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DHMC Cardiology Update 2004. December 6, 2004. Speech Recognition in Medical Practice. Jon W. Wahrenberger, MD. Medical Documentation. Old Paradigm: hand-written documentation. Jury blames doctor's bad penmanship for patient death Award = $475,000. Medical Documentation.

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DHMC Cardiology Update 2004

December 6, 2004

Speech Recognition in Medical Practice

Jon W. Wahrenberger, MD

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Medical Documentation

Old Paradigm: hand-written documentation

Jury blames doctor's bad penmanship for patient death

Award = $475,000

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Medical Documentation

More Contemporary Paradigm: Typewritten Record

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Medical Documentation

More Contemporary Paradigm: Typewritten Record

Cost of transcription? $30,000 per practitioner?

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Medical Documentation

Today’s Paradigm

Electronic Medical Record

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  • Has the quality of physician typed notes and discharge summaries improved or worsened?

  • Is typing cutting into our time with patients?

  • Are we seeing more repetitive motion injuries?

  • Has physician generation of notes increased or decreased productivity??

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Speech Recognition Technology

  • Alternative method of keyboard input

    • Text Creation

    • Computer control and navigation

  • Reduction of multiple repetitive tasks into single speech command

  • Net result: simplifies and reduces time when using computer

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How does it work?

  • Statistical technology involving interface of:

    • An acoustic model – the sound related variables of a given pronunciation

    • A lexicon – a group of words and their pronunciations

    • A language model – which specifies the relative likelihood of a sequence of words

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Available Products

Dragon NaturallySpeaking

IBM ViaVoice

Microsoft Speech

  • Best Product

  • Windows OS only

  • Windows & Mac Versions

  • Incorporated into Office

  • Poor user interface

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System Requirements

  • Intel® Pentium® III / 500 MHz processor (or equivalent AMD® processor)

  • 256 MB RAM

  • 500 MB free hard disk space

  • Creative® Sound Blaster® 16 or equivalent sound card supporting 16-bit recording or USB Pod

  • High quality microphone

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Cost of Dragon NaturallySpeaking

*Includes extensive general and specialty vocabularies

**Not Recommended for Professional Use

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  • Increased productivity

  • Economy: no transcription cost

  • Speed:

    • Good typist averages 50-90 words per min.

    • Speech dictation: 100-180 wpm

  • Reduction in repetitive motion injuries

  • Mobility

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Speech Recognition: Caveats

  • It is highly accurate and reliable

  • Dramatically easier than typing

  • Voice recognition software is not for everyone

  • Not as easy as transcription into a telephone or Dictaphone

  • Highly cost effective when compared to transcription (total cost of software and good microphone is less than $1000)

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Microphone Options

Sennheiser ME 3

Andrea ANC-600

Philips SpeechMike Pro

VXI & Andrea USB Pods

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Voice Recognition in Medical Settings

47 Emergency Room Charts

Advanced User27 Charts

Basic User20 Charts

Voice Rec Dictation


Telephone Dictation


Voice Rec Dictation


Telephone Dictation


Am J Emerg Med. 2001;19:295-298

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Speech Recognition Vs. Transcription

Am J Emerg Med. 2001;19:295-298

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Speech Recognition Vs. Transcription



Am J Emerg Med. 2001;19:295-298

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Where Next?