Medical dictation has changed substantially due to improvements in voice recognition software. When many of today’s physicians began their careers, medical dictation meant having a transcriptionist in the room taking notes in real time. But that more straightforward reality is long gone, and today there’s a wide range of medical dictation workflows that offer greater flexibility and lower costs.

These new medical dictation options are good, given that doctors spend more time on clinical documentation than ever. In 2022, the average physician spends over 15 hours weekly on paperwork and administration.

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 best fits your practice.

Which medical dictation workflow is best for your practice?

The four workflows below explain what medical dictation can look like without making specific software recommendations. This article should be a helpful starting place for physicians considering switching from typing to dictation or who want to improve their current medical dictation workflow.

If you’re interested in software advice, read about the best free medical dictation apps or the best dictation solution for doctors who use macs.

Option 1: Digital voice dictation only

This first option 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. You send the file 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 is 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 the 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.

Option 2: Automated dictation with assistance proofreading

Automated dictation with proofreading is the workflow modern medical transcription services will use if you send your dictations off-site, but you could also set this up in the office. As the physician, you still dictate into a voice recorder but with attention to the clarity of your speech. Then the speech-to-text software automatically transcribes your dictation.

Because a computer is doing the initial transcription, you need to speak clearly and at a moderate pace with good pronunciation. A medical office assistant reviews the initial transcription and corrects any dictation errors by listening to your original voice recording. As with the first option, you will want to check the final transcript for accuracy.

• Benefits: No extra time is required for the physician; no need to learn new software.
• Costs: Requires new attention to clarity when speaking dictations; price 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 the 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.

Option 3: Direct EMR speech-to-text

Direct EMR speech-to-text has become feasible recently because of considerable improvements in voice recognition software.

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, it still requires review and editing by the physician; you must purchase a 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.

Option 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.

You can easily combine mobile dictation with a desktop speech-to-text workflow. The benefit of mobile is that you don’t have to be tethered to a particular workstation or even complete notes at the clinic. 

For example, apps like Mobius Conveyor use secure dictation memos that allow you to record a dictation on your smartphone and send it to the EMR when you’re back at your workstation. Mobile dictation will enable you to dictate clinical notes anywhere, whenever you have a spare minute. 

Some physicians also dictate their notes during the patient visit, using dictation as an opportunity to engage the patient and ensure accuracy. Mobile dictation can turn documentation time into a meaningful patient interaction while saving hours each week.

• Benefits: Transcription is instant, accurate, and affordable; complete dictation anywhere; it allows flexibility and creative solutions for cutting documentation time and improving patient engagement.
• Costs: Requires accuracy review by the 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.