That's changing, according to more than a dozen health information technology experts contacted for this story, including 10 physicians of various specialties, seven of whom regularly use speech-recognition software on the job in the emergency room, pathology, radiology, other medical departments and outpatient office environments.
One satisfied daily user is Brian Zimmerman, director of the urgent-care unit in the busy emergency department at 712-bed Miami Valley Hospital in Dayton, Ohio, home to a Level I trauma center. There, he and all of his colleagues use speech-recognition software in tandem with the hospital's electronic health-record system.
Zimmerman said about four years ago he purchased a version of Dragon Speaking, now the dominant brand of speech-recognition software in healthcare. He thought it might save him time dictating e-mails and notes, he said. He was wrong.
“It was kind of a nightmare,” Zimmerman said, but added that he has subsequently changed his opinion. “If you haven't seen it in a couple of years, you should take a second look. It's just much better than you've seen in the past.”
“The administration likes it because our transcription costs went to zero,” Zimmerman said. Previously, transcription services cost the hospital $1.4 million a year for the ER alone, he said.
Speech recognition established early beachheads in radiology and pathology, medical subspecialties where free-text-based reports are key work products. Even there, its efficacy has improved dramatically in recent years, physician users say.
Keith Dreyer is vice chairman of radiology at 907-bed Massachusetts General Hospital in Boston and a user of speech-recognition software for a decade. Until recently, improvement in the technology had been gradual but steady, Dreyer said.
“I used to say, ‘If you don't like speech recognition, just wait a year—it will get better,' ” Dreyer said. Then, suddenly, in about 2004, Dreyer said, “We really saw a big difference. They really optimized it for radiology.”
Paul Valenstein, a pathologist at 529-bed St. Joseph Mercy Hospital in Ypsilanti, Mich., added that a newer version of Dragon geared to his medical specialty “produces dramatic improvements in throughput.”
And Larry Garber, director of medical informatics at the Fallon Clinic, Worcester, Mass., said a recent work study found the clinic saves about $7,000 per physician per year by switching from dictation to speech-recognition software. “The writing is on the wall for transcription departments around the country,” Garber said.