Medical dictation helps physicians document more efficiently but also adds software costs and requires a new clinical documentation workflow. Is it worth the switch? What is the return on investment of adopting medical speech-to-text software? 

We crunched the numbers based on published research and found that switching from typing to medical speech-to-text dictation increases the average physician’s overall productivity by 5.76%. 

We’ll dig in on the math so you can compute your personal ROI based on the number of relative value units (RVUs) you bill. 

As a teaser, the results show that an orthopedic sub-specialist who is compensated at $71.00 per RVU and bills 7,800 RVUs per year, switching to dictation increases their annual compensation by $31,899 (a 17x return on investment). As a family practice physician billing 8,000 RVUs per year at a compensation rate of $32.40 per RVU, switching to dictation increases their annual compensation by $14,929 (an 8x return on investment).

Let’s examine what the research says about speech-to-text software, clinical documentation efficiency, and the impact of a dictation workflow on RVUs.

Dictation is faster than typing

About 80% of EHR data is unstructured, meaning the bulk of clinical documentation is produced as a written narrative. Yet the average clinician types just 30 words per minute (WPM), severely limiting clinical documentation efficiency.

Speech-to-text medical dictation has emerged as a popular alternative to typing. Using modern software, physicians can dictate, rather than type, their clinical notes. Speech recognition software can instantly transcribe the physician’s dictation at the rate of normal speech (about 150 WPM). The provider can quickly check for accuracy before saving their note to the EHR. 

But exactly how much does medical dictation cut down on documentation time compared to typing?

Looking at peer-reviewed research can provide a decent estimate. We reviewed published studies since 2015 and found three that compare the speed of typing notes in the EHR vs. dictating using speech-to-text software.

One comparison of 1,455 clinical reports created by pediatricians and trauma surgeons found that physicians documented 26% faster when they had access to medical speech-to-text in the EHR. Another study followed 31 cardiologists and neurologists and found that notes created with dictation assistance took 7 minutes to complete, compared to 19.6 minutes typed. A third study using simulated outpatient scenarios found a 17% speed increase when providers dictated instead of typing.

When you average these findings, research shows that medical speech-to-text increases documentation efficiency by 36% compared to typing.

Importantly, each study also found that the dictated notes were as accurate as typed notes and that physicians were more satisfied after documenting with dictation.

“Research shows that medical speech-to-text increases documentation efficiency by 36% compared to typing.”

How medical dictation impacts RVUs

Physician compensation is complex, especially as healthcare systems transition toward value-based care models. But in 2023, most providers are still paid via the traditional fee-for-service model, meaning physician compensation is based on services provided. More efficient documentation frees time to attend to more patients, which increases the number of RVUs billed.

If you’re unfamiliar with RVUs, here’s a quick primer: Relative value units (RVUs) provide the simplest way to measure physician productivity. For example, CMS bases Medicare reimbursements on the Physician Fee Schedule, which assigns RVUs to each service or procedure billed. The RVUs assigned to each service or procedure are based on the extent of physician work, resources required, and necessary expertise.

RVU-based compensation is common, especially for physicians employed by hospital groups and health systems. For providers employed under an RVU-based contract, salary varies with how many RVUs they bill. Since provider compensation rates (dollars per RVU) vary between specialties and geographic regions, RVUs allow for standardized work comparisons between providers.

We can use the following assumptions to calculate the impact of medical dictation on billed RVUs.

  • Physicians across specialties spend over 15 hours weekly on paperwork and administrative tasks. 
  • Paperwork is not limited to clinical documentation, so we conservatively assume physicians spend just 10 of the 15 administrative hours in the EHR creating documentation.
  • 80% of EHR data is unstructured, so it’s reasonable to assume that physicians spend 8 out of those 10 documentation hours typing clinical notes (rather than clicking check boxes and navigating the EHR). These 8 hours of weekly typing could be replaced by dictation. 
  • Published research finds that medical dictation using speech-to-text software increases documentation efficiency by 36% compared to typing (see above). A 36% speed increase is equivalent to 21.6 minutes saved every hour. 
  • Assuming dictation replaces 8 hours of weekly typing in the EHR, providers who switch to dictation will save 2.88 hours per week or 144 hours per year. The average U.S. physician works about 50 hours per week or 2,500 hours per year. 
  • These 144 documentation hours eliminated by switching to medical dictation are equivalent to a 5.76% productivity increase. 

A physician who bills 5,000 RVUs annually can bill an additional 288 RVUs after switching to dictation. 

The ROI of speech-to-text medical dictation

How does a 5.76% productivity improvement impact a physician’s compensation? 

Different employers pay different dollar amounts per RVU depending on geographic region (to account for the cost of living), medical specialty, teaching and administrative duties, and other factors. Providers can multiply their average annual billed RVUs by 0.0576 to calculate the extra RVUs they could bill with a 5.76% productivity increase. Then, multiplying that value by an RVU compensation rate results in the increased compensation available from the increased efficiency.

Here’s how the productivity gains of switching to medical dictation would increase the following physician’s salaries:

  • A family medicine doctor paid $32.40 per RVU could earn an additional $14,929 if they bill 8,000 RVUs annually on average.
  • An OB/GYN paid $48.80 per RVU could earn an additional $17,989.63 if they billed 6,400 RVUs annually.
  • An orthopedics sub-specialist compensated at $71.00 per RVU could earn an additional $31,899 yearly if they bill 7,800 RVUs.

The last variable to consider is the cost of dictation software. We can divide net income from the investment in software to calculate return on investment (ROI). 

Leading mobile medical speech-to-text software like Mobius Conveyor costs $149 / month, or less than $1,800 annually, for unlimited dictation. So the family medicine doctor in the example above would see an ROI of over 800% after switching from typing to medical dictation.

The ROI of changing your clinical documentation workflow to dictation increases with compensation. For example, the orthopedics sub-specialist in the examples above would see a 17.7x ROI from investing in speech-to-text software.

Should you switch to medical dictation? 

It’s safe to say that clinicians frequently wish they could spend less time on documentation. Yet trends are headed in the opposite direction. In 2022, the average physician spent over 15 hours per week on paperwork and administration.

If you’re a healthcare provider, switching from typing to medical dictation will reduce your EHR time by nearly three hours per week. If you use that time to provide more patient services, you will increase your compensation by over 5%.

But not just your bank account benefits if you switch to dictation. Studies find that providers who document with speech-to-text assistance report feeling better after working in the EHR. 

One study surveyed providers in a New York hospital and concluded that documenting with dictation software led to “a dramatic increase in provider satisfaction.”

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