It always seemed incredibly inefficient and expensive but hospital management told me this was the most dependable way to get accurate records and even a single lost lawsuit would cost more than the service.
It's stupid, but that's the world we live in.
What doctors need would be secretarial services trained in medical procedures.
In the 1980s USSR, every doctor actually had a nurse who did the paperwork. And somehow, healthcare was still free.
The speed at which reports are dictated is incredible and even when familiar with the field it’s hard to understand how the typists are getting it right.
I think it's just about bureaucratic faux-economical thinking infringing to doctors workspace cutting overall effectiveness.
Nor a secretary nor a doctor nor anybody should have to hand-type data that already exists digitally.
I'm so mind-blown that this doesn't exist yet that I feel maybe I should try and build it. I have tried building the next-best thing: OCR based form filling, but hard to get far as a solo FOSS'er.
New problem: there are 20 competing standards
We have a national health database in Finland called "OmaKanta" (which translates to MyDatabase or something like that). It's not perfect but at least I can trust it with most of my health records, and it's accessible to all doctors working in both public and private sector.
The doctor was listening to my breathing, looking at the throat, asking me and my mother questions, and saying various medical phrases to her assistant, who was then writing them into my patient records (a thick paper notebook).
Furthermore, preparing/capturing docs is just one type of task specialization and isn’t that crazy: stenographers in courtrooms or historically secretaries taking dictation come to mind. Should we throw away an otherwise perfectly good doctor just for typing skills?
These models definitely aren’t foolproof, and in fact have been known to write down random stuff in the absence of recognisable speech: https://koenecke.infosci.cornell.edu/files/CarelessWhisper_E...
In a lot of provider organizations, certain doctors are chronically late about reviewing and signing their reports. This slows down the revenue cycle because bills can't be sent out without final documentation so the administrative staff have to nag the doctors to clear their backlogs.
And then the doctors double checks and signs everything. I feel like, often you go to the doctor an 80% of the time they stare at the screen and type something. If this could get automated and more time is spent on the patient, great!
I’m in an unusual situation as an anesthesiologist; I don’t have a clinic to worry about, so my rate-limiting factor isn’t me, it’s the surgeon. EMR is extremely helpful for me because 90% of my preop workup is based on documentation, and EMR not only makes that easy but lets me do it while I still have the previous patient under anesthesia. I actually need to talk to 95% of patients for about 30 seconds, no more.
But my wife is primarily a thinking rather than doing doctor, and while she can type well, why in the hell do we want doctors being typists for dictation of their exams? Yes, back in the old days, doctors did it by hand, but they also wrote things like “exam normal” for a well-baby visit. You can’t get paid for that today; you have to generate a couple of paragraphs that say “exam normal”.
Incidentally, as for cloud service, if your hospital uses Epic, your patients’ info is already shared, so security is already out of your hands.
The absurdity is that doctors have to enter a metric shit ton of information after every single visit even when there’s no clearly compelling need for it for simple office visits beyond “insurance and/or Medicare” requires it. If you’re being seen for the first time because of chest pain, sure. If you’re returning for a follow up for a laceration you had sewn closed, “patient is in similar condition as last time, but the wound has healed and left a small scar” would be medically sufficient. Alas, no, the doctor still has to dictate “Crime and Punishment” to get paid.
Some are software companies that ingest data to the cloud as you say. Some are remote/phone transcription services, which pass voice data to humans to transcribe it. Those humans then store it in the cloud when it is returned to a doctor's office. Some are EMR-integrated transcription services which are either cloud-based with the rest of the EMR or, for on-premise EMRs, ship data to/from the cloud for transcription.
It’s less accurate and much slower than a human typist (or 3) typing dictated reports.
Tested over years in an MSK radiology clinic.