May 29, 2007

The Case for Digital Dictation
By Rick Gallahan
For The Record
Vol. 19 No. 11 P. 8

Without a doubt, the world of dictation and transcription has undergone a significant transformation during the past five to 10 years. The proliferation of cellular phones, PDAs, and other electronic devices has produced a “mobile mindset”—physicians, executives, and other professionals can access the Internet, respond to messages, and generate work virtually anywhere at any time.

With the need for more mobile dictation options, new technologies have evolved to meet market demand. Handheld digital solutions, in particular, have been developed to mimic familiar work habits for ease of use, while increasing workflow efficiency and streamlining the transcription process.

Technological Advances
Traditionally, healthcare professionals have relied on analog systems that record dictation on magnetic tape. These tapes must then be handed off or shipped to a transcriptionist.

With digital dictation, however, files are stored on a small media card similar to the ones used for digital cameras. Whether working on site or from a remote location, professionals can plug the recording device into a computer or docking station and securely download the file via the Internet or Intranet. Automatic downloading decreases the chance that a file will be lost, damaged, or destroyed in transit and eliminates the delay between dictation completion and when a transcriptionist can begin work. Advanced encryption allows healthcare organizations to restrict access to files, so dictation is secure no matter where it is recorded or transmitted.

Once files are transmitted to the transcriptionist’s work station, they are displayed in folders like other types of documents. Transcriptionists are automatically notified that a new job has arrived and can better manage their workflow because they see all pending jobs and their current status.

Digital files also give physicians and other healthcare professionals greater flexibility during dictation. With analog, users are able to add information only at the end of the tape. If they try to insert information within existing dictation, they erase the earlier recording. Digital, however, permits users to move around within the file and insert or delete information as needed without overwriting previous data—similar to modifying a Word document on a computer.

In addition, digital technology provides transcriptionists with random access to any file or part of a file, eliminating the need to fast-forward through an entire cassette to find a particular document or passage. Each voice file is identified on the computer screen according to file information captured at the time of dictation, making it easier for transcriptionists to manage their workload. Displayed information may include priority status, author name, patient name or identification, or work type.

In addition, digital technology allows healthcare organizations to archive original dictations. While analog tapes are reused—causing previous files to be erased—digital dictation can be saved indefinitely. The electronic files consume no valuable office or floor space and can be produced instantaneously if required.

Benefits
These aren’t the only benefits of digital dictation technology, particularly for transcriptionists. Other primary advantages include the following:

• Sound quality: With virtually no exceptions, transcriptionists find that digital sound is superior to that of analog systems. Digital technology eliminates ambient noise from equipment, machines, background conversations, echoes, and crowds. This isolates the voice generating the dictation and makes it easier to understand on the first review, thereby reducing the number of times the transcriptionist must play back the dictation for clarification.

Digital files also offer nondistorted pitch control so dictation is easier to understand when it is slowed down or sped up. With analog, slowing the speed during playback produces cartoonish, slow-motion sound effects, and fast-forwarding generates high-pitched speech—both making dictation hard to understand. Digital technology addresses this by removing the gaps of silence produced during human speech. This process retains the word clarity without causing distortion.

Because sound quality is enhanced, digital dictation improves the accuracy of the finished product and allows transcriptionists to work faster. Transcription is completed and returned more quickly, and transcriptionists, who are usually paid by the keystroke, can increase income because they are able to complete more work during the same amount of time.

• Workflow: Because dictation is automatically uploaded onto their computers, transcriptionists can immediately see when work has arrived. An on-screen “player” allows transcriptionists to use their computer as a transcription tool. They no longer have to alternate between analog equipment and their workstation but instead move easily between tasks with fewer interruptions to workflow.

Plus, digital technology allows the individual who dictated a file to prioritize the work for transcription. For example, if a physician downloads 10 chart notes, he or she could identify three as top-priority transcriptions. Advanced digital systems mark the priority files in the transcriptionist’s in-box—the file name may appear in bold red, for instance, or an optional audible notification may alert the transcriptionist.

• Work routing: Likewise, digital dictation exhibits allow a healthcare organization or transcription service to route work more efficiently. When new dictation is created, digital voice commands can automatically prompt the physician or professional to identify the file with patient identification, work type, or priority status. The individual generating the dictation simply speaks the information, which is automatically captured and permanently attached to the voice file.

Then, when the dictation is uploaded, preconfigured settings will automatically route certain types of work to specific individuals within the organization. One staff member, for instance, may be tasked with generating all letters of referral or requests for consultations. Another may handle all medical dictations or overflow work from other departments.

The ease with which files can be routed allows an organization to optimize its transcription resources. Dictation can be distributed internally among staff or directed to a transcription outsourcing service and remote contract staff members. In addition to advancing efficient workflow, the technology allows the author and transcriptionist to monitor the real-time status of every dictation in the system.

These advantages make digital dictation a clear choice for a growing number of healthcare organizations. Those who have made the conversion from analog to digital report increased transcription accuracy, as well as gains in personal and professional productivity. By improving workflow processes, digital dictation enhances efficiency both for those who generate dictation and those who transcribe it.

— Rick Gallahan is the director of business development and marketing services for Philips Dictation Systems.