Documentation capture

The future of ambulatory care documentation, part 2: How speech recognition helps ambulatory clinicians focus on what matters most

To understand the challenges facing ambulatory practices, we interviewed clinicians from independent practices around the country. In the second article in our series exploring their answers, we highlight how Dragon Medical One gives clinicians more time and bandwidth to connect with their patients, building trust and helping them reach better health outcomes.

The relationship between a patient and their clinician is so important for care quality and patient wellbeing. When there’s a good rapport, patients are inclined to share their symptoms and concerns in more detail, and trust that their clinician is working with them toward the best possible health outcome.

But how do you maintain this relationship in a busy, modern clinical environment, where there’s such a focus on efficiency and so many different things competing for a clinician’s attention? Between mounting clinical documentation requirements, increasingly complex administrative systems, and delivering the actual care, it’s easy to let the human connection with patients slip.

We recently conducted in-depth interviews with clinicians from independent practices nationwide to understand their major challenges and what clinicians need to overcome them. One of the top themes discussed was how to prioritize the patient in every interaction without sacrificing detail and accuracy in documentation.

Can you balance attentive patient care with charting demands?

Over half of the clinicians we spoke to see clinical documentation as an issue, with many of them citing the impact on the patient as a key concern. Almost half (46%) say it limits the amount of time they spend with a patient, and 42% say it limits the quality of the time they spend with the patient.

Some clinicians complete documentation between consultations, but this can lead to missing information and rushed notes as clinicians need to prepare for their next appointment. Most of our interviewees document while the patient is in the room with them, with 65% choosing real-time documentation for routine visits and 63% for new patients.

Many of our interviewees pointed out that focusing on the EHR or handwritten notes can mean less focus for the patient themselves. “Often, we’re furiously typing to make sure we’re not missing anything, but we’re not really looking,” explained one pediatrician we spoke to. “We’re in the room the same amount of time, but we aren’t really seeing them in the same way.”

Notetaking can make it difficult to catch the non-verbal cues that signal patient needs—the small indicators that tell an experienced clinician when to press for more detail or ask an extra question. And with less direct interaction during an appointment, patients might not feel comfortable expressing their full feelings to a clinician they feel is distracted.

Speech recognition shifts the focus of clinicians

To achieve a high level of documentation quality without sacrificing patent wellbeing or adding extra stress to their working day, clinicians need a way to produce detailed, accurate records quickly while the information is fresh in their minds.

Medical speech recognition streamlines the complex documentation processes that distract clinicians from the conversation, taking typing out of the equation and allowing them to dictate directly into the EHR. Dragon Medical One is a conversational AI workflow assistant and documentation companion, which enables clinicians to complete clinical notes before, during, or after encounters—whichever is most convenient.

Nearly 70% of the clinicians we interviewed were interested in adopting advanced speech recognition in their practice. For just under a quarter of our interviewees, however, there were some reservations about the prospect of dictating in the room with the patient. With the right application, speech recognition can be a powerful addition to the consultation process, opening new lines of communication between a clinician and their patient, and ensuring the patient feels heard.

Support your patients throughout the care continuum

At ProActive Pain and Neurology, an outpatient clinic in Cumberland, MD, practice owner and neurologist Dr. Dennis Dey uses Dragon Medical One to dictate directly into his clinic’s EHR. He reviews and dictates his thoughts on test results, lab work, and previous encounters before he heads into the exam room. Then, he can focus all his attention on the patient’s needs instead of worrying about fitting all his documentation requirements into a short appointment, often using that time to dictate the clinical note with the patient in the room.

“I find that if I have a patient tell me their history and then immediately record it in the EHR in front of them, it helps build a better rapport. They’re really thankful because they can verify that they’ve been listened to,” Dr. Dey said. “It also saves a lot of time, because I’m done with the history when I’m done talking to the patient.”

When the clinician dictates live, the patient knows immediately what’s being added to their note and can give extra details or tell the clinician anything they’ve missed, if necessary.  

Speech recognition allows for more comprehensive notes, too. Clinicians can fill out structured sections of the EHR quickly and record the full narrative in free text sections, dictating everything while it’s fresh in their mind. Detailed notes support better patient care, as clinicians can be confident that all the relevant information is recorded in the clinical note.

Plus, this streamlines handover between departments and clinics, improving continuity of care for patients when they require support from other healthcare providers. “When we refer out, we’re able to give them a more comprehensive review,” explained a primary care physician from our survey.

Helping clinicians dedicate time to what matters

No one spent years in medical school with the intent to spend as many hours each day just filling out clinical notes and painstakingly working in an EHR. Speech recognition takes some of the ever-expanding list of administrative tasks and burdens now placed on providers, and simplifies them to help these clinicians refocus on why they chose the profession in the first place, taking care of their patients.

Clinician satisfaction is a core part of the patient experience too. When care providers are overstretched and burned out, it’s much harder for them to form meaningful connections with their patients. Working with a solution like Dragon Medical One alleviates the clinical documentation burden. It can save an average of five minutes per note, so clinicians are less likely to spend time after clinics and at home completing work. Happier clinicians provide better care, leading to better outcomes for everyone. As Dr. Dey puts it: “What makes Dragon Medical One stand out is that it frees our minds to focus completely on our patients. We’re faster, more accurate, and more satisfied at the end of the day.”

Explore Dragon Medical One

Make closer connections with your patients with Dragon Medical One, the documentation companion that stops you focusing on a screen and helps you focus on delivering care.

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Dr. Reid Conant

About Dr. Reid Conant

Dr. Reid Conant is a chief medical information officer for Nuance’s Healthcare division. Dr. Conant has provided medical direction and leadership to his hospital through the deployment and optimization of CPOE and physician documentation solutions. Prior to Nuance, Dr. Conant served as the president and founder of Conant and Associates, Inc. which was acquired by Nuance in 2014. For more than eight years, CAI assisted well over 200 organizations, and trained over 10,000 providers on physician documentation solutions. Dr. Conant is an actively practicing board-certified emergency physician and Chief Medical Information Officer of Tri-City Emergency Medical Group in Oceanside, CA. He earned a B.S. in Animal Physiology and Neuroscience at the University of California, San Diego and earned an M.D at Jefferson Medical College of Thomas Jefferson University.