Voice Input Technologies developed SpeechWriter Mental Health in 1996 using the Philips dictation engine SpeechMagic and a mental health language model. SpeechWriter is configured for group or hospital practices and is not cost-effective for a single user. SpeechWriter Mental Health has the advantage of a separate voice file to accompany the text file for playback during correction and editing. SpeechWriter does not include or currently support templates for psychiatric documentation.
Philips' batch-processed system differs from the other speech recognition engines by producing reports in two stages after the dictation is completed. First, the physician records a speech file, then SpeechMagic converts the file to text with a one-minute conversion time for each minute of dictation.
Thelma Camus, M.D., a psychiatrist in private practice in Sedona, Ariz., has used Voice Input Technologies' SpeechWriter for 18 months. Camus initially tried Dragon Dictate when it used discrete speech recognition, but was not satisfied with the speed. SpeechWriter achieves a 97% rate of speech- to-text recognition, and is especially good with psychiatric terms and medications based on its built-in vocabulary. Camus has also begun using an Olympus portable digital recorder to dictate and transfer information to her computer. She either dictates between patients, or writes notes during sessions and dictates afterward.Kurzweil Clinical Reporter
Kurzweil Applied Intelligence Inc.'s Clinical Reporter is configured for radiology, pathology and emergency medicine. The Clinical Reporter allows clinicians to create complete medical reports by voice and capture data for later analysis through a voice-enabled system it calls a "prompted interaction system."During dictation, users respond to the system's prompts with numbers or short phrases. Physicians have found that these prompts slow down dictation and the natural flow of speech.
Lernout & Hauspie, a Belgian firm specializing in speech and language technology, acquired Kurzweil Applied Intelligence Inc. in June 1997, and since that time, development and support of Clinical Reporter has slowed. In May 1998, Lernout & Hauspie released L&H Voice Xpress Plus, a continuous speech recognition product with integration into Microsoft Word. Early reviews have found good command and control features with 95% accuracy of speech recognition.
In 1997, Microsoft purchased an 8% interest in Lernout & Hauspie. Microsoft and Lernout & Hauspie will be sharing technologies to cooperate on future speech initiatives. Microsoft will thereby position itself for future inclusion of speech recognition into the Windows operating system. In October 1997, Microsoft, Lernout & Hauspie and the medical dictation/transcription company MedQuist announced a broad-based strategic alliance to integrate medical reporting with Kurzweil's Clinical Reporter.Dragon Systems' NaturallySpeaking
Dragon Systems' NaturallySpeaking continuous speech recognition software is widely recognized for its performance, speed, and intuitive, flexible user interface. Currently the market leader in use and acceptance, Dragon NaturallySpeaking allows users to edit and format as they dictate. Dragon NaturallySpeaking features command and control of Windows applications through voice and can handle rates of speech up to 150 words a minute.
John Carleton, M.D., an occupational psychiatrist in practice in Santa Barbara, Calif., finds that Dragon NaturallySpeaking helps him save on transcription costs: "I enjoy being more in control of my dictation; this saves me from having to drop my cassettes off with the transcriptionist, and reduces my time in the report turnover from two weeks to one day."
A companion to speech recognition software is a specialty specific language model to improve the speed and accuracy of medical dictation. Voice Input Technologies includes a psychiatry language model with SpeechWriter. Dragon Systems is currently developing a psychiatry language model for its next generation of professional speech recognition systems. Voice Automated Corporation has compiled language models for IBM Via Voice and Via Voice Gold, and Dragon NaturallySpeaking Deluxe for Disability/Workers Comp Evaluation and Psychology/Psychiatry.
Voice Automated constructs each language model by analyzing thousands of reports within the specialty. Each Voice Automated language model was created with a minimum of 15,000 reports and 12 to 15 million words of specific dictation within the field. By analyzing reports within a specific field for each specialty, 8,000 to 12,000 words are added to cover 97% to 99% of the words used within that field. These numbers mean that physicians will need less time to train words or teach the system a word's context for their specialty.VAST Express NoteTaker
Voice Activated Systems Technologies (VAST) uses Dragon Systems' NaturallySpeaking for medical dictation. VAST Express NoteTaker Psychiatry contains a pre-formatted psychiatric diagnosis-specific report template for initial assessment and progress notes. VAST Express NoteTaker is also available with dictation modules for endocrinology, radiology, pathology and emergency medicine in addition to psychiatry. VAST also offers setup and training of speech recognition systems.
Each of the 35 VAST Express NoteTaker templates outlines the DSM-IV diagnostic criteria for major psychiatric diagnoses with subsequent fields for past history, mental status examination, diagnosis and treatment. VAST Express NoteTaker Templates can be further customized or designed for each clinician's preferred document styles. Templates facilitate the generation of complete notes and allow physicians to automatically include essential information, such as the 1998 Health Care Financing Administration E/M documentation requirements.
The commands and features of speech recognition programs take time to learn. The intricacies of computer hardware, software configuration and system maintenance can also be a challenge to set up and maintain. Yet the advantages of continuous speech recognition are well worth the learning curve.
What speech recognition products are expected in the near future? Intel and Microsoft, the two driving forces of the personal computer industry, are gearing up to include speech recognition in the operating systems of their computers. In 1999, Intel will ship a new processor technology named Katmai, which is designed to enhance complex applications such as 3-D graphics and speech recognition and run at speeds starting at about 500 MHz. Microsoft' s strategic alliance with Lernout & Hauspie Speech Products will further accelerate development of the next generation of voice-enabled computing on the Windows platform.