Jun
10
Written by:
admin
Thursday, June 10, 2010
The problem with voice dictation in the context of general practice is the requirement for a quiet room. It can essentially only be used after the patient has left the consultation.
Dictating letters whilst in consultation with the patient can be performed with prior explanation to the patient of what you're about to do and the requirement for them to remain quiet.
I have been using dragon dictation at work for five years.
95%+ accuracy. It eradicates spelling mistakes but introduces incorrect words and requires proofing. It requires a good quality microphone with noise cancellation.
My favourite microphone is the GN 9350 USB wireless microphone. All Bluetooth headsets are limited by the lower bandwidth and thus lower voice quality available via Bluetooth.
Interestingly, I have also tested the inbuilt voice dictation available within windows seven (much more accurate than the voice dictation available within Windows Vista) and fairly close to the accuracy available within dragon dictation. Certainly good enough for dictating occasional letters.
One of the main benefits of using voice dictation is that the quality of notes (for those of us who can't touch type) is significantly greater when using voice dictation.
Another drawback is that voice dictation does not significantly enhance data entry into forms and is in fact impeded by the use of forms where I must resort to using the keyboard.
It would be much more convenient if the text editor could extract measures such as BP from dictated text.
However, going back to the requirement to have a quiet room and thus dictating notes at the end of consultation, there is a requirement to record measurements during consultation. I therefore use the forms in clinical software for entering data during consultation.
It is hard to achieve the best of both worlds.
Usage of macros available through dragon dictation means I can dictate the phrase "insert paediatric URTI" which will then be expanded to a consultation note that only requires embellishment for completion. This is slightly more powerful than the macros available within medical director because the expanded text includes rich formatting and the macro triggers more closely represent what we want to achieve and are therefore easier to remember than some cryptic combination of letters.
Despite the power of voice dictation my practice still uses paper notes but the days are numbered.
Our whole practice will be switching to electronic notes at the end of this month and all doctors have been trained in voice dictation.
This has been a gradual change over the past two years so please don't get the idea that switching to voice dictation is easy. It is not the nirvana for data entry.
It is a compromise between the true capabilities of voice dictation and the complex situation in which we work.
Cheers
Anton Knieriemen
note: dictated with dragon dictation