After all the time spent choosing a system to get notes into the file doctors now find a new change on the horizon-electronic medical records. With the push to get an EMR in every doctor’s office where does that leave voice recognition and transcription systems?

Voice Recognition
According to Todd Frech, a health care technology consultant and doctor, voice recognition systems have come along way. “The first systems required an enormous amount of time to train-up to 3 hours, so they were favored by specialists with a smaller medical dictionary.“

A perfect example is Dr. Theodore Corwin. For the past five years, Dr. Corwin, who is a plastic surgeon, has used Dragon Naturally Speaking for all of his dictation. Dr. Corwin explains, “I bought the regular edition for $99 rather than the medical one which costs over $1000 and I have no regrets“ When he first bought the system, he still had paper-based files, so he came up with an ingenious solution for transferring the notes into the patient file “For the first few years I would print my dictation on label paper and have the staff cut them up and stick them in the appropriate charts.” Once he went electronic, all he had to do was dictate his notes into the voice recognition system, proof read them, and then click a button to record it into the patient’s electronic record. Dr. Corwin notes “Dragon is about 95% accurate, but it does miss some words that need to be corrected. If I use medical terms that it doesn’t recognize like "blepharoplasty" I can train it so it will recognize it in the future”

Frech sees the system slowly evolving from specialists to a wider medical audience. With electronic medical records, Frech indicates the voice recognition is an enhancement to the drop down template found in many electronic records. While improvements have been made Mr. Frech believes that there are still impediments to wide spread adoption. Aside from the time to train, the system there is still finding the time to dictate and review the notes, which might be hard in a busier clinic.

Some solutions to the time crunch include devices such as the LiveScribe pen, which allows the doctor to record and playback voice notes or written notes, and then there is the option of downloading Dragon or a similar voice recognition system to the iphone or smartphone. These devices simply make it easier to find the time dictate the notes there is still the problem of getting them into the file.

Transcription
So where does this leave transcription? Will standard transcription be phased out? Not according to Lisa Pike, President of ScribeRight Transcription, her company provides transcription services to doctors and she believes that transcription is necessary even in an electronic medical record setting. Pike feels that doctors are pressured enough visiting patients. They don’t need to spend an additional 10 minutes dictating notes and reviewing them.

She also explains that transcriptionists use national standards concerning the format of medical notes. Having a transcriptionist prepare the dictation ensures readability and accuracy. Pike firmly believes, “Transcriptionists are also trained professionals familiar with medical terminology and serve as a second set of eyes for the notes. They catch errors like dosage or medication”. According to Pike, transcribed notes enhance the electronic medical record. It is crucial that the electronic system supports true integration instead of just interfacing.

Interfacing, says Pike, only allows information to be uploaded to the file. The information is there, but not searchable. Truly integrated notes allows the notes to be broken down and inserted into the precise spot in the medical record. An example Pike uses is the ability to add transcribed information into the ongoing medication history, or the ability to add a more detailed note to the EMR’s template drop down selection.

Both voice recognition systems and transcription continue to have a place in a doctor’s office, even with the coming electronic medical record conversion. Working hand in hand with the EMRs, the voice recognition and transcription will ensure greater accuracy in patient’s medical records.