How voice dictation can ease ICD-10, meaningful use burdens

January 12, 2015 | Marsha Taicher - Vice President and Director of Sales for Speech Processing Solutions North America

Physicians have historically relied on their voice, namely through dictation, to create comprehensive, patient-specific notes in a fraction of the time of typing or tapping on a screen. While it may seem old-fashioned, that enhanced level of individualized detail is needed now more than ever so practices can comply with meaningful use’s Clinical Quality Measure (CQM) requirements as well as the ICD-10 code set — both of which demand more data capture and reporting.

These regulations have driven many practices to discover the recent technological advances in digital voice technology. Physicians have found that such tools, including digital dictation and speech recognition software, can help them improve data quality, while streamlining workflows for providers and administrators, particularly when the tools integrate directly with existing EHRs.

Legacy of dictation
From the first magnetic tape cassette-based dictation machines produced 60 years ago to today’s digital handheld recorders and smartphone recorder apps, physicians have relied on dictation and transcription to improve their productivity and efficiency.

This legacy of dictation exists because, as research has shown, dictation is much faster than typing and many physicians still prefer it to this day. A 2014 survey of physicians from a large academic medical center, in fact, found that nearly 45 percent of participating doctors rated dictation to be “important” or “critical” for creating documentation. Another study found physicians who had been using typical EHR documentation methods returned to dictation and handwriting after less than a year.

What’s more, voice technology that integrates with the EHR system can ease or even eliminate the need for physicians to type their progress notes or choose from a list of pre-generated text. This improves the quantity of clinical detail, but also the quality of the information because the physician is better able to focus on the patient instead of an electronic chart.

Regulations require greater detail
The quantity and quality of clinical detail becomes even more crucial as the ICD-9-CM to ICD-10-CM update deadline approaches on October 1, 2015. ICD-10’s more numerous codes and greater specificity mean physicians will need to document patient encounters with enough detail so billing and other revenue cycle staff can accurately submit and defend claims. The more granular detail captured in the documentation is also necessary for practices to comply with meaningful use CQM reporting requirements. Physicians could deliver that level of detail simply by speaking into a modern dictation microphone paired with speech recognition software.

To ensure speech recognition accuracy, the physician must invest some time so the software "learns" the unique qualities of the speaker’s voice. Microphone technology used for speech recognition is also crucial. And the device must be designed to prevent distortions such as pop and hiss noise, and block other distracting touch, click, air or structure-borne sounds so the physician’s voice is clear and easily understandable.

Mobile physicians who prefer to dictate in multiple settings outside of their practices, such as a hospital, their home or even while traveling, can leverage handheld recorders or smartphone apps that can securely transfer the recordings to a cloud-based server to be accessed by their practice’s transcriptionist or a trusted third-party service. Cloud-based server technologies are becoming increasingly prevalent due to their lower overhead costs and accessibility from any type of device. The security of storing protected health information in such an off-site server also eliminates the HIPAA violation risk associated with a lost or stolen mobile device or recorder.

New technology, familiar solutions
Most practices have recently been focused on implementing new technologies, such as EHRs, and incorporating them into their workflows. Faced with new, unnatural documentation methods that are required by these systems, many physicians have rediscovered how their spoken voice is optimal for capturing clinical detail quickly and accurately. In this rediscovery, they are finding that not only are modern dictation and transcription technologies compatible with their practices’ new systems, but they also help streamline the documentation process while improving their productivity, which is essential for any practice specialty or size.

Marsha Taicher is vice president and director of sales for Speech Processing Solutions North America, the manufacturer of Philips voice technology and dictation solutions.