Medical dictation has evolved with improvements in voice recognition software. When many of today’s physicians began their careers, medical dictation meant having a transcriptions in the room taking notes in real-time. That simpler reality has now been replaced by a wide range of medical dictation workflows that offer greater flexibility and lower costs.
This new range of options is a good thing in an era when doctors are spending more time on clinical documentation than ever. A third of physicians now spend over 20 hours a week on paperwork and administration, and that’s not to mention homework. Research shows that family doctors spend on average 86 minutes of nightly “pajama time” completing notes in the EHR.
An efficient medical dictation workflow is one of the best ways to minimize time spent on clinical documentation. But with cost pressures and constantly changing technology it can be hard to know which workflow is the best fit for your practice.
The following list of four workflows lays out a basic explanation of what medical dictation can look like, without making specific software recommendations. It should be a helpful starting place for physicians considering switching from typing to dictation, or who want to improve their current dictation workflow.
Which medical dictation workflow is best for you?
1) Digital voice dictation only
This is as simple as it gets. As the physician, you dictate directly into a digital voice recorder that saves your dictation as an audio file. This file gets transferred to a medical transcriptionist, who could be part of your staff or off site. The transcriptionist listens to the dictation and types what they hear into a text document or directly into the EMR. After the transcription comes back, you review the note for accuracy.
- Benefits: No extra time required for the physician; no need to learn new software or workflows.
- Costs: Requires extra staff salary or paying for an off-site transcription service; final note may not be complete for several hours up to several days; requires physician to return to the note for final review.
- Who it’s good for: Physicians who don’t want to learn a new workflow and have plenty of money to allocate to transcription services or additional staff.
2) Automated dictation with assistance proofreading
This is the workflow used by modern medical transcription services if you were to send your dictations off site, but it can also be performed in office. As the physician, you still dictate into a voice recorder but with attention to the clarity of your speech. The recording is automatically transcribed by a medical grade speech-to-text software like Dragon Medical.
Because a computer is doing the initial transcription, you need to speak clearly and at a moderate pace with good pronunciation. The initial transcript is reviewed by a medical office assistant who corrects any dictation errors by listening to your original voice recording. As with the first option, you will want to review the final transcript for accuracy.
- Benefits: No extra time required for the physician; no need to learn new software.
- Costs: Requires new attention to clarity when speaking dictations; cost of transcription services may be lower than Option 1, but in office workflow also requires purchasing transcription software; final note may not be complete for several hours up to several days; requires physician to return to the note for a final review.
- Who it’s good for: Physicians who can speak clearly, have no time to review a transcript themselves, and have plenty of money to allocate to transcription services or additional staff.
3) Direct EMR speech-to-text
This workflow has become feasible in recent years because of huge improvements in speech-to-text medical dictation software. The best softwares are EMR-integrated and use deep learning/neural net technology. The result is an instant and accurate transcription directly in the EMR.
As with the previous dictation workflow, you speak your note into a microphone with attention to clarity and pace. There are many voice recorder options, and you can even configure your smartphone as a wireless microphone for your desktop EMR. Your words appear instantly in the EMR so you can proofread the dictation and make any edits before saving the note.
- Benefits: Transcription is instant and the physician can review and close the chart immediately; extremely accurate; lowest cost option; no need for additional staff or third-party transcription service.
- Costs: While much faster than typing, still requires review and editing by physician; must purchase subscription to medical speech-to-text software.
- Who it’s good for: Physicians who are cost efficient and don’t mind learning a new, streamlined workflow in exchange for instant, accurate notes that arrive directly into the EMR with no additional typing.
4) Mobile dictation
Mobile dictation is the same as the previous workflow, but with the flexibility of a smartphone or tablet. As the physician, you use a mobile speech-to-text medical dictation app that connects directly to your EMR. Your words appear on your mobile device screen as you speak, and you make any edits as you go.
This option can easily be used in combination with a desktop speech-to-text workflow. The benefit of mobile is that you don’t have to be tethered to a particular work station or even to the office. Some physicians also dictate their notes during the patient visit, using dictation as an opportunity to engage the patient and ensure accuracy. Used well, mobile dictation can turn documentation time into a meaningful patient interaction while saving hours each week.
- Benefits: Transcription is instant, accurate, and affordable; dictation can be completed anywhere; allows flexibility and creative solutions for cutting documentation time and improving patient engagement.
- Costs: Requires accuracy review by physician; requires comfort with mobile device technology like smartphones; must purchase a mobile-ready and EMR-integrated speech-to-text software.
- Who it’s good for: Physicians who are comfortable with technology and willing to explore the cutting edge of dictation workflows in exchange for substantial time and cost savings and new opportunities for patient engagement.