, Shift+End will highlight the text from the cursor to the end of the line, Shift+Home will highlight the text from the cursor to the beginning of the line, Ctrl+Shift+End will highlight the text from the cursor to the end of the document, Ctrl+Shift+Home will highlight the text from the cursor to the beginning of the document (those last two are great for generating AutoText entries, but more on that later).  Two combinations that I use most often is Ctrl-Z for Undo and Ctrl-Y for Re-Do… those are awesome.

The best thing to do to learn these quickly is to print out a list of keyboard shortcuts:

On the Tools menu, point to Macro, and then click Macros.

In the Macros in box, click Word commands.

In the Macro name box, click ListCommands.

Click Run.

In the List Commands dialog box, click Current menu and keyboard settings.

Click OK.

On the File menu, click Print.

Once you have your printable list, you can actually streamline it a little by deleting the entries that are irrelevant to what your needs are, then print that baby out.  Make it a goal to learn at least one new shortcut a day – highlight them as you go… before long, it will be second nature and you won’t even have to think about it.

I have learned recently that it’s actually mousing that contributes more to carpal tunnel syndrome than keyboarding.   To combat this, I actually recommend moving the mouse to the LEFT side of the keyboard… and here’s why: I started having problems with overuse syndrome with my right hand because I used the 9-key pad a lot AND moused (when I needed to) to the right.  I decided to learn how to mouse with my left hand and switched the mouse buttons through the Control Panel.  It took a few days, but now I have no problems mousing with my left hand.  I no longer have problems with overuse syndrome with my right hand, and it freed up some space on my desk since I’m right-handed.

You’re going to have to use the mouse from time to time… sometimes it really is quicker just to grab it to pinpoint a certain area in a large text, but for the most part, keeping your hands on the keyboard is all about working smarter, not harder, and keeping those production numbers on the rise.

Happy earning!

Macros, an MT’s best friend

Macros in the medical transcription world can mean one of two things…. the actual creating and assigning your own function keys or as a global reference to shortcuts created by a word expander, AutoText or AutoCorrect.   For this article, we’re going to be talking about the function keys to enable us to “skip” around in a template much, much easier, thereby making us more efficient.  Some platforms will not allow you to create your own “hot key” macros, so you have to work with what they give you, but there’s usually some way to work around it.

Each transcription platform has it’s own version of a “bookmark” so to speak when you need to leave blanks.  One company I worked for called them “defys” and it looked like <defy3> or <defy10>, one used brackets [[2:10]] and one used a completely separate playback system so I could only use tildes ~.   The key is to make these work for you when creating your templates. 

If you use a platform where you can set time markers in the document, try setting a time marker, then take out the numbers and see if the program will still “jump” to the bookmark anyway without interrupting the dictation you are listening to.  If that works, then you can create a shortcut of your own to place these “blank bookmarks” in your templates (for example, the company using [[2:10]], I made an AutoCorrect entry with [[ that would then enter [[]] for my bookmark).  

If you are using Microsoft Word, and your platform does not provide for bookmarks within the document, you’ll need to make your own.  A tilde ~ is not a character used much in transcription unless you’re typing in Spanish, so it’s perfect to use as a bookmark.  If you are unsure how to create macros in Word, I’m going to walk you through it.  If you’re proficient at Word, then you’ll want to leave here and go make your macro right now! 

I use Word 2003 – as do most of the companies I have worked for.  The instructions below are for Word 2003.  If you have an earlier version or newer version, it may differ slightly. 

• In Word, choose Tools and Macro from the drop down menu.  You’ll then want to choose Record New Macro.
• Once the Record Macro box appears, you’ll need to name your macro.  I used Tilde just so I could find it easier. 
• Leave everything else the same and click the Keyboard Icon or press Alt-K.
• The next window should come up that will show you where your macro will be stored.  In this window, you will choose what keystrokes will be assigned to this macro.  I used F2.  You can assign any keys that would work best for you such as Alt-B for “blank” or your own combination. 
• Type in the keystroke you want to use then press Enter for “Assign”.  Press Enter again to close this window and start recording the macro.
• You should now see a little cassette tape next to your mouse arrow and a very small box to the top left of the document page. 
• Press CTRL F which will bring up the “Find” feature in Word.  
• Type ~ in the “Find What” section. 
• Press Alt-F for “Find Next” button and press Enter. 
• Tab to Cancel and press Enter.
• You can now click the Stop button in the small box to stop recording the macro.

You now have your bookmark to set up in your templates!  Just don’t forget to check for any “stray” bookmarks you may have left behind when you have finished the dictation.

Optimizing production intro

**Disclaimer — All the information herein is for MTs on a Word-based platform.  If your platform is not Word based, you should still have some sort of feature for creating shortcuts.  Therefore, while the information may not be exactly what you need, it could still prove helpful for you. 

We all want to make more money. The way MTs make money is to actually type as few characters as possible for the maximum gain. There are software programs that can be purchased to run in the background that many MTs swear by. Honestly, I have never actually bought a text expander, mainly because most of the platforms I worked on would not support one. However, I did learn to utilize Microsoft Word’s AutoText and AutoCorrect features to maximize my production to about an average of 200 to 250 lines per hour. And I’m going to tell you how to do it for free.

I have quite a bit of information on using AutoText and AutoCorrect as word expanders, so I’m going to break it down into a couple of lessons to avoid information overload. 

Below is a sample of what I actually type into Word for a physical exam:

pexx 146/92 208 97.2 96 16 0 Vrpl wf Dbs

What actually comes up you ask?

pexx – this brings up my AutoText for a “normal” physical exam which looks like this:

VITALS:  Blood pressure~.  Weight ~ pounds.  Temperature ~.  Heart rate ~.  Respiratory rate of ~.  ECOG performance status = ~. 
GENERAL:  ~ in no acute distress. 
HEENT:  Oropharynx is clear.  Sclerae are anicteric.  Conjunctivae are pink. 
NECK:  Supple, no thyromegaly.
NODES:  No cervical, supraclavicular, axillary, or inguinal palpable lymphadenopathy.
LUNGS:  Clear to auscultation and percussion bilaterally. 
HEART:  Regular rate and rhythm, S1 and S2; no murmurs, rubs, or gallops. 
ABDOMEN:  Soft, nontender, nondistended.  Bowel sounds are present. 
EXTREMITIES:  No clubbing, cyanosis, or edema. 
NEUROLOGIC:  Alert and oriented x3, normal gait and station.  No sensory deficits. 
PSYCHIATRIC:  Normal affect and mood. 

You may notice the tilde mark in the expanded AutoText.  I created a macro to be able to “jump” around the text easily. I’ll be posting more on that later.

Next, you’ll see I entered 146/92 208 97.2 96 16 0.  All I did was jump from tilde to tilde and enter the numbers.  I had used F2 to assign that function and used the number keypad to enter the numbers… it really saves a lot of time.

Next, I jumped to the tilde in the General section and typed Vrpl wf which will come up as Very pleasant, white female.  With AutoCorrect, provided you have selected the “plain text” option, when you capitalize the first letter of your shortcut, the first letter of the expanded version will be capitalized also. 

My last entry on this physical exam was Dbs for “Decreased breath sounds” as that was the only thing the physician changed… everything else was his “normal” — what he says every single time a patient has a “normal” exam.   

I just got paid for 11.5 lines, but I only typed 40 characters (including spaces)… at 8 cpl, that’s 92 cents in less than a minute! 

Figuring out your physician’s pet phrases and having them set up in a “normal” AutoText file that you can drop in to every document you create for that physician will save time, increase your production and your paycheck.   A little time spent setting these up will pay off big time in the long run.