The key elements of an effective quality assurance program should include:

- Appropriate work environment and adequate resources are provided and maintained.

- Medical transcriptionists must have the appropriate education, training, and experience, as well as work under supervision and management.

- Managers and supervisors must be dedicated to quality assurance and provide an environment that supports quality documentation.

- Designated equipment is utilized skillfully and efficiently, with proper guidelines and demonstration for use available to transcriptionists and originators of the documentation.

- Patient demographics and Originator identification are verified. Designated formats are followed.

- English language rules are adopted and used consistently.

- Current reference materials are made available and are used consistently.

- Visual proofreading as well as electronic spellchecking and grammar checking are performed.

- Obvious inconsistencies, discrepancies, and inaccuracies are recognized and appropriately revised, edited, or clarified, without altering the meaning of dictation or changing the originator's style; flagged for review; or brought to the attention of appropriate personnel for action.

- Reasonable TAT deadlines are met.

- Patient confidentiality and systems security are protected.

- Document storage and retrieval guidelines are followed.

- A mechanism for feedback to the medical transcriptionist is provided.

A Transcription Company today must be able to deliver a service that meets customer requirements, is delivered on time and is technically superior. This is usually achieved by having good professional staff, being customer aware, working with a well defined methodology and using the best available development practices and test tools. Only a company that is committed to quality culture can deliver this.

Currently there are many standards worldwide such as ISO 9000, SEI CMM, SPICE etc. Quality management practices overlooking the production process need to be extensive and prescriptive. Process quality is an essential ingredient and with future reliance on MT, particularly with end-user MT increasing, there is a need to anticipate and plan for the future, improving existing processes to support tomorrow�s businesses, while at the same time assuring levels of quality today.

Quality is increasingly been seen as an "essential" rather than "useful" business tool. Total quality culture as opposed to quality registration is more relevant to the final service delivered. There will be greater focus on product quality in the widest sense, as complement to process quality. The emphasis must be on total quality management, with certification being an important milestone.

Total Quality management, is a management philosophy and a way of conducting business which emphasizes more sophisticated techniques of continual improvement. The requirement of ISO 9000 stops well short of the cultural environment TQM is seeking to establish.

Indian companies are not only increasingly adapting to the international quality standards but are taking a leadership position. It is the policy of the Government of India to encourage manufacturers and exporters to attain internationally accepted standards of quality for their products and services. According to the Export-Import Policy, manufacturers who have acquired quality status of ISO 9000 (Series), SEI CMM Level 2 and above or equivalent certification are eligible for the grant of incentives in the form of Special Import Licenses. The entitlement is calculated at the rate of 5% of the F.O.B. value, of exports of products and services made with the above said quality certification during the preceding year.

In India, quality certification is provided by BIS, STQC and many private agencies. Indian companies also use the services of International agencies like BVQI, KPMG, RWTUV etc. to get quality certification.