| Speech Recognition Technology for Physicians |
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Speech recognition software vendors have emerged as one of the best,
low cost, workflow compatible options for the physician practice
market. Speech recognition technology has been able to assist physician
practices by providing a relatively inexpensive, flexible tool that can
assist the practice to meet its patient care, business and compliance
goals. Because of the relatively low cost, willingness of the vendors to customize the product, and increased demands on physicians, speech recognition software has become one of the fastest growing sectors in the entire health care market. In fact, most professionals who use this technology tend to be medical practice based. Speech technology suppliers are constantly working to further meet the challenges faced by physicians and other health care providers. The software, training and hardware upgrades are relatively inexpensive compared with other options. While it is not unheard of to spend $30,000 to $50,000 on a full Electronic Medical Record (EMR) system, speech recognition solutions can start at as little as $2,000 straight out of the box. Many practices are able to use the technology to cut down or eliminate the use of transcription services and related costs, as well. The software can be customized to record macros or templates of frequently used dialogue which can be a huge time saver. The macros that can be programmed are essential, not just in decreasing time spent documenting and in keeping costs down, but also in assisting physicians to keep in compliance with the Centers for Medicare and Medicaid Services (CMS) documentation guidelines. Macros or templates can be bought from re-sellers or programmed by a vendor for the needs of the individual practice. Macros can be used for parts of an encounter or as a template for an entire visit. A simple example of a macro as a time-saving tool can be shown in a normal abdominal exam which may read: "Flat without visible scars, hernias, ecchymosis, peristalsis, pulsations or venous distention. Normoactive bowel sounds in all 4 quadrants. No aortic, renal, iliac, or femoral bruits noted. Liver span 8 cm/MCL with smooth edge. Gall bladder and spleen not palpable. No noted tenderness on light or deep palpation in any quadrant. No masses guarding or rebound. No CVAT." A macro would allow all of this information to be pre-programmed into the system. During dictation, the only thing that would have to be said by the user is "normal abdomen" and all of the above information would appear in the typed version of the patient encounter. This eliminates the need for repetition of all of the standard verbiage in a normal exam during each patient encounter. Macros are easy to learn and even easier to use. Speech recognition software does not require a major retraining of physicians since most are already using or have used some type of dictation. Speech recognition software will, in most cases, integrate into Electronic Medical Record systems, should the practice decide to upgrade in the future. It’s also been shown that speech recognition makes a practice function in "real time," since speech recognition files can be dropped to paper if needed and faxed the same day as the patient is seen. Speech recognition software works by understanding the phonetics behind words and how an individual user speaks those phonetic sounds. Individual users must spend some time "training" the software to recognize their voice patterns. Initial training of the newest versions of available speech recognition software requires only between 15 to 20 minutes of the user’s time to be able to starting effectively using the tool. Training time has become significantly reduced from previous versions available only a year or two ago. A few issues should be considered prior to purchasing this type of technology: What does the practice want to achieve with the software? Some practices may want to use speech recognition to augment EMR, others may want to decrease transcription costs, and yet others may want to use it to get notes out to referring physicians the same day the patient is seen. Easily readable compliant documentation may also be on the list of goals. Whatever the goals may be, they should be clearly defined prior to purchase and implementation. Is there adequate support among physicians for using the technology? While the practice may have goals they would like to achieve with technology, they may never be attained unless the end users have an open mind and are willing to learn. Unlike full EMR systems, not all physicians in a practice must use speech recognition software for it to be successful. Since speech recognition software can be flexible, it can be used by some but not all physicians, it can be used as a replacement for transcription, it can be used in conjunction with transcription, it can be used in conjunction with inexpensive documentation templates or also with full EMR. Whatever end-use decisions are made by the practice must be understood and supported for the product to be a successful addition to the practice. Who should we call to help with this? Many times a practice will have a technology leader. This leader may be savvy enough to purchase and install hardware and software. In other instances, practices may lack this type of expertise. In either scenario, it is critical to work with a speech recognition professional who understands the workings of a medical practice. The expert in speech recognition applications should be available to work through any problems faced with installation or day-to-day use. A good speech recognition professional advisor will also be able to take the practice to the next level by assisting with integration with other technologies or supplying macros to constantly improve efficiencies within the practice. Speech recognition technology is a great option for medical practices for many different reasons. Whether it’s being used alone, as a stepping stone to full EMR, or conjunction with an EMR system, practices will be pleased with the cost savings, ease of transition, and workflow improvements. Tracey C. Glenn. Tracey C. Glenn, CPC is a Senior Consultant at PMSCO Healthcare Consulting. Located in Harrisburg, PA, PMSCO is a subsidiary of the Pennsylvania Medical Society |
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