"Dethrone the dictaphone!"
- Bruce Springsteen
Medical reporting has always had to strike an awkward balance between fulfilling multiple needs. The physicians need to accurately and comprehensively capture everything that occurred and was observed, but they also need to do it as quickly as possible in order to provide more care to others. The reports themselves are trying to reach diverse audiences as well - referring physicians to know what happened and what the findings were, but also the billing and coding departments so they understand what transpired and ensure proper reimbursement and diagnosis ensues. Furthermore, while reporting doesn't take up too much of a physician's time (compared to actually looking at slides in the lab, performing surgery, meeting with patients, etc.), it can be a hassle and, if reports aren't done on time, can lead to facilities limiting access to physicians until they complete their reports.
For many years, the best solution to solving all of these problems surrounding reporting was using dictation and transcription. Dictation and transcription can be a powerful and helpful tool, particularly for entering in your own notes that may not be needed for patient care or containing important health data that could be used by others. However, with innovations in technology and an improved understanding of medical workflows, time is running out for using dictation and transcription for operative reporting, radiology reports, or even pathological findings. Here are the top 3 reasons to ditch dictation and trash transcription:
This may surprise people, as they think "what could be more convenient than picking up the phone to fill out your report?" It's an illusion of convenience. For most dictation programs, you have to be using the services in the facility - you can't call in from another site. Or else it's a long process to call in and authenticate. We know that a lot of surgeons, for example, move between doing procedures in hospitals, ASCs, and even their own offices. By tying them to just one option at one location, you're severely hampering the ability to report effectively. If they have to wait to record their findings, there's a chance they may forget important information or else confuse elements with different cases. Also, picking up the phone and quickly dictating may seem convenient - but it's important to remember that is just the first step of the reporting process. Because there's another reason that dictation should be discarded...
Dictation by itself is not medical reporting. Someone has to transcribe those words. And even if you use speech recognition software (or back end speech recognition software that types out a recording of your dictation), you still need to proofread what was written down. This goes back to dictation being the illusion of convenience, when in fact it's just delayed inconvenience. After dictation is complete, the next step is for that report to get written up and sent back to the physician for approval. The transcription of the report needs to be proofread in case any words are misspelled, the transcriptionist couldn't hear what was said correctly, or there's anything you (as a physician) wanted to include but forgot to when you dictated. Then, if there are any changes, you have to make them and resubmit to be re-entered and then come back to you for approval before that report goes into the record for the patient. That delays information getting to the other physicians as well as slows down reimbursement. Dictation seems easier to do, when in fact it has so many other steps attached to it - and each step represents time that physicians have to spend going over the report, or waiting for it. It's an ongoing concern as opposed to a solution that can be finished in one fell swoop. If physicians can build their reports in front of their eyes, it allows them to sign off on it and be done with it. It also takes care of the third reason to ditch dictation and transcription...
There are multiple studies out there that show how synoptic operative reports and electronic operative reports are more complete than those created by free form dictation. This is because, while it is part of a routine and therefore easy to get into a rhythm, it's just as easy to leave information out. By speaking extemporaneously, and without seeing the report you are creating before your eyes, it's very easy to confuse elements (especially given the high case volumes 
most physicians experience), or leave out information altogether. In those specialties where there's a lack of standards in the form and specific information that physicians should be recording, it's easy to not remember all of the important pieces of information you should be reporting every single time. And it's also hard to ensure that you report on that piece of information the same way every time, using the same word or phrases from a specific list. That way, in research and patient care, like can be compared to like and there's less need to parse out the specific meanings based on synonyms. By building out a report in front of your eyes, seeing exactly what you're recording and how it will be presented to others, while creating specific fields with specific choices for them, it ensures greater control over your own reports and your own messages. Physicians are empowered by taking full ownership of their reports in crafting them and not relying on others, while improving reports by including the most essential elements for research, billing, and treatment.
Working in the medical reporting field, we ask prospetive users "how long does it take for you to report on a case?" and they usually answer a matter of seconds. They mean how long it takes to dictate that report - not factoring in the time or costs it takes to transcribe the report, proof the transcription, edit the transcription, approve the transcription, upload the transcription. It also doesn't take into account the researchers and other physicians who have to search these archived reports hoping to find relevant information necessary for vital medical research or improved patient treatment, not sure where the information they seek will be located or how it will be phrased. Picking up the phone seems like a real convenience, until you see all of the complications waiting on the other end of it.