Speech Recognition and EHRs: Pros and Cons

I had an epiphany regarding voice recognition and technology this past week.

I have spent a lot of time over the past couple of years working at a very high level with EHRs in the hospital and at my private practice. I previously thought that one of the most important skills for an easy EHR transition was the ability to type rapidly and accurately.  I’m not so sure about this anymore.

I believe that dictation that is easy to use, accurate, and confidential reduces the need to type rapidly and accurately when using EHRs. Still there are some important considerations for practices when employing dictation software to improve EHR use.

Here, I'll share some of the positives and negatives from my own experience: 

Ease of EHR use
While dictation can make it easier to use the EHR, some difficult areas still remain for people that are challenged in their computer skills. I have developed a significant level of expertise by using dictation software over two years exclusively, however, there are still things that I learned every day that are important. 

Pro: I do all of my charting utilizing the electronic note component of the EHR. Histories and physical examinations, progress notes, consultations, and discharge summaries are all done utilizing the record note-taking component of the hospital electronic health record.

Con: It has been my opinion for some time that the transition to solely using electronic notes would be extremely difficult for those physicians, PAs, and other providers at the hospital who do not possess strong computer skills. Practices and other healthcare systems must ensure that they have training programs in place that allow each provider to integrate dictation technology at their own pace.

Accuracy
Our system has the ability to use macros as well as to train it on words and names that are difficult for the software to interpret. It is really reaching a higher level of function.

Pro: I am amazed by the accuracy of our medical grade dictation. I’m even more impressed with its ability to adapt to words and phrases that are ambiguous, and to deal with homonyms by analyzing the context in which words are used.

Con: The downside is that this improved flexibility is not without cost. You have to spend time training the software in your user profile. This has not been too difficult as far as I am concerned but some people may find it difficult and onerous.

Confidentiality
Typing notes into the EHR (rather than dictating them) provides a higher level of confidentiality when the user is using a keyboard and the computer or device screen is hidden from others.

Pro: Luckily, the hospital in which I work has taken this into account and provided a number of privacy areas in the hospital in addition to medical lounges where my fellow healthcare providers are well-versed in the importance of patient confidentiality.

Con: We have all seen people walking around talking into their phones dictating. We all need to be aware that when dictating, everyone within earshot hears everything that we are saying.

Conclusion
In the scheme of things, the EHR has made my documentation more accurate and complete without slowing down my patient care very much. I think that this trade-off is well worth it. With the advantage of enterprise-level dictation, I now can generate notes much faster and more accurately, with more complete information.  The jury is still out as to whether this will assist in the full implementation of EHRs among less tech savvy physicians and other providers. I believe, however, that this is the right step forward and will ease the transition for many.

This blog was provided in partnership with the American Academy of Physician Assistants.