If you're frustrated with the expense and delays of Dictaphone transcriptions, Dr. Jonathan Krant's solution may be just what the doctor ordered.
“Until 5 years ago, I utilized a Dictaphone with off-site transcriptions, a process that resulted in chart and referral consultation notes taking a week or longer to get to the referring physician,” said Dr. Krant, a rheumatologist in Pittsfield, Mass. Adding insult to injury was the $3,000 monthly cost of the Dictaphone transcriptions. There had to be a better way.
So he invested $4,000 in an off-the-shelf version of Dragon Systems Medical Suite and a Dell computer system. “Over the course of the next several months, I customized the voice recognition software with a rheumatology lexicon of about 10,000 words and corrected mistakes in real time on screen,” he said.
“Now, 5 years later, there are no charts on my desk. Follow-up appointments and new patient consultations are dictated at the time of service into either a portable handheld unit or a microphone connected to the computer. I can send either faxed notes or dictated copy with a keystroke [with] over 99.5% accuracy,” said Dr. Krant, noting that he has no financial interest in the technology.
His practice has saved $180,000 ($3,000 a month for 60 months). “Physician satisfaction cannot be overstated,” he said.
“The Dictaphone is awful technology that multiplies medical errors,” he said. He looked into voice recognition software, and learned that the Dragon Systems Medical Suite had a tolerable error rate and could be modified to fit his needs. After several thousand entries and corrections, it became a valuable tool. “Entire phrases and chart notes can be set up using templates that have assigned identifier numbers, so all I have to do is say the number and there's the phrase or chart, lickety-split.”
Dr. Krant receives referral patients from about 200 primary care physicians. He's now able to get his notes to them within 10 minutes of seeing a patient.
“If I've got a patient with leg swelling and his physician thinks he's got an effusion in the knee because of arthritis, but I'm concerned about a clot in a lower extremity, I have an ultrasound waiting to be performed and an admission pending for deep vein thrombosis lined up within 15 minutes of the patient's examination,” he said.
By Bruce K. Dixon, Chicago Bureau. Look for the next installment of this column in the Feb. 1, 2007, issue.