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DHMC Cardiology Update 2004

DHMC Cardiology Update 2004. December 6, 2004. Speech Recognition in Medical Practice. Jon W. Wahrenberger, MD. Medical Documentation. Old Paradigm: hand-written documentation. Jury blames doctor's bad penmanship for patient death Award = $475,000. Medical Documentation.

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DHMC Cardiology Update 2004

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  1. DHMC Cardiology Update 2004 December 6, 2004 Speech Recognition in Medical Practice Jon W. Wahrenberger, MD

  2. Medical Documentation Old Paradigm: hand-written documentation Jury blames doctor's bad penmanship for patient death Award = $475,000

  3. Medical Documentation More Contemporary Paradigm: Typewritten Record

  4. Medical Documentation More Contemporary Paradigm: Typewritten Record Cost of transcription? $30,000 per practitioner?

  5. Medical Documentation Today’s Paradigm Electronic Medical Record

  6. DHMC Cardiology Clinic

  7. Physician Underutilization?

  8. Questions: • Has the quality of physician typed notes and discharge summaries improved or worsened? • Is typing cutting into our time with patients? • Are we seeing more repetitive motion injuries? • Has physician generation of notes increased or decreased productivity??

  9. Alternatives to following the crowd?

  10. Speech Recognition Technology… … has arrived!

  11. Speech Recognition Technology • Alternative method of keyboard input • Text Creation • Computer control and navigation • Reduction of multiple repetitive tasks into single speech command • Net result: simplifies and reduces time when using computer

  12. How does it work? • Statistical technology involving interface of: • An acoustic model – the sound related variables of a given pronunciation • A lexicon – a group of words and their pronunciations • A language model – which specifies the relative likelihood of a sequence of words

  13. Demonstration

  14. Available Products Dragon NaturallySpeaking IBM ViaVoice Microsoft Speech • Best Product • Windows OS only • Windows & Mac Versions • Incorporated into Office • Poor user interface

  15. System Requirements • Intel® Pentium® III / 500 MHz processor (or equivalent AMD® processor) • 256 MB RAM • 500 MB free hard disk space • Creative® Sound Blaster® 16 or equivalent sound card supporting 16-bit recording or USB Pod • High quality microphone

  16. Cost of Dragon NaturallySpeaking *Includes extensive general and specialty vocabularies **Not Recommended for Professional Use

  17. Advantages • Increased productivity • Economy: no transcription cost • Speed: • Good typist averages 50-90 words per min. • Speech dictation: 100-180 wpm • Reduction in repetitive motion injuries • Mobility

  18. Speech Recognition: Caveats • It is highly accurate and reliable • Dramatically easier than typing • Voice recognition software is not for everyone • Not as easy as transcription into a telephone or Dictaphone • Highly cost effective when compared to transcription (total cost of software and good microphone is less than $1000)

  19. Microphone Options Sennheiser ME 3 Andrea ANC-600 Philips SpeechMike Pro VXI & Andrea USB Pods

  20. Studies of Speech Recognition Software in Medical Settings?

  21. Voice Recognition in Medical Settings 47 Emergency Room Charts Advanced User27 Charts Basic User20 Charts Voice Rec Dictation 27 Telephone Dictation 27 Voice Rec Dictation 20 Telephone Dictation 20 Am J Emerg Med. 2001;19:295-298

  22. 98.5 99.7 3.65 3.77 Speech Recognition Vs. Transcription Am J Emerg Med. 2001;19:295-298

  23. Speech Recognition Vs. Transcription 39.6 3.65 Am J Emerg Med. 2001;19:295-298

  24. Where Next? www.dartmouth.edu/ ~cardio/voice.htm

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