| Product Category Analysis: Voice Recognition/Transcription Systems |
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| Written by Jeff Merron | ||||||||
| Friday, 03 April 2009 09:54 | ||||||||
 Cheaper, smaller, and more powerful computer technologies. Financial pressure to see more patients. More stringent reporting requirements for physicians (including the looming transition to EMR). Advances in telecommunication. All had an impact on medical transcription over the past decade. However, while more options for recording patient visits are available, most small medical practices continue to operate pretty much they way they always have: talk in to a recorder, send off the recording to a transcriptionist or transcription company, and receive what was spoken back in a written document. What's going on behind the scenes, however, has changed a great deal: the recorder is a computer application, which usually outputs a digital .wav file. This file is sent over secure Internet connection to a transcriptionist, who could very well be in the Philippines or India, according to a report in the Feb. 14, 2009 issue of The Lancet. The practice gets back a document that is not paper, but more likely a digital text file. Because of these changes, practices should reevaluate their transcription methods and services if they havent done so recently. Outsourcing and Voice Recognition "The overseas outsourcing that started about five years ago has really changed the landscape considerably," says Jeffery Daigrepont, a senior vice president of the Coker Group. "Those companies work while we're sleeping, so it's improved turnaround time. And labor costs are significantly lower." Despite -- and perhaps in part because of -- faster, cheaper transcription services -- most practices have avoided even considering speech recognition applications (most notably Dragon Naturally Speaking), even though speech recognition accuracy has improved considerably over the past five years. "I actually don't know many practices that use voice-based transcription services," says Kevin Pho, who writes the popular medical blog, KevinMD. "It's difficult to say why. There's a lot of pressure on physician practices to adopt computerized or digital medical records, and I think that added expense of a voice recognition system really adds on to the cost." Pho makes no claim to being an expert in either transcription or voice recognition technology. However, his sentiment that voice recognition systems face "a huge obstacle" because of the likelihood (or perception) that the transition to such a system would create a "huge disruption in workflow" appears to be widespread and will be difficult to overcome. Efficiency is a major selling point for speech recognition vendors. A recent press release from Nuance Communications featured the subhead, "With Dragon Medical Speech Recognition Software, doctors create highly accurate, real-time electronic health records simply by talking." The release touted the software's ability to help doctors create accurate and detailed medical reports, spending "up to 25 percent less time documenting care, when compared to using a non voice-enabled EHR." Daigrepont agrees that accuracy of voice recognition software has greatly improved, in part due to large, specialized medical dictionaries included with the software. But voice recognition software must be "trained" to recognize an individual's voice, and this training can take a fair amount of time -- time physicians usually aren't willing to sacrifice. When they do take the time, says Daigrepont, the results can be excellent. But many expect the software to work off the shelf, which results in an unacceptable level of errors. "The problem with the mistakes is that it [the software] doesn't necessarily spell the word wrong." says Daigrepont. "It inherently confuses words. We had an ophthalmologist, for example, who was using it, and every time that this poor doctor said, 'nice eyes,' the program accidently converted it to 'nice thighs.'" While office workers or transcriptionists can be trained to edit voice-recognition output for mistakes, it can be difficult to discern errors when they are removed from their context. Sometimes a doctor's comments about a patient's thighs are entirely appropriate. Which was why one of the key summary points in the preliminary findings reported for the 2007 Bentley College survey of medical transcriptionists was "Speech-recognition technology is only a transcription tool, and not a transcription replacement. The job involves too much professional intelligence and sense-making ability to have it migrate completely to speech recognition." It is crucial, however, that speech recognition is mentioned as a transcription tool, as many are using the software to make the overall process more efficient. Nuance has said that transcriptionists "are able to transcribe an average of 30 percent more quickly through the use of the technology." Talking About the Bottom Line While global trends in transcription and speech recognition are interesting, and very useful to think about, each practice is unique and therefore must take into account many factors when assessing its current transcription system, and whether changes to the system should be made. Daigrepont says that Coker suggests practices consider the following when evaluating this:
When these factors are considered thoughtfully, it's possible that your practice can save both time and money on transcription, without significantly hampering physician workflow. | ||||||||
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About the Author: Jeff Merron is a full-time freelance editor, journalist, and copywriter who has written for the New York Times Magazine, ESPN.com, Slate, Byte Magazine, Macworld, Consumers Digest, and many other national publications. He's also a regular contributor to IT Business Insider and 108, a baseball magazine. He has a Ph.D. in Mass Communication Research from the University of North Carolina at Chapel Hill.
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