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Speech Recognition...Again

Posted Oct 23 2008 1:33pm



There are a few ways to get noticed on an AuntMinnie.com discussion. Mentioning GE Centricity always draws a lot of attention, but these days, a thread talking about speech recognition will be pounced upon like Howie Mandel after some poor "Deal or No Deal" contestant opens the case containing $0.01.
A recent AuntMinnie front page article reported the results of a study from the U.K. and Germany that discovered

. . . speech recognition technology eliminated "significant delays" in report transcription and typing issues, leading to an improvement in service to both clinicians and patients. Researchers at Hammersmith Hospital and Charing Cross Hospital also concluded that a well-planned organization-wide implementation of speech recognition technology "can have a dramatic impact on radiology service delivery. . ."

In 2004, emergency room and primary care reports took three to five days to complete at Hammersmith Hospital. Finished inpatient and outpatient reports ranged from a low of three days to as many as eight days for inpatient reports in August 2004. With the advent of speech recognition technology, the time from report generation to completion declined to one to two days from January 2005 to February 2006.

This article prompted a number of responses on an accompanying AM.com discussion. A few were positive about SR, but many were doubters, including yours truly. You may remember my earlier post about SR, and I haven't changed my mind. I haven't seen any evidence to suggest that SR has improved. Articles like the above don't do much to help SR's reputation. I mean really, three to five days! That is totally unacceptable under any circumstances. Did our British friends have only one transcriptionist available? Did she have to use the loo for 30 minutes of every hour of her 4 hour daily shift? If you set the bar that low in other venues, I could be the Steeler's next quarterback! I will have to admit that SR might be able to improve the situation if things are that bad.
Fortunately, here in my little corner of the boonies, things are pretty good. Our turnaround time with Human Transcription (HT) is usually from 10-20 minutes, with STAT's coming out within 5 minutes. Of course, if there is reason to do so, we type in a prelim, leave a voice-clip, or (gasp) even pick up the phone to call the clinician. Why would we ever want to switch to SR?
Look, I love technology more than anyone else I know, and I am absolutely fascinated by the concept of the computer listening to me and converting my uttered pearls of wisdom to text, or to commands, etc. Wonderful. But if this is such a wonderful idea, why hasn't it caught on elsewhere, such as among the administrative types that are pushing it on us rads? I think the ultimate reason is this: A machine will never understand the nuances (pun intended for the Powerscribe set) and the outright inherant inconsistancies of human speech. I can dictate this: "The left shoulder, I mean the right shoulder shows no fractures" or some equally flawed speech, and it will come out OK with HT, but not with the machine. Those for whom SR works well have not only trained the machine, but moreover, they have trained themselves to dictate in a completely different way than they learned as youngsters. I personally am not that big a fan of technology that forces me to adapt to it.
I have to wonder if some of the more ardent supporters of SR on the various AM threads work for Agfa or Nuance, or if they are just low-level administrator types taking some heat for spending $300K on something that doesn't work very well.
Has anyone really added up the cost of SR vs. HT (speech recognition vs. human transcription)? I suspect that once you pay the $300K for the initial set up, add in training time and costs, cost of upgrades, cost to replace the darn thing in 3-5 years, etc., there won't be much savings with SR. That does not, of course, take into account the radiologists' time, effort, pain, and potential malpractice suits caused by using SR. But then, the administrative types that usually make this decisions AREN'T PAYING FOR THE RADIOLOGISTS so they don't really care about that. But we rads DO care. If SR is so bloody wonderful, why don't administrators as well as the occupants of the C-suite use it? Apparently, it's good enough to generate reports upon which life-or-death decisions are made, but not good enough to replace the secretaries of any of the above. Think about it, folks....
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