I recently gave a presentation to a delightful group of physicians regarding the integration of EMR and speech recognition technology in their medical practices. One segment of my presentation addressed whether or not the variant of Dragon (medical versus nonmedical) actually made a difference. For the benefit of our prospects and clients, I would like to summarize this information below.
Please understand that when I entered this business 12 years ago even I was not convinced that Dragon® Medical was necessary. However, it was proven to me even then that it did make a difference. And now over a decade later, as a result of the advances in this speech recognition technology, that is more true than ever.
What I am about to say may seem rather harsh, but it is the honest truth: Nuance would not spend the considerable resources that it has (and continues to) on creating an extremely powerful tool (Dragon® Medical) if it did not make a difference to their target audience – that being medical practitioners. The differences are not borne in marketing, but in actual programming, which does affect the usability and efficacy for doctors. I dislike sales pitches as much as the next person, but these are solid facts, and the benefits quite measurable.
Vocabulary
Dragon® Medical includes over 40 vocabularies. A vocabulary is not just a list of words (which is often a misconception), but it also contains a statistical database of how the words are used, geared towards that specific specialty or practice’s reporting language.
For instance, there are four paediatric vocabularies:
- cardiology,
- dentistry,
- gastroenterology, and
- general.
Physicians in each of these practices may use very similar words, but their reporting style and word usage will vary. Each Dragon® Medical vocabulary takes into account that particular specialty or practice’s statistical word usage, lending to increase accuracy when using the correct vocabulary.
For this reason, simply adding medical words to a nonmedical vocabulary will not increase the accuracy for the medical practitioner. Words may be easily added to a nonmedical vocabulary, but the context in which they are used, as well as the statistics surrounding the word usage are not incorporated. Nonmedical vocabularies are based on general day-to-day or business usage.
For example, with Dragon® Medical a practitioner may say and achieve: “neck is supply with no adenopathy”, and with a nonmedical vocabulary the following would result: “neck is supple with no known for the” or “neck as supply with no odyssey”.
Quite bluntly, my medical clients do not have the time to try and tease a nonmedical vocabulary into some semblance of compliance and usefulness.
Anatomy of a Vocabulary
For those with a technical interest, please find following what can be deemed as the anatomy or construct of a specific vocabulary.
- Lexicon: list of words (this can be easily modified within each profile)
- Language Model: statistical database (the basis of a vocabulary and the probability in which words are used within the vocabulary)
- Acoustic Model: how specific words are spoken (based on a user’s voice)
- Speech Recognition Engine: ties it all together, and is the very core of Dragon
Bottom Line
In the end, Dragon® Medical vocabularies offer significant accuracy over and above the nonmedical variants, resulting in fewer corrections, less time spent dictating and more time available for patient care (or even leaving the office at a reasonable hour at the end of the day).
Commands
Dragon NaturallySpeaking Premium only offers one basic text command type, whereas Dragon® Medical offers a more robust text command type plus three other command types; all designed to increase efficiencies in a medical office.
I have said this before, and this bears repeating: many people ignore the gains that can be achieved from utilizing Dragon voice commands. Repetitive tasks such as boiler plate text entry (i.e. diet advice, surgery risks and benefits, flu shot given etc.), navigating through an EMR, creating a new document based on a Microsoft Word template, printing to a specific printer etc. amount to considerable time throughout the day – time that can be reallocated to patient care or other activities.
Command Types Available
Dragon® Medical provides the ability to create four different types of commands, each offering different benefits in a variety of situations. Commands can be created with our clients on the spot during training sessions, or after the fact once a client has had an opportunity to assess where time savings could take place. Speakeasy Solutions also enjoys teaching physicians how to create their own custom commands, allowing them to be independent and create commands as needed.
- Text & Graphics: for repetitious text with and without voice fields (voice fields are akin to a form that can be filled out)
- Step by Step: easy to create computer & EMR control commands
- Advanced Scripting: creating new consult letters based on MS Word templates
- Macro Recorder: records mouse & keystrokes
Bottom Line
Dragon® Medical offers tremendous efficiencies over and above Dragon Premium, resulting in less time spent on repetitive tasks, enabling physicians to quickly complete consult letters and encounters, thusly providing more time for other activities.
Medical Formatting Rules
Dragon® Medical provides numerous medically related formatting options, allowing the medical practitioner to customize Dragon’s output according to personal preferences.
For instance, capitalization of medical terms, as well as expansion of acronyms are very simple to modify. Abbreviations can be used or not (the trend is becoming to not using abbreviations). There are options regarding the of ordinals and other numeric scenarios.
Attempting to re-create these rules within nonmedical version of Dragon would be extremely time-consuming, and in some cases quite difficult, if not impossible.
Bottom Line
Dragon® Medical allows very quick and easy customization of medical formatting options, enabling users to have considerable control over how Dragon transcribes a variety of phrases.
Multicomputer Support
Dragon® Medical user profiles can be synchronized across multiple computers.
In other words, Dragon® Medical can be installed on several networked computers, each one accessing a single user profile which is updated from any computer, whenever the user profile is saved. There is no need to create multiple profiles. Maintain one user profile across multiple computers.
This is also extremely useful for third-party proofreading of dictations. A physician may dictate within Microsoft Word or DragonPad, saving their voice with their text dictation. Dragon® Medical would be installed upon an assistant’s computer, with access to the physician’s user profile, and any corrections made while proofreading the dictation would be saved to the master user profile, thereby increasing future recognition accuracy.
The above is not possible with Dragon NaturallySpeaking Premium.
Bottom Line
If a physician intends on using Dragon® Medical on more than one computer, possibly involving a proofreader or correctionist, Dragon® Medical (and not Dragon NaturallySpeaking Premium) will enable synchronization of user profiles and streamline efficiencies.
Multiple Vocabularies
Most medical practitioners have need of more than their specialty or family practice vocabulary. If nonmedical dictation (i.e. general email, meeting minutes, personal correspondence etc.) is attempted with a medical specialty vocabulary, the accuracy is quite poor as it is not designed to function in this fashion. Therefore, utilizing multiple vocabularies within the same user profile ensures increased accuracy regardless of the topic being dictated.
Three vocabularies are most common, such as:
- Daily use medical: specialty or family practice
- General medical: medical legal report
- Nonmedical: for email and general correspondence
Dragon NaturallySpeaking Premium does not allow the creation of multiple vocabularies.
Bottom Line
Multiple vocabularies offer higher recognition accuracy and improved efficiencies for those medical practitioners desiring to use Dragon outside of their practice.
Hidden Mode
Dragon® Medical allows medical practitioners to dictate simultaneously while reviewing data or information on the computer. In other words, if a physician needs to review chart notes, lab results or other documentation on the computer while verbally composing their consults or notes, their dictation can accumulate in the background while such a review is taking place. Once the physician has completed their dictation, the results are transferred into a final destination of choice (usually an EMR).
This feature is not available in the nonmedical versions of Dragon.
Bottom Line
If a physician needs to review information on the computer while simultaneously dictating their encounters, Dragon® Medical enables the practitioner to perform such a task efficiently.
In Conclusion
An investment of Dragon® Medical more than pays for itself in terms of productivity. Physicians are deluged and find themselves working later and later in the office (especially with the push towards EMR adoption). Implementing an effective Dragon® Medical solution can be the answer to assist the physician and making the most of their time. Yes, Dragon® Medical is pricier, but the differences between it and the nonmedical versions are considerable.
If you are prospective client of Speakeasy Solutions Inc., please do not hesitate to contact myself, Alexandria Carstens, at 604-264-9109 or 1-888-964-9109 extension 102 (within Canada ONLY). I will be more than happy to explain these differences in more detail, and consult if you on a customized speech recognition solution for your office. Speakeasy Solutions provides Dragon® Medical, microphones (i.e. Philips SpeechMikes, Sennheiser headsets), digital voice recorders (i.e. Philips DPM 9600, Olympus DS 5000), installation, training, support and customization services.
Speakeasy Solutions is based in Vancouver, and provides products and services across Canada from coast-to-coast. We look forward to working with you.
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