A community of 30,000 US Transcriptionist serving Medical Transcription Industry

Just realized what I really hate about ASR. - adkmt

Posted: Jul 14, 2010

I was just chatting with someone about transcription and ASR (it's been about 3 months since we switched) and it came to me what my biggest problem with it is. We have no control over it. With regular transcription, we are only limited by the quality of the dictation the sound. The harder we work at perfecting our typing skills and our system of word expansions, etc., the faster we can work. I spent 3 years getting to where there are very few words longer then 4 letters that I type out fully. I got to where I actually sort of thought in my "word expander language." Now all that is pretty much wasted. With ASR, I can learn all the keyboard shortcuts and, sure, my expansions help some, but I really have no control over how many things I have to edit in any given report. I can sit here and think about all the mistakes it makes over and over and over again, and how it really needs to learn the word Mynx, or what is its problem with the word draping? or why can't this doctor learn the difference between a semicolon and a colon? But I can't do a damn thing about it. There is only so fast anyone can stop and start and make all those tiny little word and punctuation changes that we think nothing about making on the fly when we are transcribing. Supposedly my making the right corrections will change it eventually, but after 3 months, I doubt it. It is out of my control and the powers that be don't seem to be working in my favor.

What is even worse, at least at transcend, is the fact that you are told to - Hate VR, too

[ In Reply To ..]
increase the playback speed so you go faster. so you increase the playback speed and you hear, most of the time, what the editor spits out, including not hearing the skipped words, etc. Then QA writes you up because you for got A, An, The, or put an extra space into something and you get marked off on your QA score, get a letter from the TL,ROM, or assistant ROM telling you are doing a horrible job and you have to slow down. Catch-22. Transcend is the pits. Of course, they can never fix anything so it comes out right, like you said. Management is the area that can control the quality, but they care nothing about the MTs nor whether they make a living. Greed is the name of the game. As long as the TLs can cherrypick their way through the reports and take the ones they know are good, nothing is ever going to change, and as long as the ones who work with the M-Modal people continue to push our complaints away, it will continue to be horrible.

ASR hate - enigma

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I agree. I've been correcting it longer than that--maybe 2 years--and the MTSOs are saying BUT WAIT! We can cut your costs using ASR! I'll bet the managers promising lower costs aren't taking pay cuts, just the transcriptionists who do the actual work.

But if it did ever actually "learn it" you would be out a job. sm - hateit2

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So essentially WE MTS are training the machines to take over our jobs. Hmm, interesting thought. Would you volunteer to train the person who was going to replace you? I wouldn't.

Ever wonder why so many MTSOs always require experienced MTs? Because no one has time to train anyone but essentially what are we doing? We are training the machines. I've done both VR and old days editing. I'd much rather train an MT straight out of school than this VR mess it puts out!!

When I first took on the VR challenge I was so stupid I didn't realize that the 50/50 VR/traditional actually only leaves you the less than 50% of dictators that the machines just simply cannot understand period and that is why they are traditional. DUH TO ME!

Why can't VR ever get the cc's? I spend more time adding cc's than editing the document.

Just wonder how line count is figured for VR? Is it before we edit or after we edit as I assume? I sure seem to hit DELETE, DELETE, AND DELETE more than I add to any document because of all the him, ha, ho's docs throw in there and repeat themselves so many times!

Wonder when some big folks in Medicare will do chart audits and start throwing out fines for inadequate/wrong documentation? Maybe that is what we need to happen to help bring this VR to a halt. Every time I view prior reports I see tons of mistakes and the bottom line is money because MTs are flying threw just trying to earn a penny and losing care. My doc just said cc all the consultants without even telling me who they are. You think I am going to waste my time looking them up? NOT, NOT, and NOT!!!!

The transcriptionist is not training VR. It doesn't work that way - see comments below

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It's a computer, not a person. Why does everyone keep saying, sm - it will learn

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The doctors are the ones who will have to learn to talk to the machine so it will type the words correctly. It's a computer. It's not going to think, oh this is Dr. Smith and the last time I typed him, he said blah but what he was really saying was blood. Let's all get real here, a computer has to be programmed. The system is only as good as the person who programmed it.

They are programmed to learn - that's the point - sm

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GOOD programs WILL learn that when Dr. Smith says blah he is meaning blood, because it compares the voice file to the work that is completed, so if the MT changes "blah" to blood soon enough it will start putting in blood when he says "blah". That's the POINT of voice recognition. Unfortunately, not all programs are created equal, therefore it is impossible to say that ALL VR is bad, or ALL VR is good, because if you read this board enough you will see a trend of which programs actually do what they advertise.

The problem is when you get too many MTs with their own ideas of what "blah" should be, one might put blood, one might put "blah", one might put "bar" - in that case it is impossible for the VR engine to distinguish what is actually said, it waits for trends, and if those don't become clear it will never learn.

And that learning process was how they justified the 50-75% pay cut - for VR. nm

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x

That is how I can tell there are new hires on my account - Too many chefs spoil that broth, eh?

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Regarding the second paragraph of your post, that is how I can always tell there are new MTs on my account, things that have always been perfect suddenly go askew (i.e., "kilograms" instead of "kg" in the PE; ROS suddenly part flush margin, part wraparound, etc.).

I can never understand why some MTs are so dog-goned determined to inflict their personal style into a report to be edited, even when it clearly goes against the account specifics, but it's always my "heads up" to pay even closer attention while editing because there are now too many chefs spoiling the eScription broth, lol!

Why can they not have an "elite" team who are the only - ones to force changes?

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The managers know who is good and who is mediocre at best. Why can they not have a core group who do the actual training of the VR. I should thing that it would not be that hard to have it only recognize "learning" from a select group of people and not recognize changes that other, maybe new, maybe less skilled, MTs make.

Once it has left the physician, it doesn't matter who you are - llll

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the voice recognition is over. You are now in the mode of editing. VR is completed. VR is not in the document you or anyone else is in looking at what you are typing. VR-VOICE RECOGNITION. The elite team you speak of will still have the issues if the physician does not learn to speak clearly for the VR and the VR does not learn that physician's voice.

But that's kind of the point - sm

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Rather than having 50 people of varying skill levels try to teach the VR "brain" what Dr. Sferoiufd is saying, why not just a handful of really good MTs? Learning should come from an exceptional teacher not in spite of a very bad one.

I'm sorry, you don't understand how many VR programs work - sm

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They compared the completed reports to the voice file, they keep track of the changes, they do learn. Not all, but those that are programmed correctly, do learn.

It is learning the speech pattern of the physician, not the typist - llll

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What's the point? Remember the commercial with the couple, sm - LOL

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trying to make a phone call with the automated voice recognition service. That is voice recognition. Ever make a call yourself and the thing took more than once to recognize what you were saying? That's voice recognition. With medical transcription you only get 1 time. It doesn't matter how many times a transcriptionist types blah, the computer will hear it and type what it hears. It will learn the voice of the person dictating, not what the transcriptionist is typing. That's the whole point of VR, not to have a transcriptionist. It is up to the physicians to learn how to use the voice recognition and since they are not actually going through their own reports, that will probably never happen. VR is just that voice recognition, not TR, transcriptionist recognition.

Wrong. - me

[ In Reply To ..]
I'm sorry, but you are wrong.
eScription learns, I can't talk about other programs because I haven't used them, but eScription does learn with consistent editing.

VR types what it hears, not what you edited in your report - llll

[ In Reply To ..]
Once the physician says the word correctly, it will type it correctly, it will never change blah to blood no matter how many times you change it to blood. It will only type blood once it hears the word as blood. It's that simple. The physician has to train the VR program to learn his voice, not the quality of your editing.

My question is..... - adkmt

[ In Reply To ..]
is there someone responsible for training it? My understanding is that an SR system periodically scan documents by a certain dictator and picks up on words and phrases they use. I work for a company that uses DocQscribe and whatever the ASR program is called. So is there someone in my company who is responsible for how often it does that or what it sees? I would think there would be a way to weed out the badly transcribed or edited reports so that it "learns" what we want it to. I know for a fact that I make the exact same changes to a certain doctor's cardiac caths every single time, but it has yet to incorporate those changes. It absolutely will not put in the word Mynx or Xience. So is that the fault of the program or something else?

Here is an article on VR. It is not the transcriptionist it needs to learn - it is the physician

[ In Reply To ..]
Is voice recognition the new solution for medical transcription needs? Voice recognition or speech recognition is one of the new developments in the medical transcription field. It has been touted as the solution for a health provider's documentation needs.

How does it work? The doctor is offered a digital platform by the Voice recognition service provider where the doctor can dial in and dictate his patient notes at the end of the day. The software converts it to typed form, which is made available to the doctor to edit and correct as needed.

Seems simple enough. But is it as simple as that? Apparently not! Voice recognition needs to be evaluated on all the criteria used while finalizing a healthcare facility's medical transcription service provider.

Time saved: When medical transcription needs are outsourced one of the main benefits is the time saving factor. Time is a precious commodity for Doctors and they would like to utilize it for providing quality care to their patients. But when voice recognition software is used the doctor has to spend more time on it in the following areas:

1. Training time: Voice recognition software requires the doctor to personally 'train' the software on the speech pattern, accent, standard terms and various nuances of his/her speech pattern so that the software can 'learn' it and adapt accordingly. This could involve a huge time commitment from the doctor using it, which he may ill afford to make.

2. Time for dictation: Voice recognition software requires the doctor to change his style of dictation to include punctuations, grammar, spellings, detailed terminology, paragraph and report start and ending etc., as opposed to the free flow form of dictations that the doctors are used to.

3. Time for editing: Unlike the traditional method of medical transcription where the records are subject to rigorous proof reading and quality checks, here the doctor needs to spend considerable time editing and correcting before signing off on the reports

Accuracy: The accuracy levels of the finished reports is of utmost importance as it affects care of the patients at every level as well as forming the basis for all further documentation needs. The accuracy level from voice recognition software is found to be about 60%-65%. That means correcting and editing the documents have to make up for the remaining 35%-40% accuracy.

Cost: The cost factor for voice recognition software will vary according to the number of users and the size of the organization. It will also have to factor in additional costs required for editing the documents to an acceptable level. One may find that it is costing more per line than was quoted in the beginning.

Learning curve: When healthcare facilities look for solutions for producing their patients' medical records they would like to have solutions that are expert and accurate from the very beginning. In the case of voice recognition software there is a definite learning curve that affects the quality of finished reports till the software 'learns' to follow a particular doctor's speech patterns and even then the accuracy levels are only 60%-65%.

Flexibility: When new doctors are added to the practice the voice recognition software has to be trained further to accept the speech nuances of the new joiners. There is no flexibility offered by voice recognition software for this.

In conclusion we can safely say that voice recognition software will never be able to completely replace manual medical transcription. The important point to be considered here is that medical records are created of human beings, dictated by human beings and therefore needs another human being to transcribe it. Medical transcriptionists will have an important role to play at least as editors and proofreaders.

Medical transcription requires a certain amount of training, subjective judgment and understanding the context to be accurate and relevant, which will not be possible to achieve completely through software, no matter how expertly created.

For the transcription needs of a healthcare facility one should look for a company that offers commitment on accuracy, turnaround time, reasonable pricing and data security.

This concerns programs such as Dragon - front end programs - sm

[ In Reply To ..]
Different VR is different. Programs that are designed for front-end speech recognition, where the doctor edits his own work are not designed to learn. However, programs such as EditScript (and I think M*Modal is supposed to be that way too, but I've never used it) do learn. They are programed different. You are coparing apples to oranges, Word to WordPerfect.

it's a misconception that MTSOs are trying to sell you, - that you are training the program

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No matter what program it is, it is learning the person's voice, not the transcriptionists keystrokes.

I am not trying to tell you that it does not learn, sm - llll

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I am just trying to tell you it is not learning what you are typing. It is learning what the physicians are saying and how they are saying it. Hence, VOICE RECOGNITION.

It learns what the physician is saying but requires what has been typed to correlate. - nm

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x

Hmm, yes, that's where you come in, not the VR, it only - does the voice recognition

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this article is from transdyne, a transcription company - lllll

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If speech recognition only learns what the doctors say.... - adkmt

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why, on the program I am on, does it not ever put in the word Mynx or Xience, no matter what doctor is saying it. They certainly don't all mumble it. Obviously, for some strange reason those words aren't in the database or memory or whatever you want to call it. It doesn't recognize those words when they are spoken by any of the dictators. So what I want to understand is what is it that has to happen for those words to start showing up in the document when they are spoken.

Most SRT can be manually adjusted... - PhillyMT

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By a user who builds a dictionary for the program telling it what to transcribe when specific sound sequences are heard. So someone actually tells the program "yes, you heard correctly" or "no, this is what was actually said" using these customized dictionaries, typically created using the ARPAbet language. Any company dedicated to the improvement of SRT will manage and maintain a process like this. In your case, I bet someone has modified the program to correctly recognize this speech.

yes, those words could be added to the dictionary, but - could still be misunderstood

[ In Reply To ..]
by the VR, Xience s/l science, so no guarantee that the VR will know what word to chose. As you know, there are thousands of words for the VR to chose from. In essence, the VR will type what it thinks it hears, just as a typist would.

You're absolutely right, you can make those corrections, sm - JMHO

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repeatedly and it will not learn what you have corrected. I hope that after 3 months, you have realized that it has nothing to do on your end for training the program. The progam is trained by the user speaking to the VR Once it leaves that person, you are the editor of what the VR has learned. Programming the VR and putting in a dictionary of new words will only go so far. When the physicians learn this stuff, then we might get a better product. I too am confused as to why all of these transcriptionist think they are helping in the correction process of the VR system. I agree with you, after 3 months, it should have learned what you were changing and since it hasn't, that should tell you that you have nothing to do with teaching it what that physician said.

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