Risks and benefits of speech recognition for clinical documentation: a systematic review

Objective: To review literature assessing the impact of speech recognition (SR) on clinical documentation. Methods: Studies published prior to December 2014 reporting clinical documentation using SR were identified by searching Scopus, Compendex and Inspect, PubMed, and Google Scholar. Outcome variables analyzed included dictation and editing time, document turnaround time (TAT), SR accuracy, error rates per document, and economic benefit. Twenty-three articles met inclusion criteria from a pool of 441. Results: Most studies compared SR to dictation and transcription (DT) in radiology, and heterogeneity across studies was high. Document editing time increased using SR compared to DT in four of six studies (+1876.47% to -16.50%). Dictation time similarly increased in three of five studies (+91.60% to -25.00%). TAT consistently improved using SR compared to DT (16.41% to 82.34%); across all studies the improvement was 0.90% per year. SR accuracy was reported in ten studies (88.90% to 96.00%) and appears to improve 0.03% per year as the technology matured. Mean number of errors per report increased using SR (0.05 to 6.66) compared to DT (0.02 to 0.40). Economic benefits were poorly reported. Conclusions: SR is steadily maturing and offers some advantages for clinical documentation. However, evidence supporting the use of SR is weak, and further investigation is required to assess the impact of SR on documentation error types, rates, and clinical outcomes.