Voice Activated Device/ MD Dictation Speech recognition devices are widely used by physicians because they provide many advantages in the health care environment that they practice. Due to managed care, doctors are restricted in the amount of time they can spend with their patients because they use most of their time doing paperwork that is required of them. Speech recognition systems such as dictation programs and devices have brought a new outlook for the application of technology in healthcare organizations especially among physicians. Dictation programs and devices allow doctors to use the time formerly spent on record keeping to see more patients. Many programs and devices exist today that physicians can choose from. Every device or program offered by a medical vendor contains advantages and disadvantages. It is therefore imperative that physicians choose a product that best compliments their treatment practices. In the early days, the benefits of voice-activated programs and devices were limited by the lack of memory capacity and speed of personal computers. Early versions ran on mainframe computers and had a limited vocabulary. Discrete speech was the first application of this technology that was created. This technology used a discrete speaking style that required the speaker to pause between words so that the engine could identify each word accurately (Scott). Most users believed these short pauses to be impractical even though it was highly accurate. Discrete speech later became popular among telephone companies since it is used for telephone commands. In 1996 continuous speech was created and has practically eliminated discrete speech. Continuous speech can recognize a person’s natural way of speaking, which does not require pauses between words. Users simply speak clearly into a microphone at a conversational pace. Once believed to be only part of science fiction, speech recognition programs have become a reality. Today’s voice-recognition products are easier to use and require less training and customization than those in the past. The latest generations of voice-activated products allow the user to control basically every aspect of their computer without having to use the keyboard. As changes in health care have increased doctors’ patient loads, it has become difficult for them to meet their filing deadlines (Scott); with today’s technological advancements physicians have the option to choose among a variety of products that will resolve today’s major issues. Two different types of speech recognition systems exist in the market today. The first one allows the user to give verbal commands that his computer will execute. Dictation is the second form of speech recognition system, which will be the focus of this paper. Dictation with transcription is widely used today, but the high costs of transcription services have developed interest in voice recognition software programs (Borowits). Digital Voice, Inc. is a company that offers a digital dictation system, a dictation station, and a transcription station. Most transcription service companies and well-known hospitals prefer this system. VoicePower is the name of the digital dictation system offered by DVI and is equipped with a number of peripherals including VoiceWave Dictate, VoiceWave Player, and VoiceWave Mobile. The dictation station and the transcription station are integrated with VoicePower to offer a complete dictation system that will satisfy any company in need of one. The starting price of an entry-level version of the VoicePower system is $3,495 and will increase depending on how many ports are needed (DVI). Physicians can benefit from this product because it offers a complete package that is needed to integrate dictation into their practice. Physicians can choose to use this dictation system because it provides more thoroughly complete and accurate patient records in accordance to federal regulations (Borowits). The disadvantages to using such a system rest in the amount of time it takes to receive a report transcribed correctly. It may take days to get a dictation returned by a transcriptionist, to then have to proof read it and possibly have it sent back for further correction. Even if the transcription service is reputable it still turns out to be costly and time consuming. Another disadvantage that I can think of about this particular digital dictation system is the limited amount of users it can handle depending on how many ports are purchased. The system can only handle 32 users at most and costs associated to support them are over $7,000 (DVI). Many physicians use this product, and even though they may be aware of the disadvantages to the system, they continue to rely on it because of skepticism among other options. Unlike DVI, Medquist not only provides a state-of-the-art digital dictation system but reliable transcription services along with it. Their digital dictation system is called Compendum, which supports dictation via the telephone, dictation at a personal computer workstation, and digital dictation through a hand-held device. Medquist provides electronic transcription services and claims to be leading the market. Medquist seems to be a better option to DVI, because it does not use hardware components such as the ones they offer. Medquist provides an inexpensive solution to the customer by allowing them to use existing devices such as a telephone or a personal computer. Medquist grants the physician the ability to dictate and have a transcribed report sent back electronically via the Internet, having the entire process completed by the same company. Physicians claim to save time this way because reports are transmitted directly to their desktop. In addition, Medquist reduces the cost of the dictation system by using existing components and eliminating annual maintenance costs. Costly on-site transcription resources are also avoided, but most important is the security and the reliability provided by Medquist (Medquist). Even though Medquist seems to lower costs, physicians must understand that transcription fees might still be too costly for having such a convenient dictation system. Another issue involved is how much time it takes for a dictation to be accurately transcribed and returned to the physician’s desktop. Medquist is an option that seems to work in pleasing their customers by paying attention to what’s important to them, but might fail in the realization that other options are available that might alleviate the costs further. The Programmers Consortium offers VoiceWare, a Windows-based dictation system that enables the user to send voice recordings digitally from any personal computer to a transcriptionist’s PC. VoiceWare has many components that are linked together by a central hub, the VoiceWare Server. This is a self-contained system that can manage dictation and transcription. The server interfaces to dictation machines, microphones, digital recorders, and can be integrated with computer-based patient records. This product gives physicians the choice to buy VoiceWare components needed for dictating reports or the option to purchase devices that might belong to another company. The Programmers Consortium does not tie the customer down to buying from their VoiceWare product line. Voiceware guarantees the highest sound quality on the market today and that’s why many physicians chose to use this product over the ones already mentioned (theprogrammers). The disadvantages attached to this dictation system still include costly transcription fees, waiting time for accurately transcribed reports, and the most important element that they do not seem to provide is security. VoiceWare dictation system might not be the best option for physicians.
Hand-held devices such as TalkNotes from Provox Technologies can be really convenient for physicians who are always on the go. TalkNotes eliminates the transcription process, but it still needs to be reviewed and edited for errors. TalkNotes requires the physician to dictate into the hand-held device. Afterwards, an editor highlights the physician’s words on a personal PC using Original Voice Recall, which will allow him to listen to the physician’s voice, reviewing and editing the dictated text. TalkNotes was specifically designed for physicians with a special vocabulary. It has a good feature that allows the hand-held device to interface with the physician’s current medical billing system, providing instant access to patient information. The disadvantage to such a device would be the cost of having to hire an editor, even though it is cheaper than a transcriptionist. Physicians who have used this product claim to have saved thousands of dollars annually and highly recommend it (Provox).
Unlike the dictation systems that I have talked about, dictation software programs are revolutionizing the market and might one day eliminate the need for transcription services and unnecessary hardware devices. MD Dictate is a voice recognition software program provided by MD Productivity. This software program saves valuable time to be used in a more effective manner, lessen the amount of medical errors, and at the same time decrease the physician’s workload. MD Dictate is a high-quality software program that turns spoken words into detailed documentation. It was developed to reduce the high costs and report turnaround time of transcription. The physician dictates into a customized speech microphone, which is plugged into a personal computer. The physician’s spoken words are then converted into digital text, accurately and efficiently. Once this step is completed, the physician archives the document and therefore completes the dictation and transcription process. Transcription costs, errors and delays are completely eliminated (MD Productivity). Physicians no longer have to wait days to get a dictation back, to then proof read and possibly be sent back for further correction. It takes about 15 hours to train your voice into the MD Dictate so it can capture and recognize it accurately. Physicians will find that the program might be slow at first, but after continued use physicians will quickly adapt to the program. Since most of physicians’ dictation is repetitive MD Dictate contains the ability to create templates and macros. A template is created for repetitive documentation, which allows the physician to quickly create a new document by only having to change the patient variables. Macros enable physicians to substitute large repetitive text with a single word, thus reducing dictation and saving time. MD Dictate’s minimum requirements consist of a Pentium III processor, a Microsoft Windows operating system, 2.0GB of free disk space, 128MB RAM, and a high quality sound card. Physicians can use this software program to substitute any other method that can be used for dictation (MD Productivity). Physicians having to edit their own work might be at the biggest disadvantage when choosing this product, but the advantages of being cost effective, fast, accurate, and easy to use outweigh the dilemma.
Dictation devices and dictation/transcription software programs help alleviate the congestion of paperwork many physicians are plagued with. Physicians are afforded the ability to treat other patients by having freed themselves of the majority of the paperwork. However, embarking on the use of a dictation device or software program requires careful analysis on practicability, cost, speed and security. Not one of the products discussed is error free and therefore physicians must carefully choose a product that best compliments their practice. Yet, it is not difficult to see that as technology continues to move forward exponentially, so too will the number of options a physician will have in choosing a dictation device or software program. It is the hope that our free market economy will forge new competition and help alleviate any of the aforementioned disadvantages.

Works Cited

Borowits, Stephen M. Computerized Voice Recognition As a Replacement for Medical Transcription. American Academy of Pediatrics: 1999.
Scott, Jeffrey C. Word of Mouth. Computer Shopper: 1998
Website: www.dvi.com
Website: www.mdproductivity.com/mddictate.html
Website: www.medquist.com
Website: www.theprogrammers.com
Website: www.provox.com