Physicians Voice Enthusiasm About Digital Dictation

By Florian Schwiecker for HIT Exchange

There’s broad consensus today that automating clinical workflow can help improve patient care and save money. But while many practices are implementing sophisticated EHR systems, their dictation methods haven’t changed much since the 1960s. Many doctors still dictate into analog recorders that have been around since The Beatles’ heyday. Then they ship those tapes off to a transcriptionist, allowing significant time to elapse before final sign-off.

Many physicians simply aren’t aware of the latest breakthroughs in digital dictation technology—and therefore have no first-hand experience with its dramatic benefits. Toss out the vinyl records and forget about analog tapes. There’s a whole new world out there!

These innovations fall into three main categories:

• Voice recording with digital devices – Simply switching from analog to digital recording devices brings numerous benefits. Audio files can be sent electronically just like Word files, so transcriptionists receive them instantly—whether they’re next door, two floors below or on another continent. With digital voice files, doctors can insert information anywhere in the recording they like, not just at the end. And it’s easy to vocally add a patient ID or priority status to make the transcriptionist’s job faster and more productive.
• Back-end speech recognition –Here’s where the real fun begins with digital voice processing. Everything remains the same on the doctor’s end. The physician creates a voice file, which then gets routed through a voice recognition engine and sent to a “correctionist.” The resulting document is reasonably close to its final form, requiring only a few minor tweaks by someone who is essentially proof-reading rather than transcribing. That makes turnaround time much faster. Speech recognition software comes in all varieties, from the fairly crude features in some products to the fairly sophisticated features in others. Medical speech recognition is much more accurate, and getting smarter all the time.
• Front-end speech recognition – Sometimes called “online” voice recognition, this technology lets physicians see their words onscreen as they dictate into a USB microphone. This means fewer steps: physicians just dictate and sign off on the final report. However, it does require physicians to edit their own documents. Each physician practice must decide when, how and if it wants to deploy this technology. For example, an eye specialist could use front-end speech recognition to expedite care for someone with a detached retina, while sending all non-emergency dictation to a correctionist.

Boosting productivity, improving workflow

Digital dictation is gaining popularity in both hospital and physician practice settings because it delivers key benefits:

• Improved sound quality – Transcriptionists have long complained that analog recordings are “muddy” and full of ambient noise—as if the notes were recorded on a subway, not in a doctor’s office. Digital recorders eliminate ambient sound, and can even remove the doctor’s breaths and gaps of silence for greater clarity. This greatly speeds up turnaround time for traditional transcription.
• Less transcription – With speech recognition tools, today’s transcriptionists are becoming tomorrow’s correctionists. Just like a proofreader at a newspaper, a correctionist is looking at text that’s already 95 percent perfect. This transition from heads-down keyboardist to proofreader means that patient records get into the system with exceptional speed and accuracy.
• Improved workflow – Digital dictation eliminates all the cumbersome analog tools that transcriptionists have long used: cassette-based rewind/forwarding devices, etc. The transcriptionist now works from digital files. These are easy handle and prioritize and never deteriorate in voice quality no matter how often they listen to one sector. Work routing is greatly improved, too. For instance, a physician can enter a vocal ID that sends all chart notes to one transcriptionist and all requests for consultation to another.
• Better patient care – In the analog days, transcription turnaround often was measured in days. Now it can be measured in minutes. In 1965, a doctor might see a patient on Friday, give the tape to a courier, and wait for the transcriptionist to start typing on Monday. Using front-end voice recognition, that process can take as little as a few minutes—and the information can go directly into an electronic health record (EHR) to be shared instantly with other physicians, nurses, billing staff, and others. Because patient data can be shared faster than ever before, the quality of care soars.

When physicians see the benefits of digital voice processing, they’re not just impressed. They become vocal supporters.