The Internet has brought medicine a lot of things, such as full-text articles on-line, message boards to discuss tough cases, and instant information on various drugs. It can also help ophthalmologists with the daily task of transcription as well, in the form of on-line transcription houses, which will take a digital recording of the dictation, or allow a doctor to dictate over the phone, and turn his words into a digital transcript. Here's a look at the benefits and possible drawbacks of on-line transcription and two companies that offer the service.

In a nutshell, according to the on-line transcription houses, the benefit of outsourcing transcription is the savings involved with not having to pay a transcriptionist to be on-staff and not having to purchase transcription equipment. The possible drawback, however, is that your on-line transcription may be done overseas by someone for whom English isn't his or her first language.

Some on-line transcription services will loan digital recorders to physicians for free.

 • MxSecure. This service allows physicians to dictate into a digital recorder and then upload the dictation to MxSecure's site, or call in their dictation to a toll-free number.

According to Craig Mercure, director of sales for MxSecure, the company offers a standard turnaround time on transcripts of 24 hours. "Users find that the immediate turnaround time is a benefit," he says, "as [is] the ability to have their documents on-line to retrieve or edit, which helps with workflow." The company offers two tiers of service: MxExpress, which has no start-up costs and allows physicians to have basic on-line transcription and retrieval of documents; and MxProfessional, which costs $500 at first but offers more reporting features on the transcripts and keeps the documents on-line indefinitely, rather than temporarily as with MxExpress. Costs for transcription vary from about 12 cents per line to use an offshore transcriptionist to 14 cents per line to use a U.S. employee. To ensure quality, though, Mr. Mercure says the company has dedicated teams for the various medical specialties to ensure the terminology is as accurate as possible. For information, call 888-580-1010.

 • SpectraMedi. This company also offers the digital recorder or phone-in options.

"We archive transcripts for five years," says Frank Kunnumpurat, SpectraMedi's owner. "This allows doctors to search their transcripts for any key word. So if a physician wanted to see how many of a certain procedure he performed in a six-month period, the system can pull transcripts with that procedure in them."

The company also just keeps one note per patient that is constantly updated when new transcription arrives, rather than a different note for each visit. "Each one includes just a summary of the last visit," Mr. Kunnumpurat says. "It then adds the notes and the date of the current visit."

The service also has several redundant systems in case the primary one goes down for some reason. They use multiple Internet providers, three data lines (two copper and one fiber optic) and redundant servers that are ready to come on-line if the primary server fails or is damaged.

SpectraMedi's pricing is around 13-16 cents per line for a U.S. transcriptionist, 10-13 cents if your transcriptionist is drawn from a pool of U.S. and Indian employees, and around 8.5-12 cents for an Indian transcriptionist. Desired turnaround time adjusts the price, with next-day delivery being the most expensive. For information call 888-329-8402.