Background. Voice recognition software (VRS), with specialized medical vocabulary, is being promoted to enhance physician efficiency, decrease costs, and improve patient safety. This study reports the experience of a pediatric subspecialist (pediatric gastroenterology) physician with the use of Dragon Naturally Speaking (version 6; ScanSoft Inc, Peabody, MA), incorporated for use with a proprietary electronic medical record, in a large university medical center ambulatory care service.

Methods. After 2 hours of group orientation and 2 hours of individual VRS instruction, the physician trained the software for 1 month (30 letters) during a hospital slowdown. Set-up, dictation, and correction times for the physician and medical transcriptionist were recorded for these training sessions, as well as for 42 subsequently dictated letters. Figures were extrapolated to the yearly clinic volume for the physician, to estimate costs (physician: $110 per hour; transcriptionist: $11 per hour, US dollars).

Results. The use of VRS required an additional 200% of physician dictation and correction time (9 minutes vs 3 minutes), compared with the use of electronic signatures for letters typed by an experienced transcriptionist and imported into the electronic medical record. When the cost of the license agreement and the costs of physician and transcriptionist time were included, the use of the software cost 100% more, for the amount of dictation performed annually by the physician.

Conclusions. VRS is an intriguing technology. It holds the possibility of streamlining medical practice. However, the learning curve and accuracy of the tested version of the software limit broad physician acceptance at this time.

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