NEONATOLOGY ON THE WEB

Title	The Use of a Computerized Voice to Text Dictation System in the Neonatal Intensive Care Nursery: A Model for Efficiency and Cost Effectiveness.
Author(s)	Mitchell Goldstein, MD; Gilbert Martin, MD; and Bruce Sindel
Source	APA Section, WSPR Meeting, February 1996
Publication Date	February, 1996
Abstract	Transcription systems are used with increasing frequency in neonatal intensive care nurseries today. Traditional problems include: accuracy, completeness, time to completion/placement of the dictation in the chart, medicolegal requirements, and the need for multiple repetitive dictation (e.g. problem lists). Using a cost effectiveness model, we implemented the use of a voice to text dictation system (Voice Type Dictation by IBM). Previously, dictation costs for transcription were $0.17 per line. Given a census of 20-30 neonates, monthly costs for dictation over a six month period are summarized in the table below: Month Dictation Cost 7/94 $12,527.64 8/94 $9,667.73 9/94 $9,522.89 10/94 $11,342.91 11/94 $11,197.90 12/94 $13,750.11 Total $68,009.18 Using anticipated costs of $6000 per dictation station (X 4 stations) to allow simultaneous dictation by the group's neonatologists, we estimate a cost savings of approximately $110,000 for the first year and $125,000 in subsequent years as capital costs decrease. Further advantages include time savings with the ability to import pertinent text from a previous day's note, automation of normal findings or procedures, and reduction of the time necessary to place a signed typed note in the chart. On call physicians, nurses, and other ancillary personnel benefit from having a "more" current summary and statement of plan. Further, point of dictation review, signature, and chart entry will reduce potential liability for unreviewed dictation entering the medical record. We propose this system as a productive, cost effective alternative to more traditional dictation/transcription systems. More information about this application is available on the IBM Corp. "Software Quarterly" Web Server at http://sq.ibm.com/sq/issues/vol24/speech.htm.