What’s New in the Patient Safety World

December 2017

Speech Recognition Still Not Up to Snuff



It’s been quite a while since we discussed errors related to speech recognition (see our October 4, 2011 Patient Safety Tip of the Week “Radiology Report Errors and Speech Recognition Software”). We certainly thought by now the technology had improved considerably and that errors related to speech recognition software would have diminished.


But a new study (Hodgson 2017) compared the efficiency and safety of using speech recognition assisted clinical documentation within an electronic health record (EHR) system with use of keyboard and mouse in an emergency department setting. 35 ED clinicians were randomly allocated to clinical documentation tasks using speech recognition or keyboard and mouse on a commercial EHR system


The researchers found that mean task completion times were 18.11% slower overall when using speech recognition compared to keyboard and mouse. For simple tasks speech recognition was 16.95% slower and for complex tasks 18.40% slower. Increased errors were observed with use of speech recognition (138 vs. 32 total errors, 75 vs. 9 errors for simple tasks, and 63 vs. 23 errors for complex tasks). Interestingly, interruptions did not significantly affect task completion times or error rates for either modality.


The authors felt that some of the observed increase in errors may be due to suboptimal speech recognition to EHR integration and workflow. They concluded that improving system integration and workflow, as well as speech recognition accuracy and user-focused error correction strategies, may improve SR performance.


Bottom line: we still have a long way to go before speech recognition software can improve both efficiency and patient safety. Lots of promise but still too many glitches.







Hodgson T, Magrabi F, Coiera E. Efficiency and safety of speech recognition for documentation in the electronic health record. Journal of the American Medical Informatics Association 2017; 24960; 1127-1133






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