Dictation for street reports

[ParamedicCharlie]

There was a great JEMS article about a private company using there own, voice automated dictation for street reports on patients.

There are just so many pros to using these in the field.
1)shorter report times
2) more accurate, precise, and all inclusive, reports.
3) easier accessibility by doctors, (we all know only 25% of the medic report gets past the RNs front desk, unless you personally talk to the DOC!)

I know that dragon medical dictation is over 1000 dollars plus. Does anyone have any good medical dictation programs? Does anyone use them now? Any input is great!

See you all on the next one.

 

[Akulahawk]

There was a great JEMS article about a private company using there own, voice automated dictation for street reports on patients.

There are just so many pros to using these in the field.
1)shorter report times
2) more accurate, precise, and all inclusive, reports.
3) easier accessibility by doctors, (we all know only 25% of the medic report gets past the RNs front desk, unless you personally talk to the DOC!)

I know that dragon medical dictation is over 1000 dollars plus. Does anyone have any good medical dictation programs? Does anyone use them now? Any input is great!

See you all on the next one.

I am using Dragon naturally speaking now, on my computer. The version I have is the "premium" version and it retails for about $200. While the medical version costs about $1000, understand that the medical version is specifically targeted towards that particular audience. You can certainly take the premium version and training to recognize most medical terms. I have done so with many of the care plans that I have written for nursing school. I have rarely had to make corrections to the dictated portions of my care plans.

The bigger problem that you would have with dictating reports to a medical facility, is that it's really would go no further than whoever receives those reports. You would also have to train each provider to dictate reports in the same manner. While training everyone to dictate in a similar format is a good thing to do, it could take a while to accomplish this task. Once everyone is dictating the reports in the same manner, the upshot is that everyone would look more professional and everyone reading reports would understand very quickly where to look for information about patient's.

When I read physicians H&P reports, the format is essentially identical from provider to provider, therefore I know where to look for certain information. This is something that we would need to train our paramedic level providers to do.

The amount of time it took me to dictate this particular response, was approximately 3 min. I do not type that fast. In this entire dictated response to your post, I have only had to make 3 corrections total. I have found that dictating stuff is relatively easy, fast, and trouble-free as long as I do my part and enunciate the words reasonably well and speak relatively fluidly and not in a choppy, soundbite like manner.

 

[JPINFV]

When I read physicians H&P reports, the format is essentially identical from provider to provider, therefore I know where to look for certain information. This is something that we would need to train our paramedic level providers to do.

That's because we're taught and tested on the SOAP format from when we first start learning to do physical exams, including the sub-sections. In general, when I see EMS discuss the SOAP format, it feels very superficial and generally leaves out the subsections, which in my opinion is the true strength of the SOAP format. For physicians, we're taught how to document in the SOAP format when we're learning to do physical exams and consistently document in that format during rotations (how many EMTs fill out run sheets during ride alongs?). Thus, by the time we actually get into practice, we're fairly comfortable with a format that pretty much everyone uses.

 

[MedicalDictate]

Dragon Options for Dictation

Paramedic Charlie:

We can assist you and there are many alternatives to the Dragon Medical version. More importantly, all of our Dragon products include free/unlimited training and support with free shipping. If you are interested, you may visit our website at MedicalDictate.com or call me directly at (352) 328-0117, and I will gladly answer any questions.

We look forward to helping you and any other healthcare providers.

Tony Scalese
CEO/President

 

[RocketMedic]

I'd love to see this at my agency- it would greatly improve our system availability. Heck, even just replacing the narrative would be an improvement.

 

[TransportJockey]

I'd love to see this at my agency- it would greatly improve our system availability. Heck, even just replacing the narrative would be an improvement.

I was thinking that for my 911 job. Some of our people just can't type or spell worth a damn lol

 

[JPINFV]

One thing to remember is that the professional medical/physician dictation is not computer dictation. It's dictation to a recorded line where another human transcribes what is written, verbatim (unless it's obvious that you're talking directly to the dictationist, such as, "Can we go back to ___section and add the following at the end? .... Thanks, continuing dictation...").

 

[Akulahawk]

That's because we're taught and tested on the SOAP format from when we first start learning to do physical exams, including the sub-sections. In general, when I see EMS discuss the SOAP format, it feels very superficial and generally leaves out the subsections, which in my opinion is the true strength of the SOAP format. For physicians, we're taught how to document in the SOAP format when we're learning to do physical exams and consistently document in that format during rotations (how many EMTs fill out run sheets during ride alongs?). Thus, by the time we actually get into practice, we're fairly comfortable with a format that pretty much everyone uses.

I was also taught SOAP as well, just not all the sub-sections as those weren't relevant to sports med. It's been years since I've done as proper a SOAP note, so I'm kind of rusty at it. Given a choice of formats, I'd use SOAP because it's generally understood by all that read it, even if the reader isn't good at writing them themselves.

Notice that I didn't say that I was surprised that physicians do SOAP format notes. It's precisely because physicians are taught that format and pretty much universally use it that I know where to look in an H&P for info that I need.

I currently don't write SOAP notes in my clinicals for 2 reasons: 1 - it's not the school approved format. 2 - I could get into too much detail going system by system and spend way too much time writing.

I've tried the CHARTED format and a couple others, but I keep going back to SOAP or a variation of it, if given a choice.

 

[VFlutter]

I do not know how the hospital dictatonist understand what some doctors say. I will occasionally call the dictation line to get test results before they are posted and you can usually understand half of what they say, if your lucky. "Blah blah blah Ejection fraction 20% blah blah I like waffles" in a thick Indian accent. The surgeons are the worst

 

[VFlutter]

3) easier accessibility by doctors, (we all know only 25% of the medic report gets past the RNs front desk, unless you personally talk to the DOC!)

I'm my experience, there is usually are fairly detailed EMS notes in our ER reports. And I am not sure making it more accessible will actually get the Dr to look at it.

 

[JustMyType]

Mobile App

We utilize mobile apps for dictation on the go and then we have a web-based platform that houses the final product for electronic signatures, review by doctors, etc.

It's definitely a streamlined process that is extremely user-friendly and cutting edge. We, too, offer speech understanding technology options. Our website can be found on my profile page for more information and please let me know if you need more information.

Nicole Camporese
Owner | Just My Type Transcription

 

[NomadicMedic]

Not quite the same thing, but I use the speech to text dictation on my iPhone when I'm riding back to the station and I cut and paste my dictated portions of my report into my Epcr. Works like a champ.

Here's a sample from a recent report...

"...Patient was at home tonight, sitting in his kitchen, watching television when he had a sudden onset of visual disturbance, weakness and the inability to grasp his TV remote control with his left hand. Believing he was suffering a CVA, he called 911. Patient relates he's had no past CVA history, and upon our arrival all the symptoms had dissipated. Patient denies any additional pain or discomfort, specifically denying chest pain..."

 

[JPINFV]

I'm my experience, there is usually are fairly detailed EMS notes in our ER reports. And I am not sure making it more accessible will actually get the Dr to look at it.

How do you know what the doctors do and do not look at?

 

[Christopher]

I was thinking that for my 911 job. Some of our people just can't type or spell worth a damn lol

We deal with this a lot at my volunteer department, even among paid staff. I enabled spell check on all pages by default and made it mandatory as the only way to combat the vast majority of problems.

As for dictation...for me I'd be pretty mad at it. I type for a living and quite quickly. That being said, I'd imagine the vast majority of our providers would prefer dictation over typing.

 

[Aidey]

Honestly, I don't know if there is much of a point. Probably 75% of my tickets are drop down menus and fill in the blanks. The narrative is usually the part that takes me the least amount of time.

 

[Handsome Robb]

Honestly, I don't know if there is much of a point. Probably 75% of my tickets are drop down menus and fill in the blanks. The narrative is usually the part that takes me the least amount of time.

Agreed.

Narrative takes me ~5 minutes to do. It's all the damn things you have to click on that takes up the rest of the time!

 

[MSDeltaFlt]

For those of us who have multiple speech impediments, basically making one sound like Porky Pug strung out on crack, might not work too well. Might go over like a turd in a punch bowl.

 

[TransportJockey]

Agreed.

Narrative takes me ~5 minutes to do. It's all the damn things you have to click on that takes up the rest of the time!

I tend to write novels for narratives. It's habit from when we did paper reports. so my narratives are ten to fifteen minutes a piece