EMR and Voice recognition

[Jeff698]

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Is anyone using an EMR package w/ voice recognition?

I was off in a dream land last night thinking about what my perfect documentation system would be. I pictured a computer system with point and click boxes for PMH, ROS, PE, procedures etc (all the stuff needed for billing) and a voice recognition capability for dictating the clinically important stuff like HPI and medical decision making.

I was browsing the web site for iBex (picis) and saw that they say they support voice recognition. We use a hobbled version of iBex without many of its features. I'd be interested in hearing from anyone who uses voice recognition in iBex or with any other system.

Thanks and take care,
Jeff

 

[deleted87716]

Most EMRs support speech recognition using third-party recognition engines like Dragon Naturally Speaking.

 

[Jeff698]

Any experience with how well it works?

Especially in a noisy ED environment?

Thanks and take care,
Jeff

 

[spyderdoc]

I use Dragon 9 to dictate into Ibex. It really does work well. You have to train it to recognize your voice, and add words here and there, but I really love it. Saves a lot of typing. In the noisy ED, it works OK...Every now and then, it will pick up a word from others talking in the immediate area, but the ambient noise really doesn't seem to bother it too much. I am a search and peck kind of typer as well as a compulsive charter, so I tend to have pretty long winded charts...Dictating using Dragon sure saves me a lot of time typing....Highly recommended...

 

[Jeff698]

I use Dragon 9 to dictate into Ibex.<snip>....Highly recommended...

Cool. Is this something you do on your own of does your entire group do it? If you're doing it solo, how'd did you do it?

What type of mic do you use? Which version of Dragon are you using (ie. the expensive medical one or the regular version)?

How do you train it to recognize your voice? Are you using a personal laptop or login? Do you have to copy the text from, say, Word into the text fields in iBex?

Sorry for all the questions, but I'm really interested. If this seems to work, we might be able to give it a try.

 

[spyderdoc]

Cool. Is this something you do on your own of does your entire group do it? If you're doing it solo, how'd did you do it?

What type of mic do you use? Which version of Dragon are you using (ie. the expensive medical one or the regular version)?

How do you train it to recognize your voice? Are you using a personal laptop or login? Do you have to copy the text from, say, Word into the text fields in iBex?

Sorry for all the questions, but I'm really interested. If this seems to work, we might be able to give it a try.

The hospital IT dept supplies us with the program. It is the expensive (professional medical) version, since it has the medical language database. The mics supplied to us are the Andrea anti-noise mics. They work well. A couple of the computers have more expensive Sennheiser mics, but I see no real difference in quality.

I dictate directly into the Ibex chart, so no copying and pasting text.

I use the program both at home and work (hospital supplied me with disks to load on home computers). The training takes about 10-15 minutes and you can put the info on a jump drive and load it onto other computers with Dragon so you don't have to train each computer that you dictate on. We have about 8 or 9 computers in different parts of the ER with different noise levels. They all seem to work well, but of course the ones in the quiet area do work a little better....To me, it still beats typing....I find myself using Dragon on Word documents and occasionally long emails. I am typing this one though....

I use it at home on my desktop and laptop computers. Works well on both. I recommend 2GB RAM and an upgraded sound card if possible. Our ER computers had 1GB RAM and the computers were constantly bogged down when using Dragon. I pestered the IT people for months, and they finally upgraded all the ER computers to be 2GB, so they run MUCH smoother.

SO, in a nutshell, I do recommend Dragon, but you really need to have 2GB of RAM and a good sound card....Make sure to "optimize" and calibrate the program on occasion to reduce recognition errors...

Let me know if you have any other questions....

 

[Jeff698]

Sweet. Thanks for the information.

It's now off to the IT people to see if we can set up a demo project.

Take care,
Jeff

 

[Apollyon]

Let me know if you have any other questions....

One of my classmates in residency used Dragon Naturally Speaking for WellSoft, where it worked well. We have IBEX/Picis now, and it only takes me about 5 minutes per chart - from start to finish, prescriptions, reconciliation, and DC instructions. How long does it take you, and what do you dictate? I mean, it's all click boxes for the HPI, ROS, history, and physical.

 

[spyderdoc]

One of my classmates in residency used Dragon Naturally Speaking for WellSoft, where it worked well. We have IBEX/Picis now, and it only takes me about 5 minutes per chart - from start to finish, prescriptions, reconciliation, and DC instructions. How long does it take you, and what do you dictate? I mean, it's all click boxes for the HPI, ROS, history, and physical.

I tend to write a lot in the HPI section (complaint) and the doctor's note (A/P). I personally feel that the click boxes don't give enough "personalized" info for the patients....Some of the guys in my group just do all the clickboxes with no text entry, and although the billing is the same, it is a bit tough to look at the chart and know what they were thinking if the pt comes back....Also, I feel that by documenting more stuff, I will be able to have better recall later on god forbid I should get sued...

Now my snotty nose kid charts are all done on macros...I have about 10 different macros for the different variations of URI and AOM so I see the patient and hit the macro and I am done with the chart.....I also have a lot of macros for other common things like female UTI, biliary colic, gastritis, as well as many trauma exam blanks, H&P blanks, etc....

The macros really do help out a lot, and I highly recommend making them...

 

[Apollyon]

I tend to write a lot in the HPI section (complaint) and the doctor's note (A/P). I personally feel that the click boxes don't give enough "personalized" info for the patients....Some of the guys in my group just do all the clickboxes with no text entry, and although the billing is the same, it is a bit tough to look at the chart and know what they were thinking if the pt comes back....Also, I feel that by documenting more stuff, I will be able to have better recall later on god forbid I should get sued...

Now my snotty nose kid charts are all done on macros...I have about 10 different macros for the different variations of URI and AOM so I see the patient and hit the macro and I am done with the chart.....I also have a lot of macros for other common things like female UTI, biliary colic, gastritis, as well as many trauma exam blanks, H&P blanks, etc....

The macros really do help out a lot, and I highly recommend making them...

People have said that about the macros - just haven't gotten to it yet.

I put all of my MDM/thoughts in the "text" box. I totally agree that the people who only check the boxes leave you scratching your head if there's ANYTHING that isn't straightforward. The chart is really made for billing and screwing EM docs. At the same time, one of our docs hijacked a tablet PC, and did IBEX the way it was supposed to be - at the bedside, like an electronic T-sheet. THAT worked like a charm!

 

[spyderdoc]

People have said that about the macros - just haven't gotten to it yet.

I put all of my MDM/thoughts in the "text" box. I totally agree that the people who only check the boxes leave you scratching your head if there's ANYTHING that isn't straightforward. The chart is really made for billing and screwing EM docs. At the same time, one of our docs hijacked a tablet PC, and did IBEX the way it was supposed to be - at the bedside, like an electronic T-sheet. THAT worked like a charm!

Well, if you want a boatload of macros, PM me with your email address, and I will send them to you....The thing is is that I think the macros are all sort of personalized to chart in your own style, so you may not like my macros...Some of them need some work, but I am kinda lazy and just make changes from chart ot chart on occasion.....

 

[Jeff698]

How long does it take you, and what do you dictate? I mean, it's all click boxes for the HPI, ROS, history, and physical.

I can do a level 5 chart on, say a complicated septic shock patient with intubation, central line, CVP monitoring, multiple drips, yada yada, in about 7-10 minutes. I could probably do it quicker if our hospital would let us activate the lab component. Straight forward ACS patients can be done in about 5.

I'm also a pretty compulsive charter. I only use the blank template for HPI because I would rather type the story in myself. It doesn't have to be all that long but I do want it to sound like me and not a computer.

Take care,
Jeff