Hear me now? Another audition for speech recognition

Create PDF

Dr. Jodry

“My addendum rate for typos is zero,” she boasts.

Using a vast array of keyboard shortcuts—for example, typing in “nomc” yields “fragments of unremarkable colorectal mucosa; no evidence of microscopic colitis (lymphocytic or collagenous)” on the screen—she can zip through her cases just fine.

“I don’t like the typos you get with [speech recognition],” she says. “I really pride myself on having very few errors or typos or things like that in my reports. Most of the typos come from my head and not my fingers. I say the wrong thing. So that was one of the reasons I stopped using it. And if someone walks in your office and you forget to turn it off, you’ll have seven sentences of gobbledygook.”

Beyond annoying or potentially embarrassing typos, some critics of the lab industry’s growing adoption of speech-recognition software argue it is pennywise and pound foolish.

Steven Suvalsky, MHS, PA(ASCP), and his colleagues at Iowa Methodist Medical Center timed how long it took each professional involved in the process of handling a case to do their work during the course of one day. One pathologist and one PA with six months or more experience using speech-recognition software were timed using Dragon, and compared with one pathologist and PA who did traditional dictation (Suvalsky S, et al. MLO Med Lab Obs. 2012;44[9]:36, 38–39).

Suvalsky

While the speech-recognition process was faster overall (by 0.88 minutes per specimen), the pathologist using speech recognition took nearly twice as long (0.71 minutes more) with each specimen as his dictating counterpart, while the PA using speech recognition took nearly about a third longer.

The study concluded that even with zero (relatively low-paid) transcriptionist time in the speech-recognition regime, because the higher-paid pathologist and PA took more time with each specimen to speak and fix the system’s mistakes, it wound up costing $1.46 more per specimen. (Nuance, the maker of Dragon, declined to provide a company representative to speak about the company’s efforts to serve pathologists and laboratories.)

“The cost differential is that you have the very highest-salaried individuals spending the extra time to generate the report,” Suvalsky tells CAP TODAY. “Time costs money, and it matters who you have doing the work.”

Voicebrook CEO Ross Weinstein says he’s not surprised that Dragon, as a standalone technology, did not deliver a return on investment for the pathologists in the Iowa study.

“The positive cost savings of speech recognition can only be achieved as part of a complete pathology reporting workflow solution that includes templating and other enhancements,” Weinstein says. “This is one of the reasons that we created VoiceOver. As a result, clients of ours such as the Stamford Pathology Group in Connecticut have eliminated transcription and are completing 20 percent more reports per day.”

For his part, Dr. Fisher in Montana finds the difference in how long it takes to sign out cases using VoiceOver compared with dictation to be “negligible.” To him, the little extra time it may take him is worth the satisfaction that comes from knowing, in real time, that the report reads exactly as he intends and will get to the ordering clinician sooner.

“There’s a big difference between getting a result back Saturday morning and Monday morning,” Dr. Fisher says. “A lot can happen in those two days.”

Kevin B. O’Reilly is CAP TODAY senior editor.