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05 Jun 2004

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Speech-recognition vs Transcription

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Dear Friends,

Here are some interesting excerpts, from an article in the American
Medical News:

<Internist Jeffrey Clode, MD, of Spokane, Wash., remembers a
colleague at his 20-physician practice who told his computer that a
female patient had come in after choking on peanuts.

Except on screen, the software didn't get the dictation quite
right. Instead of "peanuts," the software entered...well, something
more anatomical. "It was funnier than hell because our nurse
practitioner found the error and was just in hysterics," Dr. Clode
said. "You have to watch out [and proof carefully] when you use
it.">

<Doctors not only have to spend considerable time learning the
software but also must "adapt to the technology," said Joe Marion,
an executive director with Superior Consultant Co., Southfield,
Mich. "If they are not willing to do that and [think] that the
computer is going to figure them out, then they will struggle," he
said.

Speech recognition is "not for everybody," he said. "One of my
partners who tried it would yell into the microphone, 'Damn it! I
said ...' Well, if you're kind of rigid like that, don't want do to
proofing and are the type of individual who can't stand any errors,
it's not going to work.">

<"The real value will come when speech recognition is integrated
with the EMR and gets more accurate," Dr. Gibson said.

"It will happen, but I'm not going to hazard a guess as to when.
We've always said five years from now, and for 20 years we've been
wrong.">

I appreciate the strong participation in the MT India Quiz Contest
'2004. The finals will be held on Tuesday, 08th. Instructions
towards the same can be viewed online at the at 1000 hrs on the
08th.

Details can be found at: www.mtindia.org/mtweek

Ciao!

Maj (Dr.) Amit Chatterjee, SM
Strategist / Founder ~ mailto:amit@...
MT India ~ www.mtindia.org
"The Community of MT Professionals"

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NEWS AND VIEWS :
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1) Program Could Put Medical Records In Criminal Hands

Ttwo years of top secret negotiations between Florida's Moore Haven
Correctional Facility and Allied Healthcare Services of Ohio, led
to a program which would use the prison population as cheap labor
to transcribe the confidential medical records of people outside
the prison walls.

Corrections Privatization Executive Director Alan Duffee signed off
on the program last year, as a representative of the state,
according to the report. He admitted to having some reservations
about the program, but was assured Florida residents would be
protected.

Residents of the other 49 states would still be fair game, Local 6
News reported. However, in Duffee's words, the program also had
another added measure of security -- the institution would screen
the inmates to find the best possible criminals for the job. "For a
lack of a better word, they are the best of the inmates there,"
Duffee said.

"The potential in a situation like this for someone's information
to get into the wrong hands. "It's actually being put into the
wrong hands from the very beginning." Ivey said. "They're inmates.
They have committed some type of felony crime if they are in a
state institution."

Certified Medical Transcriptionist Traci Lutter applied for a job
at Moore Haven, supervising the inmate program. She withdrew her
application when she realized she'd be helping inmates gain access
to people's names, drugs, and valuable information. "I'm sure that
the prisoners are not ethical enough to keep the information
private," Lutter said.

The inmates would make 2 cents for every line of they transcribe.
In comparison, a certified medical transcriptionist in the free
world makes approximately 8 cents a line.

"I feel it's trying to get the cheapest labor, looking for the
dollar," Lutter said. Duffee still defends medical transcription as
a viable option at other state facilities. He told Local 6 News,
"If safeguards can be implemented so that the public is not at
risk, then I think it would be an excellent program."

http://www.local6.com/money/3334235/detail.html

2) Electronic doctors

The one thing electronic charting doesn't do for doctors is save
time, according to Dr. Joseph Overhage, an associate professor at
the Indiana University School of Medicine and a nationally
recognized expert on electronic medical records and their effects
on the practice of medicine.

Studies have shown it actually takes doctors longer to chart a
patient exam electronically than by old-fashioned paper and
dictation, he said. The efficiency is gained by other members of
the office staff, the clerks who pull charts.

So what's in it for the doctors?

Overhage said the advantage for them is that it makes them better
clinicians by warning them of medical errors and helping them make
better decisions.
Overhage, whose office has been digitized for decades, said he
especially values instant access to a patient's most recent labs,
X-rays and specialist reports.
He says it allows him to get right to the point with his patients,
a good thing considering the average exam lasts a scant eight
minutes.

"You don't have to interrogate them about whether they had seen
their cardiologist or if they had an X-ray," Overhage said. "It
changes the focus of the patient encounter to what they want to
talk about."

http://www.southbendtribune.com/stories/2004/05/23/local.20040523-s
bt-FULL-A1-Electronic.sto

3) Electronic medical network gains support

All those paper medical files lining the walls of doctors offices
and filling storage rooms in hospitals are on the endangered list
in Western New York.
advertisement

Plans are under way to replace the thick manila folders with
electronic medical records that would be available with a touch of
a computer button. Though initiatives are just getting started,
supporters say the switch from paper to cyberspace will greatly
improve medical care while saving costs.

"The region desperately needs it," said Dr. Julian Ambrus Jr. an
immunologist. "We as physicians know that information is fragmented
and there is a huge amount of duplication. And there's poor ability
to get data from one place to another."

The potential costs savings of such a system are significant,
supporters said. Recent studies indicate that physicians spend as
much as 38 percent of their time paper shuffling while nurses spend
half their time with paper files. The cost of physically finding a
chart or file range from $8 to $15 per chart and there's money to
be saved from requiring less physical storage area. Further,
doctors could pocket more than $10,000 annually in transcription
costs if they switch to the electronic version.

http://msnbc.msn.com/id/5087127/

4) Blind teaching blind IT skills project makes inroads, aspires
expansion

Depending on one's skills level, one can actually copy an entire
booklet without glancing at a single typewriter key and yet attain
more than 95 percent accuracy in under an hour or two.

Furthermore, on a specialized field, doing a medical transcription
with an accuracy rating of 90 to 98 percent. The fundamental skill,
which is not a secret, is I believe called "Touch Typing". A skill,
we the sighted individuals take for granted.

The Medical Transcription, which is a new one, is for college
graduates or individuals with college-level education who wish to
pursue a financially rewarding career in the fast-growing medical
transcription industry. On-the-job training is provided in
partnership with Total Transcription Solutions Inc., a company that
specializes in medical transcription services.

http://biz.yahoo.com/prnews/040528/nyf009a_1.html

5) At Maine Med, it's click vs. scribble

A clerk, in one instance, mistook an ill-formed "u" - as in
"unit" - for "4." So the patient was ordered much more insulin than
needed. This and most transcription mistakes are caught by a
pharmacist or nurse before an allergic reaction or overdose can
happen; errors that reach the patient are less than 1 percent of
the millions of medication orders administered annually. But to
decrease those odds, the Portland hospital last year became among
the first in the country to ask all its doctors to enter
prescriptions and other orders into computers.

The number of transcription errors has dropped 78 percent in a
year's time. From January to March 2003, there were 103 mistakes,
compared to 23 made during the same period this year.

http://www.pressherald.com/news/local/040524medicalerror.shtml

6) 'There has to be a better way' wins invention award

LuAnn Takens spent hours on her computer, typing furiously and
backpedaling when she missed a beat. The East Grand Rapids resident
said she barely started working as a certified medical
transcriptionist when she sat back in her chair, deciding, "There
has to be a better way."

Two years ago, she came up with the Takens Medical Transcription
System, an electronic device designed to record and categorize the
information dictated by doctors about their patients and eliminate
the need for professional transcriptionists.

With Takens' device, doctors can dictate a patient's name to the
machine with a compact disc program inside, which would either
visually or vocally prompt the doctor to then say the patient's
symptoms, past history, vital signs and other medical information,
organizing it categorically.

When the doctor is finished, a secretary should be able to pop the
CD from the device into a computer and the digital information
could be stored onto files.
"I just started typing my thoughts onto the computer, and I came up
with it," she said. "I really think I was divinely inspired."

"The bad part of it will be eliminating medical transcription
jobs," she said. "But the savings for the medical field will be
huge, and technology is moving in that direction anyway."

http://www.mlive.com/news/grpress/index.ssf?/base/news-14/108541017
3225370.xml
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