Dragonspeak vs AHLTA

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Homunculus

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just got trained in on dragonspeak 10 today. interesting concept, we'll see if it saves me any time. anyone else out there use it for clinic visits?

--your friendly neighborhood rockin' the headset caveman

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just got trained in on dragonspeak 10 today. interesting concept, we'll see if it saves me any time. anyone else out there use it for clinic visits?

--your friendly neighborhood rockin' the headset caveman

It can't spell my name right no matter what I do to train it. Other than that, it's OK I guess.
 
i find that it works well if you set up tons of macros so u can just say insert x, etc...otherwise i think I type faster.
 
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just got trained in on dragonspeak 10 today. interesting concept, we'll see if it saves me any time. anyone else out there use it for clinic visits?

--your friendly neighborhood rockin' the headset caveman

Our internists and WTB love it because they have lots of long notes. I am pretty efficient with the FP AIM Usability Template. Since >50% of my patients are for acute visits, the scripted formats is very helpful. It also has prompts for coding. I get a 14 or 13 with all of those visits. For stuff that takes longer (behavioral issues or very complex histories) I just type. I can type about 60 WPM, however. I'm getting out in 5 months, so I figured it wasn't worth the trouble.

Ed
 
I'm not sure it is a lot faster but my notes are tremendously better which makes me more satisfied at the end of the day. Much more detail, and more useable to me and others. I also like to paste standard text such as patient education, counseling etc. Please make sure you proof read. I occasionally find some pretty embarrassing or scary mistakes.
 
I'm not sure it is a lot faster but my notes are tremendously better which makes me more satisfied at the end of the day. Much more detail, and more useable to me and others. I also like to paste standard text such as patient education, counseling etc. Please make sure you proof read. I occasionally find some pretty embarrassing or scary mistakes.

Never used the system, but anything is a better system than AHLTA, so I am glad that you at least have an option. The clinical notes that you see in AHLTA are a disgrace to the medical profession and an embarrassment to military medicine. Thankfully, I work in one of the few places in Navy medicine where we type SF-600's on word files. It's still far less efficient than dictating, but at least my notes look like the dictated clinical notes that we are all taught to make.

You can say a lot about military medicine, it has plusses and also a lot of minuses. But regardless, AHLTA, by itself, is a reason to get out as soon as possible.

OK, my blood just started to boil again.....
 
just got trained in on dragonspeak 10 today. interesting concept, we'll see if it saves me any time. anyone else out there use it for clinic visits?

--your friendly neighborhood rockin' the headset caveman


I started off using it...had some killer templates saved...such as "2 month well child" and up came a nicely pre-dictated A/P, however, I found I spent more time correcting all the errors then I was actually saving time. So I sent it back. Back to the old fashioned typing and AHLTA clicking for me.
 
Never used the system, but anything is a better system than AHLTA, so I am glad that you at least have an option. The clinical notes that you see in AHLTA are a disgrace to the medical profession and an embarrassment to military medicine. Thankfully, I work in one of the few places in Navy medicine where we type SF-600's on word files. It's still far less efficient than dictating, but at least my notes look like the dictated clinical notes that we are all taught to make.

You can say a lot about military medicine, it has plusses and also a lot of minuses. But regardless, AHLTA, by itself, is a reason to get out as soon as possible.

OK, my blood just started to boil again.....

What...you don't like all the double negatives in AHLTA. :D
 
just got trained in on dragonspeak 10 today. interesting concept, we'll see if it saves me any time. anyone else out there use it for clinic visits?

--your friendly neighborhood rockin' the headset caveman

How are you using dragonspeak 10 w/ AHLTA? Is AHLTA now set up with some sort of way to integrate dragonspeak into it? Or do you just use "add note" function and speak your note into it?

I basically just cut and paste a form note with modifications into the "add note" section, and that is the fastest method I've found. It's not the best documentation but it's sufficient and efficient.
 
How are you using dragonspeak 10 w/ AHLTA? Is AHLTA now set up with some sort of way to integrate dragonspeak into it? Or do you just use "add note" function and speak your note into it?

I basically just cut and paste a form note with modifications into the "add note" section, and that is the fastest method I've found. It's not the best documentation but it's sufficient and efficient.
there is an aim form which is essentially just text boxes for CC, HPI, PMHX, PSHx, SHs, FHx, ROS, PE, and A/P.

You just dictate whatever you want into each text box and it formats it to look like an actual professional note. I have prepopulated some fields, i.e. social hx, PE, and ROS with standard text which speeds me up a lot.

Many people talk about misrecognition with Dragon but I'm amazed at what it gets right and I don't have many problems unless I'm very tired and am not speaking clearly.

Everyone in my clinic except one provider use it. This includes 60+ year old contractors who love it. Both the quality of the notes and the workload value of each note are much improved. There are no medcin tree's thus no double negatives, or illogical jibberish.
 
there is an aim form which is essentially just text boxes for CC, HPI, PMHX, PSHx, SHs, FHx, ROS, PE, and A/P.

You just dictate whatever you want into each text box and it formats it to look like an actual professional note. I have prepopulated some fields, i.e. social hx, PE, and ROS with standard text which speeds me up a lot.

Many people talk about misrecognition with Dragon but I'm amazed at what it gets right and I don't have many problems unless I'm very tired and am not speaking clearly.

Everyone in my clinic except one provider use it. This includes 60+ year old contractors who love it. Both the quality of the notes and the workload value of each note are much improved. There are no medcin tree's thus no double negatives, or illogical jibberish.

so far i like it. i can actually do a more detailed comment section with less work. plus, even if it's only minimally saving me time, it "feels" like less work because i type less. i've not done the formal "add note" full text thing yet, because then i have to self-code. i have a nice "sick visit" template i can normally get 99214's without much of a problem. i dragonspeak the comment section and more detailed areas of the S/O. the PE i clicky-click away.

could you post your AIM template? i think i may even start a sticky with templates and other life improving shortcuts. i'll post my sick visit one if i can figure out how to export it.

--your friendly neighborhood AHLTA modding caveman
 
so far i like it. i can actually do a more detailed comment section with less work. plus, even if it's only minimally saving me time, it "feels" like less work because i type less. i've not done the formal "add note" full text thing yet, because then i have to self-code. i have a nice "sick visit" template i can normally get 99214's without much of a problem. i dragonspeak the comment section and more detailed areas of the S/O. the PE i clicky-click away.

could you post your AIM template? i think i may even start a sticky with templates and other life improving shortcuts. i'll post my sick visit one if i can figure out how to export it.

--your friendly neighborhood AHLTA modding caveman
We didn't create our own - we stole the one from Pensacola - I think is titled PC-Generic or something like that.

There is something very satisfying about being able to kick back with the feet on the desk and dictate your notes, patient letters, memos, whatever.

I paste in my signature block, and even memo or patient letter templates.

Works for me.
 
We didn't create our own - we stole the one from Pensacola - I think is titled PC-Generic or something like that.

There is something very satisfying about being able to kick back with the feet on the desk and dictate your notes, patient letters, memos, whatever.

I paste in my signature block, and even memo or patient letter templates.

Works for me.

PC-Generic is the way to go! I tried looking for it for a friend though and couldn't find it, wouldn't surprise me if they deleted the darn thing.

The way to find it was to add NH Pensacola to the location/mtf and then search for PC-generic . It looks like a real note when you use it.
 
As a member of the military medical department for several years, I have seen multiple stages and changes in the military electronic health record. I am aware of the challenges and complications associated with the initial and ongoing use of AHLTA and impact on seeing patients. I realize that clinicians have assessed AHLTA as a pivotal issue whether staying in the military or not. Dragonspeak has alleviated some of the AHLTA challenges. However, I am a realist. Dragonspeak has not solved all of the "headaches." Personally, dragonspeak did improve the speed of patient encounters and offer some improved quality of life as a clinician. In addition, the macros program has helped with efficient documentation.

Dragonspeak is a definite advantage when completing the history of present illness and impression/plan sections. I found it easier to dictate these sections instead of trying to free text or "check boxes." Now, I use only one standard template, no "checking of boxes," and use macros for physical exam section. My typical patient encounter and documentation time has decreased by several minutes per patient encounter and quality of documentation has improved. Currently, I am trying to figure out when it is best to use dragonspeak -- during the patient encounter or immediately after the encounter before seeing the next patient.

However, there are disadvantages, but they do resolve over time. The initial start-up challenge was dictating with efficiency and not pontificating on unnecessary issues. While my typing has developed over time, learning how to "get to the point" and adhere to a relevant patient work up (basic differential diagnosis and general evaluation and plan), my initial dictations in dragonspeak resulted in long notes and included a lot of unnecessary comments and too much comprehenisve thought processes. After time, this improved. In addition, dragonspeak training required some time investment, but was well worth it.

I recommend trying out dragonspeak, do the training, and give it a chance. However, time to try is important. Allowing more time to see patients initially is very important when trying this out for the first several weeks. For most, quick adaptation will ensue. Administrators should realize that initially productivity will decrease, but will improve over time. Realistically, productivity does not drastically improve after adept use of dragonspeak, but mostly improves the clinicians' quality of life.

Overall, I recommend using dragonspeak. It has significantly improved my time and exposure with patient care. Once again, I use dragonspeak in the HPI, macro the PE, and then dragonspeak the impression/plan. Most other internists I speak to seem to follow this general pattern.


The veiws expressed are those of the author and do not reflect the official policy or postion of the Dept. of Defense, Dept. of Army, or US Govt.
 
ok, i think i found the PC- generic. i found one that contained coding clickies, but i just override it at the end. i'm not sure if this version has those or not. i couldn't upload my normal "sick child" visit (clicky-box template) unless i changed it to a "txt" file. if you DL it, rename it to a ".tpl" file and it may work for you . . . we'll see what happens. if anyone is able to successfully import them, i may make a thread with useful templates for people.

--your friendly neighborhood AHLTA battling caveman
 

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ok, i think i found the PC- generic. i found one that contained coding clickies, but i just override it at the end. i'm not sure if this version has those or not. i couldn't upload my normal "sick child" visit (clicky-box template) unless i changed it to a "txt" file. if you DL it, rename it to a ".tpl" file and it may work for you . . . we'll see what happens. if anyone is able to successfully import them, i may make a thread with useful templates for people.

--your friendly neighborhood AHLTA battling caveman

Try searching for this AIM form. I love it:

Usability AIM FM (Department of Defense).

It's not peds specific, but it gets me pretty close. I have a template of "my exam" that I will sometimes click on to get some of my favorites findings.

Ed
 
ok, i think i found the PC- generic. i found one that contained coding clickies, but i just override it at the end. i'm not sure if this version has those or not. i couldn't upload my normal "sick child" visit (clicky-box template) unless i changed it to a "txt" file. if you DL it, rename it to a ".tpl" file and it may work for you . . . we'll see what happens. if anyone is able to successfully import them, i may make a thread with useful templates for people.

--your friendly neighborhood AHLTA battling caveman
we should probably have a Dragon/AHLTA lessons learned thread.
 
You could consider checking out the DOD AIM template SAMMC Cardio.

Although designed for cardiology, it can be used for really most medical encounters
Once used, like other AIM templates, when you copy forward, it will autopopulate into the text boxes for future encounters. It was designed to be very redundant, so can be used with a variety of doc input styles. It also has coding hints built in and has defaults to make your coding easier.

I use it exclusively in combination with Dragon for my dictation.

Now if only AHLTA would be faster and more stable .... hmm.
 
Try searching for this AIM form. I love it:

Usability AIM FM (Department of Defense).

It's not peds specific, but it gets me pretty close. I have a template of "my exam" that I will sometimes click on to get some of my favorites findings.

Ed


holy crap. that form is awesome :love: 99214's with half the hassle. and i can talk into the boxes. as long as they don't nerf the form, i may actually be ok with notes now. . . . :cool: that form + -25 modifier= :thumbup:

--your friendly neighborhood heading to CRC :)sleep:) caveman
 
---------------- Now playing: Rob Dougan - Furious Angels via FoxyTunesAHLTA is a bloated and pretty crappy software. However, I have a pretty good template that I've been using since medical school. My notes tend to be fairly detailed. It doesn't hurt that I am a fairly fast typer ~45-50wpm and I do not see a whole lot of clinic patients, I am a subspecialist who does more inpatient and procedures (as outpatient).
 
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