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Dictating vs charting/typing


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We transitioned to a Dragon based dictation EMR about a year ago.  It is faster than typing.  However, you do have to pay attention to how Dragon interprets what you're saying.  There are times when it just doesn't get anything right.  Usually, though, it's pretty spot on.

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Dragon Medical Enterprise is well worth the time and effort. Our hospital has it installed everywhere. I type 60 words a minute, but it is MUCH faster to dictate with Dragon. As long as you take the time to train it for words that it doesn't get, you will be very happy with the result.

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At one hospital I currently work we transitioned to Epic in 2013. That EHR has dragon medical built in (as an add on I think). I became frustrated with the learning curve and stopped using it. At the time  it seemed I spent more time saying "scratch that"..... repeat what I said....."scratch that". repeat a 2nd, 3rd, 4th time what I just said.... It was a bit like the movie Ground hog Day.  In retrospect I think it was a combination of learning dragon in Epic, The ED module for Epic, the hospital module, and the FM module all at the same time (not sure way I had to learn the FM module as I don't work in any of the clinics).

 

I keep thinking I should give dragon another chance, but now I have my templates complete and can use and change the information very efficiently. Being a creature of habit, 2 years out I doubt I'll go back unless forced.

 

Having said that some of my colleagues use dragon daily and love it. I would encourage you to try it. Just be ready for a steep learning curve.  

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One thing you can do with Dragon is to make macros.

So for physical exams, common presentations, ROS, etc, etc inserting commonly used text linked to a word or short prompt.

Caveat is to not fall victim to documentation with brain disengaged and create a chart with identical documentation.

GB PA-C

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I type very quickly and have become adept at completing notes and even dismissal summaries super fast by using shorthand built into the system, with the pro that my typed documents are available for viewing seconds after I hit "complete."

 

That said, one of my goals this year is to learn and become comfortable dictating. Important to take advantage of tools at your disposal.

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We had the option to use dragon and I decided to type my notes along with some very good templates.  I am very happy with it so far, I am a very fast typist and I actually enjoy typing after talking so much all day with patients.  I always dreaded dictating, however I know for many people it is more efficient and preferable to typing. 

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Quick EHR question. the other hospital I work at uses Nextgen. has anyone else used this EHR. I have a very low opinion of it and wonder if its just me.

 

I use NextGen at one of my jobs. It is the worst EMR I have ever used. I just finished PA school last year and I used a Cerner based EMR, two slightly different versions of Epic, CPRS at the VA, paper records. I use Epic at my other job. NextGen has way too many boxes that you have to stop and click in or radio-dials to click in and it doesn't save previous information or draw in lab or imaging information. To make matters worse, we  do some of our notes in Word and type in medications and then reconcile them ourselves. I much prefer Epic.

 

To answer the questions about Dragon, several of us stopped using it because it took down our whole computers, requiring several hours of IT work. I have no idea what happened, but it took down my "profile" (whatever that means) and they had to rebuild my whole laptop about a week after I started using Dragon. I never used it again. That happened to another coworker a few weeks later. Maybe we had bad installs?

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Use it. Love it for the most part. Definitely some prep time to get proficient but what system does not have this problem?

 

I used EPIC for a while and had all of my templates down, but then I moved to an EMR (AllScripts) that does not have this capability so I use Dragon for my templates (normal ROS, normal Exam).

 

HPI is difficult because it will pick up most words but you have to proof read or else you will put stuff into your chart like "She was walking down the stairs and fell on her children" instead "fell on her back."

 

Its always good for a chuckle though.

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