The Impact of Speech Recognition on Clinical Documentation Quality

Health care providers report several stressors related to the use of electronic healthrecord (EHR) systems to complete clinical documentation. These stressors include frustrations resulting from time-consuming and cumbersome interaction with the EHR. Speech recognition(SR) has been suggested as a way to help reduce this stress. Consensus is lacking in the research regarding the effect of SR on clinical documentation quality, and the research that has been conducted is primarily quantitative.The purpose of this study was to increase understanding of how the use of SR changes the work of completing clinical documentation and to identify strategies that would facilitate the implementation and use of SR for documentation. Additionally the study aimed to examine how the use of SR is perceived to impact clinical documentation quality. Qualitative methods were employed. Four physicians (three radiologists and one internist) with experience of using SR to complete documentation participated insemi-structured interviews. The results showed that an internist reported increased time spent on documentation due to the need to proofread and correct errors. Radiologists reported experiencing no significant change in the amount of time spent completing documentation. All physicians experienced an increased rate of errors and increased effort needed for proofreading documentation generated via SR. Physicians reported worries arising from the increased error rate to be a source of stress. A set of strategies to improve users’ experience of SR was developed based on physicians’ experiences, and issues to consider when healthcare organizations implement the use of SR for documentation were identified. Uncorrected SR errors, the ability to see the text while using SR and the immediacy that results from eliminating turn-around time were found to affect physicians’ perception of their documentation quality