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Physicians explaining how they use Dragon   My solo cardiology practice employed two full-time transcriptionists but was always 4-5 days behind in getting out our consults and notes to our referring physicians. We switched to Dragon a number of years ago and immediately were no more than 5 minutes behind (the time it took to proof read the dictations) prior to sending them out. We currently have no transcriptionists and have replaced them with more nurses to provide better and faster patient care as well as information to our referring physicians. Dr. RP    Dragon Medical, in conjunction with our EMR, has improved my practice life dramatically. I finish my charts half an hour to an hour earlier per day. My charting is more complete and more legible. I can dictate consult notes in front of my patient and have them walk out the door with them to my front staff, eliminating the need to set aside the paper chart, and return to it at the end of the day. I can dictate sick notes, imaging requisitions, and lab requisitions as well. It's an indispensable part of my practice now! Dr. CL   I have never seen a product (Dragon Medical 10) undergo such superb improvement over time and I have been a Dragon user since v6. Dr. LL   Simply stated, I use Dragon Medical to dictate my office testing and consult notes. My typing service was charging me $0.12 per line. Since using Dragon Medical, I have saved $36,000 per year in transcription costs- and that has been for 5 years-- approximately $180,000 savings!!! Dr. RS    I’ve used Dragon Medical speech recognition for about 8 years. We use Dragon Medical in our busy emergency department with the Allscripts electronic medical record and have eliminated medical transcription. Dragon speech recognition has greatly increased the value of our medical records by including detailed narratives that point-and-click templates simply can’t capture — accuracy is near perfect, even in a hectic emergency department environment. Based on my testing and use of Dragon Medical 10, the software seems more intuitive and the recognition has yet again improved from previous versions. Beyond the documentation efficiency gains for our providers, Dragon lets our team tell our patient’s complete story and that raises our quality of care.” Dr. BR   We were most interested in the ROI associated with implementing a speech-enabled technology. We were spending close to $1.2 million on transcription costs in our primary care network and with the implementation of Dragon Medical to complement our Allscripts EMR, our projected cost for transcription has been brought to zero.”   I am a neurosurgeon. I began using speech recognition with Power Secretary. I even switched my whole office to Macintosh and switched back to Windows to follow NaturallySpeaking. Every patient I see comes from a referral source. Consequently, every time I see a patient I write a letter utilizing NaturallySpeaking. It is faxed back to the referring Doctor immediately so that he is in the loop of patient care. Prior to this software, I had to hire a typist and then wait a week before this could be returned. I now orient my entire office around the utilization of this indispensable software. Not to mention the time and money that I have saved over the number of years that I have been using it. Dr. EL   I am a psychotherapist for emotionally disturbed children and adolescent. As budgets are being cut, I have less and less time to write quality notes about my clients. By using the Dragon, I am able to see more children and write better notes for other professionals to use. My employer and colleagues are so impressed with my personal version and production, they are buying the commercial version for the whole department to use. What a life saver! (Literally). TM   I am chiropractor. I have to keep patient notes. This can be a long and tedious task. Years ago, with dragon 4 or 5, I don't remember, I had my first experience with voice recognition. After writing with a pen day after day taking notes on patient records I said to myself there must be a better way. I researched this on the net and I found Dragon Naturally Speaking. I purchased my first one. I upgraded every year and now I sit back and dictate my patient notes with ease on a daily basis. I did subsequently buy a Sony portable dictator. Which I do carry around and it will beautifully transcribe into my word program all my patient notes at the end of the day. It gives me the freedom to dictate notes in a private room or anywhere I want to go in the office. I have reduced my time sitting and writing with a pen to a fraction of the time. I love it. Dr. SS    I am a dermatologist in a large multispecialty clinic and we converted to an electronic medical record several years ago, instead of the previous dictated transcription record. This change added at least an hour a day to my work schedule for two years, because I am a poor typist. Recently we added Dragon NaturallySpeaking 9 Medical to our EMR and it has made a BIG difference to my productivity, because it takes me much less time to finish my charts and the notes are now more complete and satisfy the billing codes better. I get out of the clinic at least an hour earlier than before!! Dr. WM   I am a physician specializing in internal medicine, the former Chief of Medicine of a local hospital, now the head of the six person internal medicine group in West Palm Beach Florida that has been together for over 50 years. I started using the Dragon over 12 years ago and have gradually taught its use to all the members of my group. We have created medical templates for most of the common medical diagnoses and use them frequently. Use of the dragon has dramatically speeded up our ability to create accurate medical records at the time of patient visits. We have been able to do without paying for transcription for most of the past decade at the savings of approximately 17,000 dollars per physician. We save the transcript as an electronic medical record in which we can easily e-mail as requested and as a hard copy in the patient's files. When we eventually convert to fully electronic medical records, we should be able to do so easily. Dr. MR    I am a physician and I have been using Dragon Naturally Speaking since 2000 with version 5 to version 9 when I started my practice. Prior to using Dragon, I spent $2,000/month for transcription. Since I have used Dragon, I no longer use the transcription service. This allow me to save $168,000 for the past 7 years. I see approximately 100 patient a week which means that I have used Dragon Naturally Speaking to dictate 150,000 charts for the past 7 years. Dragon has allowed me to spend quality time with my family and to dictate at home, office and even at my children's Lacrosse practice. By using Dragon with a fax program, my referral physicians receive their notes on the same day I dictate instead of 2 weeks after transcription. Thanks Dragon. Dr. PK   I am a Psychiatrist. I worked for the court. I interview 30 to 40 patients a week. Since my reports must be in to the court in a very short time, I have learned to write my own reports rather than to send them out for dictation. In addition, I am the president of the Unitarian Universalist Congregation of Las Vegas. Because of this I receive numerous e- mails each day. To be able to answer these I have to resort to Dragon NaturallySpeaking. I only type at eight words a minute. So Dragon NaturallySpeaking has been a lifesaver to me. Previously for 15 years I was the executive director of the Nevada Psychiatric Association. I am still receiving e-mails about this organization. Without a dictating machine I would be overwhelmed with the work. So I want to thank you for being in existence. Dr. WS   I am a very busy neurologist in clinical practice but I also lecture around the country on applying functional medicine and clinical nutritional biochemistry to improving human health. I started using Dragon in the 1990's, the very earliest versions but have applied new features progressively. It goes like this, I was ecstatic when I could start to say "chronic inflammatory demyelinating polyradiculoneuropathy" and the system would have typed it before I got it out, but the other features that let me just use the initials were the tip of the proverbial iceberg. I bless the day I came across this software and now use voice recognition to prepare my slides, organize my presentations and manage all the inevitable paperwork involved in keeping patient records… Dr. CW    I am a dermatologist in private practice and have a great number of patients on referral. I have to write letters to the referring physician on each patient I see. In the past I used to type the letter, copy them, and then fax them. Since using Dragon 9, especially with the service pack I do letters individually, which are almost word perfect and correct them and then fax them directly from the computer. This saves a great deal of time and I actually enjoy doing it. It has changed the way I practice. Dr. BK   Besides handwriting what is it that doctors do the worst. Record keeping!! They actually teach courses in it now in medical school, but that doesn't make us hate it less. Record keeping, keeping the patient charts up to date, is a necessary evil in a medical practice. I have found the device that makes my dictation of chart notes not quite pleasant, but as close as you can get. Voice recognition using Dragon Naturally Speaking has made my chart dictation tolerable, but has increased my efficiency and decreased my time spent immensely. There is also a great cost benefit. The old technique, before Dragon, was to dictate the chart notes into a tape recorder. The transcriber would come by the office once per week and pick up the tapes, transcribe them and return the typewritten notes to the office. Each note had to be reviewed and signed and then placed in the appropriate chart. Every now and then the tape would be lost and all of those notes had to be re-dictated. The transcriber charges by the word. If she goes on vacation those words get delayed a week or two. Enter the Dragon. I now dictate and read my notes as Dragon enters them onto my computer screen. At the end of each note I say "signature" and it signs them for me. When I finish a page I print the page on label paper so each note can be pasted into the appropriate chart. Everything is saved on my computer so that when a note is lost I simply re-print it. I have standard forms for letters and operative notes which saves me huge amounts of time. As I watch my partners, who are stuck in the 20th century, struggling with their dictation and paying the transcriber I smile smugly because I know that I can get my dictation done cheaply, efficiently and almost enjoyably. Dr. TC   I am medical professional, podiatrist, who dictates my patients progress notes on a daily basis. This has eliminated my need for a transcription, which not only saves me money, but allows me to have my completed progress notes, if needed, in only a matter of minutes. Therefore, my referral sources have immediate feedback after I have seen and evaluated their patients. I have been utilizing Dragon Naturally Speaking for the last two years and find it an invaluable component of my practice. Thank you Dragon. Dr. MA   I am a forensic psychiatrist since 1985. This required immeasurable paperwork in the form of independent medical examinations, reports of legal evaluations of patient's mental state for lawyers, judges, Dept of Professional Regulations, insurance companies, competency evaluations, surgical clearance, informational reports to colleagues, and other assorted reports. As a psychiatrist, the majority of my reports are very lengthy consisting of anywhere from 4 to 15+ pages. The number of reports a week varied from 2 to 10. The time and cost was quite hefty, involving a transcriptionist which included time to send her rough draft; time to transcribe; time to proof (inc. time to return); usually numerous misspellings and grammatical errors; re-submit to transcriptionist; usually further corrections; and eventually the final draft. The time involved averaged 10-12 days, even for stat dictations. Even dictation over the phone did little to reduce the time. The cost at anywhere from $5 to $7 per page plus more than double that for re-typing and time-- an extremely costly venture that significantly subtracted from my income monetarily and amount of added time in many many hours. Upon the purchase of Dragon all of this has come to a pleasurable and productive halt. I am now able to generate long and complicated reports in a matter of an hour or two. Costs are minimal to none other than the initial purchase. As a result my income has significantly risen; more reports can be created in much less time; and I have more time for other professional and personal endeavors. Dragon has almost been a miracle for me in all those areas, even vastly improving the quality and efficiency of the reports; in that I can see what I am dictating and correct or consolidate immediately, leading to a much more professional and compact report (of note, I am very visual; and the ability to see the dictation on the spot leads to a much improved product). Dr. JR    My work consists of generating clinical reports that average about 4 or 5 pages long. In an average week I probably compose some 30 reports. That is roughly 150 pages of type per week. When I started I either dictated over the phone or into a tape recorder and then waited for the typed copy for proofing and signature. Now I sit back and speak...quickly...and Dragon NaturallySpeaking takes care of the rest. Reports are finished, signed, and sent faster than anybody else in my line of work. I have also been using a mini digital recorder when I'm not in front of the computer screen and the transcribing into the computer is just as accurate. I have found that there is really no need to turn off Dragon when reports are finished because navigating the internet and the computer keeps getting easier by just speaking into the microphone and the mousegrid system is pretty quick after using it just a few times. I'm going to start a comic novel and I will use Dragon to do it. How nice that it recognizes the difference between English, a cough, and laughter. Dr. DN    Dictation is a necessary and expensive part of medicine. To properly record notes and findings allows clarity in pursuing a diagnosis, as well as protection from allegations of malpractice. Good legible notes are also required upon demand from insurance carriers to document appropriate charges for services. Dictation in a busy practice can cost $15,000 yearly or more. The Dragon was a key part of my new practice. I not only saved the expense of dictation, but it also allowed me to create an electronic medical record based on off-the-shelf Window's products. This likewise allowed me to run a leaner, more efficient office without extra staff necessary to pull and file endless records and endless dictations. The Dragon is really a "Time Machine". It creates more time in the office for me and my staff. It's money saving efficiencies ripples through my work place. It quiets the bean counting beast within. It helps me survive modern times. With the Dragon at my side I can be the Professional I always wanted to be. Dr. AB    I am a psychologist and have to do extensive reports and have had every version of Dragon. However the most personal impact I experienced was to teach one of my counselees, a student stricken with Muscular Dystrophy the use of Dragon. The student quickly outstripped my skills and was teaching me elements of the program I had neglected to learn. This student suddenly died in December without any significant onset of symptoms. Every time I now use Dragon, I marvel at the things he actually taught me and how I had previously taken the program for granted. Dr. LR   I am a clinical psychologist in private practice for thirty years, who happens to be dyslexic and exceeds the criteria for the diagnosis of ADHD. I have several other learning disabilities as well. Every bit of writing has been a painful chore for me since first grade. Regrettably, I've never been good at spelling either. A major flaw in my education was never taking a typing class in high school. I had to barter and pay others to do my typing in college. It boggles the mind, when I think of all the weird things; I agreed to do in order to get someone to do my typing. I built bookshelves, built guitars, and fixed anything made out of wood or was mechanical. More than 15 years ago, I thought I had found the answer. I paid an incredible amount of money to purchase two different voice recognition software packages. Both programs required me to train the software to recognize my voice and speech patterns. I must have spent more than 20 hours on each program “training the software” by reading long and boring passages. Then I was required, to go back and make all the corrections and individually train the program to recognize each word I apparently had mispronounced. I reluctantly and pessimistically purchased Dragon Speak 8. Having the attention span of a gnat and the patience of a two-year-old, I installed the software without reading the instructions and immediately started dictating. I figured, I would demonstrate that the program would be a big fiasco, and I'd be done with it. Instead, it blew my mind! The darn software, not only recognized my voice and pronunciations, but, was accomplishing it while I was speaking in normal conversation speed. Then I started having fun, challenging the program to keep up with my fast-paced, speech. It was amazing, how incredibly accurate, the program was in typing out exactly what I was saying. The weird part was, I never had to train the program to recognize my speech patterns. I have about 10 minutes to write clinical notes, in between clinical sessions. Before I started using Dragon Speak, my clinical notes were usually incomplete or nonexistent. Now I can dictate two full pages between sessions. I can only assume (and hope) that Dragon Speak 10 will have electrodes that connect to my skull, and I will only have to imagine what I want to write. Thank you, Dragon Speak, for making me a great typist and speller, as well as saving me numerous hours of typing with two fingers. Dr.  JH    I am a speech-language pathologist in private practice. I have been using dragon naturally speaking to assist my clients with learning to talk more fluently and at an even pace. There learning is reinforced by seeing their words displayed on the screen. Their confidence is given a much needed boost by having Dragon recognize their speech. Your technology provides great therapeutic benefit. EM   Our office uses NaturallySpeaking to control the dental cameras we use to take intraoral photographs (i.e. turn camera on/off, freeze-frame pictures, transfer to patient's file) without using footswitches or any type of hardware. We also use it to view patient radiographs in the opertory (so the patient can see the digital xrays also), and to dictate patient progress notes with a minimum of typing (macros, both text and navigational). Dr. RW   Dragon naturally speaking has greatly improved my productivity as a school psychologist working at three busy elementary schools. I can write my reports faster and include a lot more details about the children I test. I used to leave out information from parents and teachers that I did not have time to type. Thanks for making such a useful product. Dr. DM   I'm a family physician in rural Ontario. Despite our small size, we run a busy emergency department with over 25,000 visits yearly. You can imagine how hard it is to conduct a history and deal with investigations and treatments on a timely basis. I have pioneered the use of voice dictation in our emergency department which allows me to reduce my charting to one minute or less. As a matter of fact, statistically, I am the fastest ER officer in our department and this is largely due to the gain in productivity using the Dragon Medical edition. I continue the use of this program in my office and have used versions since before version 4. The additional time not lost to charting by hand has allowed me to see 10-15 patients more daily!!! Overall, the gains to my practice both from productivity, medical care and economic efficiency has been nothing less than phenomenal! Dr. TH    As a physician in clinical practice, I have been using Dragon Naturally Speaking since its first release. Version 8.0 was good for office letters which are quite standardized in terms of vocabulary. Version 9.10 has the full capability to handle the twists and turns of language used to document a medical office visit. I currently dictate all of my patient visits using Dragon. So for a $100 upgrade, I eliminated $450 per month in transcription fees and my note is in the patient’s chart before they have reached the parking lot. And at the end of the day, I transfer all of my dictations to my thumb drive…just in case Mrs. Schmidlapp should call with a question about that “green pill” that I gave her three months ago. So which is better? One hundred bucks for an upgrade or $450 per month forever? Hmmm, lemme think. Dr. JS   I am a physician and have been using Dragon for over 10 years. Dragon has significantly increased my productivity on several levels in my office. We are a two-person medical specialty office and my partner also uses Dragon. Firstly, our documentation regarding patient visits has markedly improved as requirements from insurance companies have become more demanding. We have had several audits in the past and most auditors comments have been extremely favorable regarding the legibility of our notes and the level of documentation. While I do not have an electronic medical record program per se, I save all my dictations on my patients as templates. Therefore when they return I simply update and dictate into the template. If I receive a phone call from the patient or another physician, I can view their last letter, medical problems and medications instantly. Dragon has allowed me to easily update a patient's problem list and physical examination. Better documentation translates into better patient care. After dictating my consultation, I immediately print the document and it is ready to be filed. At the same time, I Fax the letter to the referring physician via my computer. Therefore, the referring physician often receives a consultation before the patient leaves the office. Not only does this make for better patient care, but we no longer send out letters via mail. This has saved a substantial amount of time and money in our small office. Needless to say, using Dragon has drastically decreased transcription costs. We estimated in the past that we save at least $10,000 per year since we are a consultative office and sent letters on just about all our patients. In summary, our productivity gain can be measured several ways. Because we document a more detailed examination, we can bill more aggressively and justify our high level of care. Because we document everything by dictation, we have instant access to almost all of a patient's medical problems, whether we are in the office or at the hospital. Referring physicians appreciate receiving our consultations in a swift and timely manner. All of these aspects clearly increase our efficiency and productivity.   I see about 60 patients per week in my gastroenterology office. Dictation is required for each patient encounter. Using Dragon and templates created for me, I am able to pull up the patient's prior notes with all the past medical history, procedures, diagnoses, allergies, past history, and more, all ready filled in. I just have to dictate the new history and physical exam, along with a treatment plan. This has saved me countless of hours and increased my productivity. It also has provided for a note compliant with the third party payers so as to document the level of billing submitted. Finally, it is safer for patient care as all the relevant information such as allergies is present on each note. Prior to using Dragon, I had to spend twice the time documenting all these points. Thank you Dragon. Dr. MF    I am the Associate Medical Director of Puget Sound Physicians. We staff a busy Emergency Department at Overlake Hospital in Bellevue Washington. Our ED cares for about 55,000 emergency patients per year. 15 of our doctors started using Dragon Voice Recognition two years ago. For this group of Emergency Physicians, Dragon has replaced traditional human transcriptionists. We use Dragon to generate text that we drop into an Electronic Health Record (EHR). Our EHR is Ibex, an ED EHR produced by PICIS. Our Physicians have become very sophisticated users of Dragon. We use this application at work when we get a chance in the heat of the ER battle, we also use it at home to complete our charts in the comfort of our own homes. We have Dragon installed on fixed work stations in the Emergency Department as well as on computers on rolling carts that we can take into patient rooms or use anywhere we want in the Emergency Department. We use top quality directional microphones and we have had no problem with background noise - we are able to use Dragon amid the chaos and noise of an Emergency Department without difficulty. Large cost savings have been realized by avoiding our traditional dependence on human transcriptionists. By using Dragon in conjunction with our electronic health record we are able to stay at the cutting edge of the current revolution in Electronic Health Records. We have updated to every new version as it comes out. Our accuracy is excellent and we are very satisfied with the product. MH     The use of Dragon NaturallySpeaking along with an EMR system will improve patient care immensely. National standards for EMRs are being developed and many EMRs now include support for Dragon NaturallySpeaking - I think this should be a requirement for every EMR system on the market today. Using Dragon NaturallySpeaking, has allowed me to provide better patient care and physician communication while at the same time saving me enough money to take a very nice vacation! I use Dragon NaturallySpeaking on a daily basis to perform all of my medical documentation including chart notes, telephone messaging, staff messaging and order commenting.   We see a significant workflow efficiency advantage when a physician can document directly into our EpicCare EMR instead of toggling between the EMR and the speech recognition product's documentation windows. We also see an advantage in being able to leverage Epic's intrinsic charting tools with voice by building custom commands in Dragon to voice activate those charting tools. The third advantage is the ability to create custom commands for voice navigation within the EMR application, including multi-step macros. This can reduce the number of "mouse-clicks" needed to complete a process or navigate to a particular section of the EMR.   In general, we have found Dragon NaturallySpeaking to be extremely accurate for most users. The accuracy claims for the product have proven to be true. I do appreciate the faster load time with version 9 of the command browser and user interface. The preview feature has been very useful to me personally when reviewing the hundreds of custom commands that Advanced Healthcare deploys for our physicians. I also think that the Select-and-Say indicator is a very useful addition.   Using Dragon NaturallySpeaking is successful for us because we are able to obtain a significant reduction in transcription utilization and the cost of transcription overhead to the entire organization. In 2005 Advanced Healthcare saved approximately $90,000 by utilizing Dragon NaturallySpeaking.   Dragon NaturallySpeaking is an extremely accurate and flexible speech recognition product that permits efficient documentation in the ambulatory medical setting and saves us money. In the next two months, we will expand the use of DNS to our new Epic Radiant RIS. After that we plan to continue deploying Dragon NaturallySpeaking to additional interested physicians, new physicians, and radiologists within the organization. Dr. RF
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