Nuance Launches Dragon Medical Practice Edition

In an effort to address usability hurdles associated with the adoption of electronic health records (EHRs), Nuance has released a new version of Dragon Medical Practice Edition to make it easier for physicians in small practices to document care into medical records using their voice.

While adoption of EHRs by physicians has increased, satisfaction with the technology has waned, according to recent studies.

A survey of clinicians released by The American College of Physicians found that satisfaction with EHRs has fallen since 2010. User satisfaction declined 12 percent from 2010 to 2012. The number of users who were "very dissatisfied" climbed 10 percent during the same time period. In addition, the survey found that the percentage of clinicians who would not recommend their EHR to a colleague increased from 24 percent in 2010 to 39 percent in 2012.

"Dissatisfaction is increasing regardless of practice type or EHR system," said Michael Barr, MD, MBA, FACP, leader of ACP's Medical Practice, Professionalism, and Quality division. "These findings highlight the need for EHR manufacturers to focus on improving EHR features and usability to help reduce inefficient work flows [and] improve error rates and patient care."

Nuance has several healthcare solutions, including those for EHRs, and the company said it is also seeing some clinicians who are hesitant to use the technology.

"The challenges stem from a number of things," says Keith Belton, senior director of Healthcare Solutions Marketing at Nuance. "There was a dirty little secret that if you put an EHR in front of a very busy, overworked, and increasingly underpaid physician, it slows [him]down. Physicians didn't go to medical school to become typists, and many of the ways that are EHRs are built are driving them to become data-entry people. There's not only a usability issue, there's also a time pressure and documentation issue."

Nuance is addressing these issues with the launch of Dragon Medical Practice Edition, specifically designed for smaller practices. The solution uses Dragon Medical speech recognition technology, which features voice shortcuts to aid medical searches for information, and supports more than 90 specialized medical vocabularies and the customized needs of small practices.

"Our mission in healthcare is to improve the interaction between the physician and the EHR," Belton says. "Dragon Medical is a front-end [solution] that has real-time speech recognition technology. "It allows [physicians] to tell the patient story by speaking naturally and having that narrative appear directly in the EHR as if they typed, but it's also three times faster than typing."

Dragon also allows doctors to navigate the EHR using voice commands, which eliminates the need, for example, for a doctor to move between a patient encounter screen to a prescription pad to lab results. Dragon Medical offers a speech accuracy rate of 99 percent out of the box.

"[With Dragon Medical], there is a time savings of about 30 minutes a day on average, compared to what physicians would be doing with the EHR if they were typing," Belton says. "Another benefit is that notes are more complete because physicians are going faster with speech recognition than typing, which in some cases are resulting in higher reimbursement. You don't get paid for what you do, you get paid for what you document."

Belton also sees speech recognition playing a critical role in the industry, with clinicians using mobile devices to dictate medical records.

"Almost all physicians have a smartphone, and they're on the go," Belton says. "Nuance has a cloud-based version of our speech recognition, which means that a physician on the go can dictate in the car or walking down the hallway and not worry about a keyboard."

Going forward, Belton feels that EHR adoption rates will rise.

"As [government regulations] continue to loom and as physicians are changing from a world of just being of service to accountable care and paid performance, I think you're going to see greater pressure on them to make sure that they document quickly and completely," he says.

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