Dictation trends point to digital

MGMA Connexion, Jul 2006 by Hanson, Vickie

Health care technology is quickly moving from analog to digital - with digital dictation systems replacing handheld analog (tape) devices.

Driving the change is an emphasis on better clinical and business operations. For example, new industry regulations governing medical record keeping, specifically the Health Insurance Portability and Accountability Act (HIPAA), have forced group practices to adopt more sophisticated technologies, including those used for dictation.

As the number of analog dictation vendors dwindles, digital dictation sales have jumped. Some manufacturers may soon halt production of analog products altogether, leaving users without a resource for service, parts and replacement tapes.

Therefore, this might be the time to consider a transition to a digital dictation system. Not doing so might leave group practices out in the cold - relying on an almost-extinct technology to handle a critical component of their business.

Technology breaks down resistance to digital systems

Like all health care technology, digital dictation initially faced resistance. Human aversion to change remains a primary hitch.

Some early digital dictation users feared that their files would be lost in cyberspace, mainly because they couldn't touch or see them. However, many people now own digital cameras and download pictures to a computer. Digital voice files operate the same way; users are growing accustomed to digital technology.

Early digital dictation systems were unwieldy and difficult to use within the existing clinical workflow. The systems were expensive, requiring specific hardware and computer systems, and intimidating because of difficulties with hardware interfaces and software loading. The cost for upgrading to digital dictation technology has diminished: Individual handheld units range from $250 to $450, depending on features and accessories. You can purchase removable multimedia cards with a wide range of memory capacity at office supply or electronics stores.

Today's digital dictation technology has matured, offering user-friendly, one-touch controls for precise, single-handed operation. It allows a seamless connection with existing workflow, it's compatible with existing desktop computers and networks and enables digital software downloading and "plug and play" functionality.

Benefits abound

Digital dictation can bring many advantages to a medical practice. It:

* Allows quick, secure uploading of files to a desktop computer and transmission via intranet or Internet for transcription, incurring no costs for delivery of tapes and no risk of damaged, erased or lost tapes;

* Allows attachment of supporting documents;

* Simplifies file archiving and retrieval;

* Minimizes confusion by using job identifiers and file headers to facilitate sorting for transcription, filing and retrieval;

* Facilitates HlPAA compliance by allowing file encryption for storage and transmission, and electronic routing from provider to transcriptionist, providing an audit trail;

* Lets providers take advantage of other technologies such as bar-code identification labels for patient records; and

* May offer users the ability to leave a job "open" to add data later.

Downsides to digital

No innovation is perfect, and group practices that adopt digital dictation need to know potential downsides:

* Digital memory cards can be erased by strong magnetic fields;

* Dictation files may be temporarily inaccessible if a group's computer network goes down;

* Users can inadvertently remove files from digital devices by making incorrect selections from prompt menus;

* New users might feel insecure about whether or not dictation is being recorded; and

* Some providers believe it requires more work and information management on their part, since they must download files and transfer them to the proper directories.

While process changes can challenge medical groups, the transition to digital dictation is eased by its potential benefits. Since analog-based dictation may go the way of the dinosaur, practices may want to begin serious investigation into digital technology.

about the author

Vickie Hanson, manager, Business Development/ Marketing Services. Philips Speech Processing, North America, Atlanta, vickie hanson@philips.com