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University of California, San Diego HealthSpan Vol. 2 No. 1 - February 2010 Dragon System: Taking Dictation to the Next Level

Picture: UCSD’s Dr. M, using Dragon Voice


The high costs and time delays of transcribing

medical notes are being slain by a dragon…the

Dragon Naturally Speaking Voice Recognition

Software being deployed throughout the UC San

Diego Medical Group and Medical Center. Mr. C. C., clinical systems documentation

coordinator, explains that when providers use voice recognition software with Epic-

integrated software to document their patient encounters – rather than traditional

transcription methods – they are entering clinical content immediately into that patient’s

medical record, simply by dictating into their computers.

“The ultimate beneficiaries are our patients, Immediate documentation enhances the

timeliness of entries in the medical record and eliminates the delay usually associated with

outside transcription services.” And, it reduces expenses associated with transcription

services, which is also a bonus.

The benefits for physicians are also tangible, according to Dr. J. R., professor of medicine

and chief of General Internal Medicine. He is an early adopter of the Dragon voice

recognition software for his own practice and for the Internal Medicine Group, which was

paying more than $300,000 to $500,000 annually for dictation services.

“The system is great for efficiency, economy, accuracy and legibility, and it allows us to

spend more time with more patients and still go home at the end of the day,” said Dr. R.

Relationships with referring physicians are also enhanced as a result of real-time

documentation using this software. “Utilizing voice recognition software to update the

patient’s record enhances the quality of feedback to community providers, providing

complete clinical observations and timely delivery,” said Mr. C. C.. 

When traditional transcription services are used, the initial encounter information is sent to

the referring physician via Epic Communication Manager and the dictation may not arrive

back for days after. Dragon ensures that comprehensive progress notes are sent along with

the encounter report, ensuring rapid, detailed communication with the referring physician

regarding a patient’s status.

The same is true within the UCSD clinical system. For example, operative reports created

with Dragon are immediately available on the Patient Care Information Systems (PCIS) to be

sent to the nursing treatment unit where the patient will be receiving post-operative care.

Mr. C reported that more than 200 computers throughout the Medical Group and Medical

Center have been loaded with Dragon software and more than 150 physicians have

participated in the ongoing training program. When they receive training, physician users

are provided with individual headsets that they simply plug into the computer. Physicians

can also install the Dragon software on their home computers.   

The system types 160 words per minute, according to trainer M. K. (from A1 Productivity

Products), who is providing instruction for UCSD users. Templates and commands can be

established to further expedite the dictation, allowing physicians to pre-program frequently

used phrases or acronyms which the system will spell out, and create other shortcuts to

rapidly and accurately fill out standard forms. By watching as the dictated record appears

on the screen, the physician can verbally or manually correct any errors as they appear. 

“It takes a brief initial investment of time to make the system work for you, and you need to

learn a little vocabulary to make things go quickly,” said Dr. R, noting that, to aid the user

during the first stages of learning the system, a pocket-sized reference card is provided

during the training session. “Now, I have my normal exam set up as a macro, so I can

record the information and edit very quickly. The system provides a lot of flexibility, and we

have learned as we’ve implemented the system in our practice that whenever we’ve

encountered a question or problem, there has been a solution.”

The Medical Group and Medical Center are committed to deploying Dragon Naturally

Speaking Voice Recognition Software throughout the system. Dragon software has been

installed in all physician work rooms, on the nursing units, in the OR lounges and in most

ambulatory clinic work rooms.

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