FREE Health Data Management Site Registration

Sign up today and access the leading source of Health Care I.T. information on the Web.
Your FREE site registration entitles you to:

Free Health Data Management e-newsletter
 
Search more than 12,000 articles
 
Access Web Seminars on a host of I.T. topics
 
White Papers and Industry Research that provide valuable insights on a variety of technologies and implementation issues
 
Podcasts, updates on industry events, and much more!

 
   

Giving Transcription A Trim


By Howard J. Anderson, Executive Editor September 2007
For years, many health care organizations have been trying to sort out what role, if any, speech recognition can play in reducing the high cost of transcribing physicians' dictated notes.

At Baystate Medical Center, executives concluded that the technology, which converts spoken words directly into text, could be used in two very different ways. Some 850 of its 1,400 physicians dictate their notes into a phone, as they've always done. But now their recorded voices are converted to text on the back end using speech recognition. That way, transcribers only have to edit the report, rather than type it up line by line, says Walter Houlihan, director of health information management.

Meanwhile, radiologists at the three-hospital delivery system in Springfield, Mass., use speech recognition on the front end and edit their own work. The specialists use a very specific vocabulary, so the front-end technology is well suited to their needs, Houlihan says.

Gradually, more hospitals and clinics across the country, faced with staggering transcription costs, are turning to front-end or back-end speech recognition. But executives are pondering whether over the long haul a move to comprehensive electronic health records will lead to increased or decreased use of the technology (see related story, page 38).

Many physicians resist the idea of editing their dictated notes because of concerns about time constraints, says William Meisel, president of TMA Associates, a Tarzana, Calif.-based consultancy specializing in speech recognition technology. But if doctors in all specialties truly understood the role front-end speech recognition technology can play, they'd realize that it actually saves them time, he argues.

Physicians can more easily edit a freshly dictated report than one that is transcribed and sent back to them hours or days later for review, he argues. "That can be as time-consuming as if they did it on the front end."

Also, radiologists and pathologists deal solely with referrals from other doctors who are anxious to receive reports, he adds. By using speech recognition on the front end and editing the reports immediately, the information can be available to referring physicians right away, which improves service-and leads to more referrals, the consultant says.

"The most efficient method for the health care system is for all doctors to edit their reports. It's advantageous from a cost point of view as well as a timeliness point of view," he says.

By using templates for standard reports, physicians can minimize the need to dictate, saving even more time, he notes.

Another consultant, however, sees a long-time role for both front-end and back-end dictation.

Different physician specialties have vastly different dictation needs, says Joe Marion, senior manager at ACS Healthcare Solutions, a Dearborn, Mich.-based consulting firm. For example, a radiologist may use a well-defined template to dictate a few fill-in-the-blank values, while an internist may need to dictate lengthy free text for a discharge summary, he notes.

Those specialties that can rely heavily on templates are perfectly suited for front-end dictation because their reports will have little need for editing, Marion says. In contrast, doctors who dictate large amounts of free text will most likely rely on others for editing, which means back-end speech recognition best meets their needs, he adds.

In addition, some provider organizations may find that expanding front-end dictation to more doctors is cost-prohibitive because it could require a broader investment in computer hardware for each physician, Marion contends.

Nevertheless, Marion predicts demand for speech recognition will surge because of two factors. First, physicians will recognize that the more detailed, accurate documentation that comes from using speech recognition can help them better defend the diagnostic codes they use for payment purposes, ultimately increasing their revenue, he says. Second, organizations will conclude that the technology, whether used on the front end or back end, can slash astronomical transcription costs, which can amount to millions of dollars for a typical hospital.

More Special Report Articles

Hospitals Archive

I.T. Spotlights