Variables have to be considered at both the dictator's and the service provider's end:

Dictation variables over which the service provider cannot exert control, however, influence service rates -

* Dictator characteristics (speech inflection, articulation skills, new or experienced dictator).
* Dictation equipment (analog, digital, controls, maintenance, media quality, rerecord or original).
* Dictation software (speech recognition technology).
* Type of report (operative, discharge, SOAP, progress notes, H&P;, radiology, pathology, specialty).
* Completeness of dictation (provision of patient demographics, use of abbreviations, incomplete reports or sentences).
* Difficulty factors of reports (routine or complex; new procedures, drugs, instruments).
* Environmental factors (background noise; sound quality; frequent interruptions).

Transcription variables

* MT knowledge (education, experience, English and medical language fluency, editing skills, familiarity with report types, familiarity with dictating staff).
* MT equipment knowledge (experience on facility's equipment).
* Transcription equipment characteristics (quality, features, maintenance).
* Resource availability (adequate, up-to-date, accessible references; access to other MTs, electronic assistants, Internet access).
* Environmental factors (ergonomics, distractions).
* Performance expectations (demands for quantity, demands for quality, personnel policies).
* Other responsibilities (answering telephone, filing, etc).

In addition to transcription responsibilities, many MTs during the past decade have acquired new responsibilities in the areas of editing and risk management. Some have learned coding and others are involved with information systems. The historical performance of an individual MT or an entire department can still be determined by establishing the method to quantify productivity and then tracking it over a period of time. If all factors remain the same, productivity will remain the same. However, if one or more dictation or transcription factors change, average productivity (individual and collective) will change. Something as simple as a new chair can alter productivity. Equipment failure, lighting, furniture, poor dictating habits, adequate breaks, background noise, or just not feeling well...many factors contribute to variations in an MT's productivity.