In addition to a consolidating transcription industry, there are two key trends in that arena today.
One is the growing sophistication of programs such as Dragon NaturallySpeaking, which is being adopted by transcription super-users such as radiologists and pathologists.
The other trend is toward the use of digital recording technology for review and storage of transcriptions. Research from Philips Dictation Systems (Atlanta, Ga.) shows that in 1998 analog dictation business represented 80 percent of sales. A year from now, the company predicts digital dictation devices will account for 80 percent of sales.
Digital recording technology allows a physician to transfer and update information in electronic health records much faster than traditional tapes, says Peter Preziosi, executive director of the American Association for Medical Transcription (Modesto, Calif.). Although digital transcription has become common in large institutions, smaller practitioners continue, in many cases, to use tape cassettes, he adds.
Just say it
"I think speech recognition, at the front and back end, is growing in market share," says Preziosi. "I think we're going to continue to move in that direction." The association feels speech recognition could put its members out of business, but that it could also create opportunities, he suggests. Transcriptionists can help standardize templates for health records and assist, after training, with the database management of healthcare institutions, says Preziosi.
For the past two years, Jeff Pearson, M.D., and his staff of six pathologists and one pathologist-assistant have been using Nuance's Dragon NaturallySpeaking software for medical transcription. The change to voice recognition software has allowed Pearson to reassign or reduce the transcription staff while increasing productivity and accuracy of diagnoses.
"You used to have to drop off your notes for the transcriptionist in the morning and you'd get it back in the afternoon," says Pearson, medical director of the Department of Pathology at Bronson Methodist Hospital in Kalamazoo, Mich. "But now you can see your notes immediately on a computer screen."
The move to automate transcription has been a boon at Bronson. Pearson's department, which used to have four transcriptionists, now has one three-quarter time staff member. Two transcribers now work fielding phone calls, filing and doing other office-related matters. "We've been able to cut some full-time equivalents, and that was a significant cost savings" estimated at $200,000 annually, he says.
In February, Nuance Communications Inc. (Burlington, Mass.) purchased Dictaphone, Inc. (Stratford, Conn.) for $357 million in cash. Dictaphone will add 4,000 customers and 400,000 physician users to Nuance's portfolio, as well as more than $80 million in revenues this year.
Pearson's pathology staff wears headsets which allow them to wirelessly transmit their notes to the hospital's network. They can view them immediately on a monitor while studying slides of several patients at one sitting, saving a great deal of time. And if necessary, the pathology staff can work from home or at night and see their reports in real-time and correct them immediately by saying "scratch that" or using other verbal cues.
In fact, much of the work required to make Dragon NaturallySpeaking into labor-saving applications comes in the creation of macros developed by users. Macros allow pathologists to use a single word or phrase to fill in common documents they use. Pearson's team has 20 macros assigned to colon biopsies and eight macros for gall blander issues. The software itself has a vocabulary for pathology and 13 other healthcare specialties. "We've built our own macros and they are great, but it requires you to do a lot of upfront work," he says.
Frank Jossi is a freelance writer based in St. Paul, Minn.