There also appear to be fundamental cognitive limits to the use of SR. This may be simply because SR to date is “bolted on” to a system primarily designed with KBM in mind. 19 This suggests that, while SR is useful for dictating long notes, it may not be an ideal mechanism for interacting with complex environments like the EHR. When evaluations are performed, they suggest that SR leads to higher error rates, compared to the use of keyboard and mouse (KBM), and significantly increases documentation times. Despite the wide availability of such technology, it has surprisingly had little formal evaluation. SR can be used to navigate within the EHR, select items in drop down lists, and enter text in different fields of the record. ![]() SR is also now increasingly used not just for note dictation, but as the primary mechanism to interact with the EHR. SR appears to be beneficial for transcription tasks, reducing report turn-around time, but when compared to human transcriptionists, does have a higher error rate and documents take longer to edit. ![]() SR technologies can create verbatim transcripts of human speech, 17 or can be used to invoke templates and standard paragraphs to simplifying the burden of data entry. Dictation technologies are widely used to support documentation in settings such as radiology where letters and reports are a major element of the workflow. In today’s state of the art systems, humans are still the ones tasked with creating clinical documentation, but are provided with tools to make the task simpler or more effective. Digital scribes promisingly offer a gateway into the clinical workflow for more advanced support for diagnostic, prognostic and therapeutic tasks. The electronic record also shifts from a human created summary of events to potentially a full audio, video and sensor record of the clinical encounter. Automation bias may see clinicians automatically accept scribe documents without checking. Digital scribes raise many issues for clinical practice, including new patient safety risks. Data from clinical instruments can be automatically transmitted, interpreted using AI and entered directly into the record. Intelligent clinical environments permit such augmented clinical encounters to occur in a fully digitised space where the environment becomes the computer. ![]() Computer-led systems are delegated full control of documentation and only request human interaction when exceptions are encountered. Mixed-initiative systems are delegated part of the documentation task, converting the conversations in a clinical encounter into summaries suitable for the electronic record. Human led systems task clinicians with creating documentation, but provide tools to make the task simpler and more effective, for example with dictation support, semantic checking and templates. Whilst in their infancy, digital scribes are likely to evolve through three broad stages. ![]() Digital scribes or intelligent documentation support systems, take advantage of advances in speech recognition, natural language processing and artificial intelligence, to automate the clinical documentation task currently conducted by humans. Current generation electronic health records suffer a number of problems that make them inefficient and associated with poor clinical satisfaction.
0 Comments
Leave a Reply. |