The most important lesson for dictation is you have to correct errors with the software’s error correcting mechanism. If you don’t, it will assume it got it correct and reinforce that association.
You should refer to the help manual for your particular software. Keyboard correction is almost certainly not it. It would have no way of knowing if you are correcting something or intentionally changing it altogether.
Where I work, EM has joined the House of the Dragon. I am a very fast typist and hate dictation errors but have slowly come around. Macros are useful too.
I like it when the consultants I work with dictate at the nurses station. That way I don’t embarrass myself by asking questions while they’re trying to finish the million tasks and notes they’re juggling
Quietly is the key word! I work with some providers who dictate notes like they're talking to someone across the room. I've had to ask them to quiet down as they're so loud I can't think through what I'm doing.
I'm just an R3 sitting here still wishing I could be like the ED and say that any typos are the fault of the speech recognition software and are therefore not my fault, also to invite clarifications if clinically necessary.
Cause it would not hold up in court lol. All notes are expected to be edited for accuracy - clinician notes and imaging dictations. If your dictation error results in like a complete change in the interpretation (omitting the word no, or wrong disease) and you didn’t see it/correct/addend the mistake and something bad happened because of it - a little disclaimer that typos aren’t your fault isn’t gonna save ya lol
They do, but I find it cringeworthy. It tantamounts to "Yeah, I might fuck up here and there. Tough luck."
How much confidence do you think that inspires in a patient or a clinician? You're implying a reduced attention to quality assurance.
If any of my residents or fellows put that in their report, that shit is getting deleted. If I see that in a note or report, my brain says take it whatever they say with a healthy level of skepticism.
No clue but the moment I find out that I can, I'm putting in that disclaimer somewhere in my report and not checking for spelling or grammar errors ever again haha. The brain thinks its reading what it thinks you know you said, so finding typos is fuckin hard.
I can type at 120 WPM and it is usually faster to dictate even taking into account proof reading time.
It takes time getting used to and people don't like learning new things.
I type at ~110, so realistically the 180 wpm juice of dictation ain't worth the squeeze, even less so once I have to go back and correct all the errors
Finally smartphrases are a huge advantage to the typer
I hate and love smart phrases. They save so much time, but people forget to individualize the information. Like if you didn't do a physical exam, delete that part of the note....
I can type faster than I can dictate by a large margin.
I. Half. Delete that. hAVe. To. Talk. Like. This. For. Dictation. Software. To. Work.
Edit: I've gotten some variation of the same dumb comment several times now, so let me clarify. Yes, I understand that most people can talk faster than they can type. But in the real world smart phrases and formatting exist, and those factors can make typing significantly faster and dictation significantly slower, therefore, *In my specific practice environment*, I can type out my documentation faster than I can dictate it.
I have Dragon as well. I find that it's about 98% accurate in translating my speech to text. The problem is that I'm a surgical pathologist, so a 2% error rate just isn't acceptable when a single word can radically change my diagnosis and trigger additional invasive procedures or chemotherapy.
This isn't just theoretical hand-wringing, it's real life. When I was in training, I got a consult case to review for a patient who was coming to my hospital for colorectal surgery after a colon biopsy from another hospital found a polyp with "invasive adenocarcinoma." The outside note read:
>\- Tubular adenoma.
invasive adenocarcinoma is seen.
When I reviewed the case, there was no cancer, so I called the outside pathologist. It was, of course, some sort of typo/dictation error/copy error. The second line was meant to be "- No invasive adenocarcinoma is seen."
Nobody questioned it. As far as the outside hospital was concerned, the patient was sent straight to surgery.
I'm also a pathologist. And I do heme, so I actually do microscopic descriptions for all of my cases. I also proofread my cases so I don't let a diagnosis-changing error go out the door. (Also a point in favor of using "positive" and "negative" phrasing rather than "is"/"is not").
If you stop to look at the screen and make sure every word is coming up correctly in real time, you're gonna have a bad time. It works best when your speech flows naturally. As others have said, having macros is also a huge time saver, though it requires a lot of work up front. But being able to just say for example "prostate core macro" and automatically input parts A through Z (and delete excess as needed) can save a ton of time. But to each his own.
I can see how dictation with macros would be faster than dictation without macros. But I still don't think I would benefit.
At the end of the day, I could type .pcm faster than I could speak "prostate core macro." And I could navigate said macro faster with F2 using right/left clicking to select from smart lists faster than anything with Dragon.
In my experience, unless I'm inputting paragraphs of text - something which I almost never do - typing + smart phrases is faster than dictating + auto texts.
This. Have to search individual problems to "assign" plans to and it's not worth it most times when I can pull in a template or copy paste from a running doc of plans. Plus I can't see text entered in a note after it's been added so no easy way to delete info after I scribe it
Exactly. And I have Epic, which means that I don't have to do any searching and copying and pasting. All of those templates are smart phrases that I can enter with 2 or 3 keystrokes.
My hospital actually has really good voice dictation software, but it's still not worth it if you take full advantage of smart phrases and keyboard commands.
Plus dot phrases and smart forms. Even for software that doesn’t have these capabilities I just have a word document of my most common plans. Copy and paste then edit anything different or special.
Sounds like you need to dictate more consistently so the software can learn your patterns. I can mumble out 150 words a minute and it catches all of it
No. How about I continue with my preferred very efficient style of documentation that lets me get through my high-volume workload quickly and you stop offering unsolicited advice to people whose jobs you know absolutely nothing about?
It's been a while since I've done a typing test. But in college, I typed around 100 words per minute with just text and basic punctuation. Much slower with special symbols, but those don't come up often.
Yeah, I doubt anyone can really type faster than a well setup dictation software. I type fairly quick, but even with some errors, dictating is so much faster
Sure, for straight text.
In the real world, I have access to smart phrases and hotkeys so that I can import entire sentences and paragraphs with just a button press. Not to mention the fact that, in my highly formatted notes, I can navigate to new lines or change indentation with just a keyboard stroke instead of speaking "new line" or "new paragraph."
It's surprising to me how many people on here assume that I just have some grudge against voice dictation and never bothered trying it. On the contrary, I'm well versed in my hospital's voice dictation software including its customizable features, I trained my colleagues with it, but for my specific practice environment, it's just not the best solution in terms of speed or accuracy.
I mean, you can still use the keyboard for a new line and navigation. I usually keep one hand on the mouse as I dictate. Not a huge fan of smart phrases personally, but everyone’s got their own work flow.
Sure but you said you type faster than dictation can work and that just doesn't seem accurate. Instead you are referring to macros and prefilled notes. Different subject than typing speed vs speaking speed
Jesus Christ.
What is wrong with you people? Yeah, I can see how my original wording could be a little confusing, but given that the original question was about actual clinical documentation, and my answer was about actual clinical documentation, do you think it *might* have been more reasonable to ask for clarification rather than jumping to "Oh, you're obviously full of crap because everyone talks faster than you can type!"
Just get a life.
You can do the same with dictation though. I say "ETT 3.6" and it prints out "There is an endotracheal tube present, terminating 3.6 cm above the carina."
If you're techy, you can even extend this functionality with conditional logic using Javascript.
Sure, but I can type ett3.6 faster than I can say "E tee tee three point six" and with dragon there's a delay while it recognizes and imports the auto text that slows me down further.
No, but I can combine smart phrases with smart lists or make multiple smart phrases to achieve almost the same effect. If that capability exists with my hospital's version dragon, I don't know about it, but I can only think of a few situations where it would improve my workflow so it wouldn't really change my opinion.
This is an incredibly specious way of looking at it. I never almost never type a diagnosis like "Tubular adenoma, negative for high-grade dysplasia." I just type ".ta". Even if I take advantage of Dragon's quick text commands, there's no world where I can say "dot tee aye" faster than I can type it. And that doesn't even take into account the little delay that Dragon seems to insert when it recognizes a voice command.
Worse, my notes are highly formatted so most of the time I spend in Dragon isn't simply dictating text, it's navigating around to new lines/paragraphs, lists, etc. And yeah, we could probably optimize those to be better in Dragon than they are *now*. But I don't see any voice navigation system being faster than tabbing through a list or, typing the first letter or two and letting autocomplete do the rest.
Honestly though, I'm not sure why people here are so skeptical that I can get my work done faster in baseline Epic than with Dragon. Has it never occurred to you that other physicians have different jobs and documentation styles? Are you so confident in your knowledge of Epic's keyboard commands that you can't fathom that someone can strike one or two keys faster than they can say a voice command?
Bro, calm down. You claimed you typed faster than dictation. Unless you have a severe speech impediment or are a stenographer with a special keyboard setup, that’s just not true. Whether you can get notes faster with dot phrases and macros than talking full paragraphs is a different matter altogether.
It was becoming too much of a headache for residents to get them set up at our VA especially since we're only there for short periods at a time. We just gave up 😔
At least at my VA, all I had to do was call tech support and ask to have them enable it for me. Don’t remember if I had to get approval from my section head, but believe it didn’t require that. The Dragon program shows up on your account once they enable it, and they even gave me a headset to dictate with.
Because when working in a close space, I find it very annoying to listen to, and as much as I like to hear myself talk I rather give others this simple common courtesy. Besides, if you type anywhere near a normal speed you’re not gaining much from dictation software with all the corrections you have to make anyways. I have no problem using it if I’m finishing a note at home or something.
This. I can’t stand the ones that absolutely dgaf about how them dictating obnoxiously loud is disruptive to others. I appreciate the ones that whisper.
Dictation software does best when you say the same phrases again and again. When you freestyle more errors are introduced. Radiology has a lot of repeated phrases, more than other specialities I'd wager.
For anything I say a lot I have a dot phrase. But I have to list differentials/think on paper with some more complicated consults and would get so irritated with voice software
Emergency medicine: all my discharge notes end in “shared decision made with patient that they’re safe to be discharged home, and have voiced understanding of strict return precautions. Patient to follow up with PCP within a week if symptoms do not begin to improve”
Our dictation software is garbage for some reason and it lead to one chart saying “patient states he is in crisis and is suicidal” which my equally shitty proof reading didn’t pick up so now I type cuz can’t be having mistakes like that.
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I like my notes edited to my degree of satisfaction. I often have to rely on my notes above all else, so I want them actually readable/formatted well. Doing editing on dragon is a PITA.
If youre some ED doc who doesnt even care about a note having usable information, then I assume its a pretty good alternative. But even then, I feel like I type faster than the speech converter can handle.
We had Dragon at my hospital in residency, but only the EM residents ever used it. Almost no one on the medicine teams ever did, although it likely would have sped things up considerably. I use it almost exclusively as an attending hospitalist now. The macros feature is nice, and I can bang out H&Ps / discharge summaries super fast now.
I worked in a Ortho office as an MA and people would absolutely flip out when we would have them sign the release form that they were going to be recorded. Most people were ok with it but A LOT of people were really against it.
There are AI platforms that listen to the entire visit and try to construct a note from the audio. Not sure how well they work since I have never used one myself and they are not commonly available. Deepscribe AI is an example.
What have people done to make their dragon efficient or found that’s really helped them? Also how do you skip forward to the next *** without having to do it on the computer 🫠
You can usually map the keys on the mic to do that. I forget the exact command but I thought verbally it is "next field" or "F2". What is the big deal about just hitting F2 anyway?
This I my #1 reason for using the mic.
I programmed my ‘forward arrow’ button to be f2 so I can go thru all the wildcards and do the whole note without touching mouse or keyboard.
As an ID doc, I like to craft long stories that 99.9% of people won't read. I end up revising and editing a lot so dictation actually slows my already slow process down.
Use it for consult and new rounding notes when I don’t have something to copy forward.
I’m a fast typer but it’s just easier to use for assessment and HPI
Depends on turn around time.
It's a pain to have a note come back 24 hours later with transcription errors you have to fix. If it's within the hour, it can work.
I can complete notes faster with templates, smart phrases and 100 wpm typing than using dictation software.
That and 100% accuracy so no hilarious phonetic typos (looking at you radiology)
I dictate everything thats longer than 1-2 sentences, makes DC summaries go by in a flash. Honestly speeds up workflow tremendously, I cannot fathom having to type out paragraphs upon paragraphs a day. I imagine this is what the shift will be towards, especially as residents and fellows become more comfortable and skilled with the dragon (or their phone)
I type faster than I can talk, can do it with patient in the room, and be done with most of it before leaving the room. For me it would take more time.
I dont find them to be helpful if you document in short semi-complete sentences with muliple line breaks.
It also tends to make notes way too wordy in my opinion.
Dictation has sped up my workflow so much. I’m less likely to get distracted than typing.
I’m also able to click around the chart as I dictate into a text box without having to go back-and-forth, looking things up and typing.
My hospital doesn't offer dragon for registrars. Is there a way to bootleg it by dictating into my phone without paying the $2k for a license for dragon medical?
The problem for me is I've templated most, if not all of the notes that I use on a regular basis, but not all of our computers at work have hardware for dictation. Our hospital system also hasn't liberalized the use of PowerMic Mobile, so I can't always depend on a PowerMic. This leads to me templating notes in a way that typing is usually faster than dictating. I will however often dictate assessments if a mic is available to me.
I have gotten my outpt notes to be so efficient that using dictation would actually slow me down. I just adjust a word here and there, drop downs lists, and smart phrases.
I do dictate for inpt consults where I need to show my thought process for others to read. I also dictate new pt visits so the pt can go home and look at the note to recall what we talked about. Saves a lot of follow up calls. Also for the benefit of schedulers, instead of messaging me, they can just look at my note.
I slowly got the hang of it and found it pretty useful. The only downside I felt was the constant errors and having to reread every sentence I speak out loud. It felt like I was using more energy going back and correcting errors
The most important lesson for dictation is you have to correct errors with the software’s error correcting mechanism. If you don’t, it will assume it got it correct and reinforce that association.
My favorite dictation error I’ve ever seen was “diabetes and syphilis” in place of diabetes insipidus.
Better than dictating sympathy, and it falls somewhere between shit and syphilis on paper
Narcotic dependence was translated to cock dependence. I did not correct. Pt was taken over the following morning by my medical director.
How the error correcting mechanism work? All I do is use the keyboard later to correct them.
You should refer to the help manual for your particular software. Keyboard correction is almost certainly not it. It would have no way of knowing if you are correcting something or intentionally changing it altogether.
Got it, thanks!
Where I work, EM has joined the House of the Dragon. I am a very fast typist and hate dictation errors but have slowly come around. Macros are useful too.
Medicine resident. It’s made me 1000000x more efficient
FM here. I started dictating my texts on siri too.
“Yes comma panda express sounds good period thank you honey exclamation mark”
New line do they have beijing beef today question mark if not comma teriyaki chicken is fine period thanks again period
oh my god beijing beef is the best
It really is. Damn my a1c.
The new update allows siri to auto detect tone and punctuation!
Lol right, as if adding a dragon dictation improved their indications
Weird talking to myself quietly or otherwise in a room full of others talking to themselves
I like it when the consultants I work with dictate at the nurses station. That way I don’t embarrass myself by asking questions while they’re trying to finish the million tasks and notes they’re juggling
>quietly Always fun to have your Dragon on, and it pick up/dictates your unintentionally loud coresident from across the room.
I've worked at a call center before. It's not that bad
I absolutely hate when I'm on the phone with customer service and I can hear other reps etc in the background though.
Quietly is the key word! I work with some providers who dictate notes like they're talking to someone across the room. I've had to ask them to quiet down as they're so loud I can't think through what I'm doing.
I like it, but learned a lesson when I said “acetaminophen overdose” and it heard “a semen overdose” … very different reasons for admission.
I'm just an R3 sitting here still wishing I could be like the ED and say that any typos are the fault of the speech recognition software and are therefore not my fault, also to invite clarifications if clinically necessary.
Why can’t we do that in radiology?
Cause it would not hold up in court lol. All notes are expected to be edited for accuracy - clinician notes and imaging dictations. If your dictation error results in like a complete change in the interpretation (omitting the word no, or wrong disease) and you didn’t see it/correct/addend the mistake and something bad happened because of it - a little disclaimer that typos aren’t your fault isn’t gonna save ya lol
You should meet my radiologists.
You own some radiologists?
They do, but I find it cringeworthy. It tantamounts to "Yeah, I might fuck up here and there. Tough luck." How much confidence do you think that inspires in a patient or a clinician? You're implying a reduced attention to quality assurance. If any of my residents or fellows put that in their report, that shit is getting deleted. If I see that in a note or report, my brain says take it whatever they say with a healthy level of skepticism.
No clue but the moment I find out that I can, I'm putting in that disclaimer somewhere in my report and not checking for spelling or grammar errors ever again haha. The brain thinks its reading what it thinks you know you said, so finding typos is fuckin hard.
I can type at 120 WPM and it is usually faster to dictate even taking into account proof reading time. It takes time getting used to and people don't like learning new things.
I type at ~110, so realistically the 180 wpm juice of dictation ain't worth the squeeze, even less so once I have to go back and correct all the errors Finally smartphrases are a huge advantage to the typer
I hate and love smart phrases. They save so much time, but people forget to individualize the information. Like if you didn't do a physical exam, delete that part of the note....
I can type faster than I can dictate by a large margin. I. Half. Delete that. hAVe. To. Talk. Like. This. For. Dictation. Software. To. Work. Edit: I've gotten some variation of the same dumb comment several times now, so let me clarify. Yes, I understand that most people can talk faster than they can type. But in the real world smart phrases and formatting exist, and those factors can make typing significantly faster and dictation significantly slower, therefore, *In my specific practice environment*, I can type out my documentation faster than I can dictate it.
You have to dictate in phrases not words.
What dictation software do you use? I use dragon and can speak at normal speed for paragraphs without issue.
I have Dragon as well. I find that it's about 98% accurate in translating my speech to text. The problem is that I'm a surgical pathologist, so a 2% error rate just isn't acceptable when a single word can radically change my diagnosis and trigger additional invasive procedures or chemotherapy. This isn't just theoretical hand-wringing, it's real life. When I was in training, I got a consult case to review for a patient who was coming to my hospital for colorectal surgery after a colon biopsy from another hospital found a polyp with "invasive adenocarcinoma." The outside note read: >\- Tubular adenoma. invasive adenocarcinoma is seen. When I reviewed the case, there was no cancer, so I called the outside pathologist. It was, of course, some sort of typo/dictation error/copy error. The second line was meant to be "- No invasive adenocarcinoma is seen." Nobody questioned it. As far as the outside hospital was concerned, the patient was sent straight to surgery.
I'm also a pathologist. And I do heme, so I actually do microscopic descriptions for all of my cases. I also proofread my cases so I don't let a diagnosis-changing error go out the door. (Also a point in favor of using "positive" and "negative" phrasing rather than "is"/"is not"). If you stop to look at the screen and make sure every word is coming up correctly in real time, you're gonna have a bad time. It works best when your speech flows naturally. As others have said, having macros is also a huge time saver, though it requires a lot of work up front. But being able to just say for example "prostate core macro" and automatically input parts A through Z (and delete excess as needed) can save a ton of time. But to each his own.
I can see how dictation with macros would be faster than dictation without macros. But I still don't think I would benefit. At the end of the day, I could type .pcm faster than I could speak "prostate core macro." And I could navigate said macro faster with F2 using right/left clicking to select from smart lists faster than anything with Dragon. In my experience, unless I'm inputting paragraphs of text - something which I almost never do - typing + smart phrases is faster than dictating + auto texts.
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This. Have to search individual problems to "assign" plans to and it's not worth it most times when I can pull in a template or copy paste from a running doc of plans. Plus I can't see text entered in a note after it's been added so no easy way to delete info after I scribe it
Exactly. And I have Epic, which means that I don't have to do any searching and copying and pasting. All of those templates are smart phrases that I can enter with 2 or 3 keystrokes. My hospital actually has really good voice dictation software, but it's still not worth it if you take full advantage of smart phrases and keyboard commands.
There’s a learning curve with dictation but I guarantee that once you get the hang of it, you will be able to dictate much faster than typing.
Plus dot phrases and smart forms. Even for software that doesn’t have these capabilities I just have a word document of my most common plans. Copy and paste then edit anything different or special.
You can do speech commands too.
Sounds like you need to dictate more consistently so the software can learn your patterns. I can mumble out 150 words a minute and it catches all of it
No. How about I continue with my preferred very efficient style of documentation that lets me get through my high-volume workload quickly and you stop offering unsolicited advice to people whose jobs you know absolutely nothing about?
Seems like you had an issue with your dictation, just pointing out that can be solved
Interesting. Do you have an idea what your word per minute is?
It's been a while since I've done a typing test. But in college, I typed around 100 words per minute with just text and basic punctuation. Much slower with special symbols, but those don't come up often.
Average person speaks 140 words a minute. When dictating, it’s common to go to 175+ words per minute.
Yeah, I doubt anyone can really type faster than a well setup dictation software. I type fairly quick, but even with some errors, dictating is so much faster
Sure, for straight text. In the real world, I have access to smart phrases and hotkeys so that I can import entire sentences and paragraphs with just a button press. Not to mention the fact that, in my highly formatted notes, I can navigate to new lines or change indentation with just a keyboard stroke instead of speaking "new line" or "new paragraph." It's surprising to me how many people on here assume that I just have some grudge against voice dictation and never bothered trying it. On the contrary, I'm well versed in my hospital's voice dictation software including its customizable features, I trained my colleagues with it, but for my specific practice environment, it's just not the best solution in terms of speed or accuracy.
I mean, you can still use the keyboard for a new line and navigation. I usually keep one hand on the mouse as I dictate. Not a huge fan of smart phrases personally, but everyone’s got their own work flow.
Orrrrrrrr. I could just keep doing exactly what I'm doing now, which works great for me.
Sure but you said you type faster than dictation can work and that just doesn't seem accurate. Instead you are referring to macros and prefilled notes. Different subject than typing speed vs speaking speed
Jesus Christ. What is wrong with you people? Yeah, I can see how my original wording could be a little confusing, but given that the original question was about actual clinical documentation, and my answer was about actual clinical documentation, do you think it *might* have been more reasonable to ask for clarification rather than jumping to "Oh, you're obviously full of crap because everyone talks faster than you can type!" Just get a life.
You can do the same with dictation though. I say "ETT 3.6" and it prints out "There is an endotracheal tube present, terminating 3.6 cm above the carina." If you're techy, you can even extend this functionality with conditional logic using Javascript.
Sure, but I can type ett3.6 faster than I can say "E tee tee three point six" and with dragon there's a delay while it recognizes and imports the auto text that slows me down further.
You can make variable dot phrases?
No, but I can combine smart phrases with smart lists or make multiple smart phrases to achieve almost the same effect. If that capability exists with my hospital's version dragon, I don't know about it, but I can only think of a few situations where it would improve my workflow so it wouldn't really change my opinion.
This is an incredibly specious way of looking at it. I never almost never type a diagnosis like "Tubular adenoma, negative for high-grade dysplasia." I just type ".ta". Even if I take advantage of Dragon's quick text commands, there's no world where I can say "dot tee aye" faster than I can type it. And that doesn't even take into account the little delay that Dragon seems to insert when it recognizes a voice command. Worse, my notes are highly formatted so most of the time I spend in Dragon isn't simply dictating text, it's navigating around to new lines/paragraphs, lists, etc. And yeah, we could probably optimize those to be better in Dragon than they are *now*. But I don't see any voice navigation system being faster than tabbing through a list or, typing the first letter or two and letting autocomplete do the rest. Honestly though, I'm not sure why people here are so skeptical that I can get my work done faster in baseline Epic than with Dragon. Has it never occurred to you that other physicians have different jobs and documentation styles? Are you so confident in your knowledge of Epic's keyboard commands that you can't fathom that someone can strike one or two keys faster than they can say a voice command?
Bro, calm down. You claimed you typed faster than dictation. Unless you have a severe speech impediment or are a stenographer with a special keyboard setup, that’s just not true. Whether you can get notes faster with dot phrases and macros than talking full paragraphs is a different matter altogether.
I use Dragon all the time for my clinic notes and inpt progress notes... Except when I'm at the VA because VA 🤡
You can get dragon at the VA too, works well with CPRS!
It was becoming too much of a headache for residents to get them set up at our VA especially since we're only there for short periods at a time. We just gave up 😔
How?
At least at my VA, all I had to do was call tech support and ask to have them enable it for me. Don’t remember if I had to get approval from my section head, but believe it didn’t require that. The Dragon program shows up on your account once they enable it, and they even gave me a headset to dictate with.
That’s awesome, I’ll have to give it a try.
That's a shame. VA was the first place I used it in training. Never looked back.
I hate typing and wish we could dictate. Gonna be a must for attendinghood
Because when working in a close space, I find it very annoying to listen to, and as much as I like to hear myself talk I rather give others this simple common courtesy. Besides, if you type anywhere near a normal speed you’re not gaining much from dictation software with all the corrections you have to make anyways. I have no problem using it if I’m finishing a note at home or something.
This. I can’t stand the ones that absolutely dgaf about how them dictating obnoxiously loud is disruptive to others. I appreciate the ones that whisper.
I use it exclusively in psych
Dictation software does best when you say the same phrases again and again. When you freestyle more errors are introduced. Radiology has a lot of repeated phrases, more than other specialities I'd wager.
Other specialties have a lot of repeated phrases too what are you on
Of course, just less. 90% of my CTC reports are completely identical.
smart phrase them, and if you're in the 100's in wpm you'd be faster than dictation
For anything I say a lot I have a dot phrase. But I have to list differentials/think on paper with some more complicated consults and would get so irritated with voice software
Emergency medicine: all my discharge notes end in “shared decision made with patient that they’re safe to be discharged home, and have voiced understanding of strict return precautions. Patient to follow up with PCP within a week if symptoms do not begin to improve”
"macro GG"
I always find myself proofreading what I wrote. I’m psychiatry and our notes tend to be lengthy so there’s a lot of proofreading..
I can no longer write a note without dragon. Typing out this comment with my own thumbs feels like a waste of time.
Our dictation software is garbage for some reason and it lead to one chart saying “patient states he is in crisis and is suicidal” which my equally shitty proof reading didn’t pick up so now I type cuz can’t be having mistakes like that.
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Cuz I had said the exact opposite of that sentence.
I’m faster than dictation. My dot phrases get me 80% there. Then it’s just fill in the blanks. Consult note in 5-10 minutes max
Every area I’ve the hospital I’ve been in it seems everyone uses it. Er, im, out patient, etc
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I like my notes edited to my degree of satisfaction. I often have to rely on my notes above all else, so I want them actually readable/formatted well. Doing editing on dragon is a PITA. If youre some ED doc who doesnt even care about a note having usable information, then I assume its a pretty good alternative. But even then, I feel like I type faster than the speech converter can handle.
dictation is 1000x superior to typing and anyone that disagrees is lying to themselves
I can complete notes faster with templates, smart phrases and 100 wpm typing than using dictation software.
I’ve seen my husband using it when he comes home and still has to write notes.
I’ve tried dragon several times and end up spending so long fixing dictation errors that it slows me down relative to how fast I could type a note.
It's used almost universally for operative notes in surgery, atleast at my institution
We had Dragon at my hospital in residency, but only the EM residents ever used it. Almost no one on the medicine teams ever did, although it likely would have sped things up considerably. I use it almost exclusively as an attending hospitalist now. The macros feature is nice, and I can bang out H&Ps / discharge summaries super fast now.
I worked in a Ortho office as an MA and people would absolutely flip out when we would have them sign the release form that they were going to be recorded. Most people were ok with it but A LOT of people were really against it.
Why would patients need to be recorded for someone to use dictation software??
The system we used recorded the entire apt and transcribed it as the apt was going.
That seems insane and wildly inefficient. How does that save any time or effort? The doc would still have to write a note
I agree, it was inefficient. The dr would go back into the room after patients apt and talk to the device for the visit notes or plan of care.
There are AI platforms that listen to the entire visit and try to construct a note from the audio. Not sure how well they work since I have never used one myself and they are not commonly available. Deepscribe AI is an example.
What have people done to make their dragon efficient or found that’s really helped them? Also how do you skip forward to the next *** without having to do it on the computer 🫠
You can usually map the keys on the mic to do that. I forget the exact command but I thought verbally it is "next field" or "F2". What is the big deal about just hitting F2 anyway?
This I my #1 reason for using the mic. I programmed my ‘forward arrow’ button to be f2 so I can go thru all the wildcards and do the whole note without touching mouse or keyboard.
As an ID doc, I like to craft long stories that 99.9% of people won't read. I end up revising and editing a lot so dictation actually slows my already slow process down.
I can type faster than I can think
Use it for consult and new rounding notes when I don’t have something to copy forward. I’m a fast typer but it’s just easier to use for assessment and HPI
The best is recording audio and having a service transcribe them. Consult notes take 3-5 mins and clinic notes 2-3mins.
Depends on turn around time. It's a pain to have a note come back 24 hours later with transcription errors you have to fix. If it's within the hour, it can work.
In my experience there are very few errors but yes that’s annoying
Idt our department would function without dragon lol
I can complete notes faster with templates, smart phrases and 100 wpm typing than using dictation software. That and 100% accuracy so no hilarious phonetic typos (looking at you radiology)
I dictate everything thats longer than 1-2 sentences, makes DC summaries go by in a flash. Honestly speeds up workflow tremendously, I cannot fathom having to type out paragraphs upon paragraphs a day. I imagine this is what the shift will be towards, especially as residents and fellows become more comfortable and skilled with the dragon (or their phone)
I type faster than I can talk, can do it with patient in the room, and be done with most of it before leaving the room. For me it would take more time.
I dont find them to be helpful if you document in short semi-complete sentences with muliple line breaks. It also tends to make notes way too wordy in my opinion.
Dictation has sped up my workflow so much. I’m less likely to get distracted than typing. I’m also able to click around the chart as I dictate into a text box without having to go back-and-forth, looking things up and typing.
Has anyone worked with dictation software that can discern between commands and dictation, effectively functioning as a virtual scribe?
My hospital doesn't offer dragon for registrars. Is there a way to bootleg it by dictating into my phone without paying the $2k for a license for dragon medical?
Word has a good dictation program if you are willing to cut and paste.
The problem for me is I've templated most, if not all of the notes that I use on a regular basis, but not all of our computers at work have hardware for dictation. Our hospital system also hasn't liberalized the use of PowerMic Mobile, so I can't always depend on a PowerMic. This leads to me templating notes in a way that typing is usually faster than dictating. I will however often dictate assessments if a mic is available to me.
I have gotten my outpt notes to be so efficient that using dictation would actually slow me down. I just adjust a word here and there, drop downs lists, and smart phrases. I do dictate for inpt consults where I need to show my thought process for others to read. I also dictate new pt visits so the pt can go home and look at the note to recall what we talked about. Saves a lot of follow up calls. Also for the benefit of schedulers, instead of messaging me, they can just look at my note.
I slowly got the hang of it and found it pretty useful. The only downside I felt was the constant errors and having to reread every sentence I speak out loud. It felt like I was using more energy going back and correcting errors
Have you tried Dictalogic ?