Errors in medical notes produced by speech recognition software could affect care

Speech recognition software may lessen physicians' documentation load, but the errors that frequently occur when using this tool, including clinically significant errors, could affect patient care, a study published in JAMA Network Open found.

The study found an error rate of more than seven words per 100 in unedited SR-generated documents, including clinically significant errors in one of every 250 words, highlighting a need for manual review and editing of SR-generated notes.

"While this technology is very useful for our clinical productivity and work flow, it's not perfect, and as we enter dictation into the system, we need to be careful about errors and to carefully proofread our notes," coauthor Foster Goss, DO, told Medscape Medical News.

The researchers looked at 217 clinical documents dictated during 2016 at Partners Healthcare System in Boston and the University of Colorado Health System in Aurora to determine the error rate and types of errors.

Six study insights:

1. Of the 217 documents, about 96 percent of the unedited SR-generated notes contained errors.

2. The overall rate of errors in SR-generated text was about 7 percent. After medical transcriptionists edited the SR texts, the error rate fell to 0.4 percent. This number dropped to 0.3 percent when corrected and signed by dictating physicians.

3. Deletions/omissions (34.7 percent) and insertions (27 percent) were the most common SR mistakes.

4. Errors also occurred in numbers, with "17-year-old" becoming "70-year-old," and involved incorrect, added, or omitted prefixes, such as incorrectly converting "inadequate" to "adequate."

5. The authors also noted several more worrisome errors relating to medical conditions and potential biopsies. For example, one case found SR-generated notes read "dengue" instead of "DKA" (diabetic ketoacidosis) in the original audio transcript.

6. "Taken together, these findings demonstrate the necessity of further studies investigating clinicians' use of and satisfaction with SR technology, its ability to integrate with clinicians' existing workflows, and its effect on documentation quality and efficiency compared with other documentation methods," the researchers wrote.

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