Doctors Use Speech Recognition Tools To Enhance Patient E-Health Records

By 2011, the Defense Department expects to have its integrated, interoperable electronic medical record system at more than 500 military medical facilities and hospitals worldwide.
With the ongoing wars in Iraq and Afghanistan, there has been "100% turnover" in the doctors staffing some military medical facilities, such as the one in Heidelberg, Germany, where Walker works, he said.

Many of the physicians at these bases are military reservists who have 90-day or one-year service deployments, said Walker. So training on the AHLTA system -- and the voice-recognition features -- is a constant, he said. But once doctors move onto to other facilities, or even back to their private practices, the training pays off -- they see how they can use voice recognition in their own workflow back home, he said.

For certain, doctors of the U.S. Military Health System aren't the first or only health care providers using speech recognition to enhance patient records. In the private health care sector, Dragon speech-recognition products are also being used to supplement information in e-health records systems, as well as replace traditional medical dictation and transcription processes.

Mount Carmel St. Ann's hospital in Columbus, Ohio, has been among the early wave of health care providers using electronic clinical systems bolstered with speech-recognition capabilities. About seven years ago, emergency department doctors at Mount Carmel St. Ann's hospital began having access to Dragon's speech-recognition software not long after an e-health record system from Allscripts was rolled out there.

When the e-health record was first rolled out -- without the voice capabilities -- Mount Carmel St. Ann's doctors didn't necessarily see the kind of productivity boost they had been hoping for, in large part because they found themselves spending a lot of time typing notes, said Dr. Loren Leidheiser, chairman and director of emergency medicine at Mount Carmel St. Ann's emergency department. But as more Mount Carmel St. Ann's ER doctors began incorporating the speech-recognition capabilities into their workflow -- whether speaking notes into a lapel microphone or into a computer in the patient room or hallway -- the efficiency picked up tremendously, said Leidheiser.

Also, before using the Dragon software, the ER department spent about $500,000 annually in traditional dictation transcription costs for the care associated with the hospital's 60,000 to 70,000 patient visits yearly at the time. That was cut down "to zero," he said. The return on investment on the speech recognition, combined with the use of the e-health record system, was "within a year and a half," he said.

Leidheiser also makes use of time stuck in traffic to dictate notes that are later incorporated into patient records or turned into e-mails or letters. Using a Sony digital recorder, Leidheiser can dictate a letter or note while in his car, then later plug the recorder into his desktop computer, where his spoken words are converted to text.

By adding spoken notes to medical records, e-mails, and letters, "it's easier to tell the story," he said.