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#103927 - 07/17/08 10:14 AM
Intelligent Language Processing
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Nae
Administrator
Registered: 07/16/98
Posts: 6465
Loc: Sanford, Fl, USA
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Oh my, oh my, oh my...
“A lot of the value of ILP on the front end is just starting to be realized now,” says Mardini. “Physicians are learning that they don’t have to be aware of the different parts of a report. They just have to speak, and the ILP will organize information into specific parts or sections. Additionally, a properly designed system will guide the clinician to what they may not have commented on, when in fact the patient’s condition requires that something else be looked at or commented on.”
Intelligent language processing
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#103953 - 07/17/08 12:26 PM
Re: Intelligent Language Processing
[Re: Nae]
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MTBeach
Junior Member
Registered: 12/30/04
Posts: 48
Loc: Connecticut
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Oh great. It will get even better now. They don't even have to be aware of the different "parts" of a report. All they need to do is speak and miracles will happen!
I thought the following quote from the article was quite the gem.
"We frequently hear that MTs do not want to go back to traditional transcription once they have started using speech recognition and are editing draft documents vs. typing from scratch. They are amazed at the accuracy of the drafts produced and how well the documents are formatted due to intelligent language processing."
Yep, I'm amazed. Amazed at how many edits a report actually requires to be accurate. I actually like editing and would LOVE to see a program on the market that will actually produce a draft that is AT LEAST 70 percent accurate. I had a report the other day that needed approximately 5 percent editing. I actually sat there dumbfounded when the voice file ended. I remember thinking if just half the SR jobs I had to do were like that I would be in hog heaven!
I've been editing for over 2-1/2 years. I just don't see where the system is "learning" anything at this point. It was decent at one point and now seems to have gone downhill. I have a sneaky suspicion where all the "half-way decent" SR jobs are going, but that is another topic.
I do have a question for anyone that is familiar with SR. Is it possible to obtain the number of edits one makes to an SR job? Just recently I've opened jobs to edit, read the entire report (or should I say gibberish), and then wish I had a way to actually track the number of edits I had to make. Is this a "pie in the sky" wish? There has to be a way.
Sorry if this is off track Nae.
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#103959 - 07/17/08 12:35 PM
Re: Intelligent Language Processing
[Re: Nae]
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bippy
Member
Registered: 11/01/06
Posts: 460
Loc: Summerland.
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"They just have to speak ..." Not impressed.
Now if they said "They just have to mumble ..." I would be shaking in my boots.
The example in that article shows a doctor speaking clearly. They also say how MTs loved editing. I can't say I mind it for the good dictators but when most of the report doesn't make sense and you have to change every other word, that's a different story. I wonder what type of MTs they talked to.
_________________________
Love my new house!
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#103991 - 07/17/08 03:40 PM
Re: Intelligent Language Processing
[Re: Nae]
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Glory1863
Member
Registered: 03/27/08
Posts: 440
Loc: Beyond Antares
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It's an interesting article, but I'm firmly one of those skeptical MTs. I notice the only platform mentioned was eScription. I don't work on that one, so I would be interested in hearing from anyone who does. Do you feel your experience is as rosy a picture as the article paints?
Would you mind saying for what type of facility you type? Not client name, of course, just something along the lines of big, lots of docs, lots of turnover or small, few docs, little turnover. The reason I ask is that I'm trying to figure out why the platform I work on seems uniformly better with some clients than others, not just some dictators and not others. I've heard conflicting information as to whether the dictators even know VR is being used, but I know they don't train it. That's supposedly done back end by the MTs and the magic machine itself. As far as I can tell, success isn't predicated on length of time on the system, either.
My platform, even after a couple of years, still cannot reliably understand "end of dictation" as something we'd never want in a document; perhaps it's because its intelligence tells it to change the phrase to "indications" and make it a heading on a fairly regular basis. I'm also not convinced that Patrick Stewart or James Earl Jones reading a document into it would necessarily come out any better. I guess what I'm saying is that I can't figure out any pattern to success or failure with it.
I'd really like to know what platforms, if any, work uniformly well. I don't expect perfection, just an environment where productivity is enhanced anywhere near the manufacturer's claim. That's a good piece of information to have for anyone who is job hunting.
_________________________
The dogmas of the quiet past are inadequate to the stormy present. Abraham Lincoln
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#104002 - 07/17/08 04:52 PM
Re: Intelligent Language Processing
[Re: Glory1863]
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Jay_Vance_CMT
Member
Registered: 12/08/01
Posts: 1451
Loc: Columbia, MO
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The reason I ask is that I'm trying to figure out why the platform I work on seems uniformly better with some clients than others, not just some dictators and not others.
One factor which might be in play in a case like this is the accuracy threshold at which dictators' reports are routed for editing rather than transcription. If this is set too low, dictators' reports which would be better off transcribed from scratch are instead routed for editing. The client can choose to set this threshold wherever they wish, so it's entirely possible for two different customers using the same platform to produce dramatically different outcomes in terms of what the MTs see.
Also, in terms of the dictators "training" the system, on a back-end platform all the "training" is done by computers as they compare their original drafts with the human-edited versions. The dictators have no direct interaction with the system as they would with a front-end application like Dragon. With a back-end platform like eScription, Dictaphone, etc., it's actually the DICTATORS who need to be "trained" how to dictate in a way that will optimize SR output. Unfortunately, one of the big selling points SRT vendors use is that the doctor's DON'T have to change the way they dictate. But the truth is that you're not going to see optimum results without some degree of adaptation on the part of the dictators. That's another factor that could influence the quality of the SR drafts the MTs encounter.
_________________________
Jay Vance, CMT
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#104247 - 07/19/08 08:10 AM
Re: Intelligent Language Processing
[Re: Jay_Vance_CMT]
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HoosierFemme
Member
Registered: 09/28/05
Posts: 1172
Loc: Parisian suburbs, France
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Wonderful! Make my job harder by having me edit reports that are less than 70% accurate and would have been a lot easier to transcribe from scratch and also give me doctors who refuse to change their dictation habits. On top of that, pay me less per line. Yeah, I'm all for THAT!
_________________________
For sin shall not be my master, for I am not under law but under grace. ~ The Bible, Romans 6:14
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#104254 - 07/19/08 11:26 AM
Re: Intelligent Language Processing
[Re: Jay_Vance_CMT]
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FarAwayDeb
Member
Registered: 03/15/02
Posts: 2956
Loc: just south of Rochester, NY
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Unfortunately, one of the big selling points SRT vendors use is that the doctor's DON'T have to change the way they dictate.
They should have to do a certain number of reports while watching a screen, to see what is actually entered vs what they dictate. Like that little YouTube clip where the man became so frustrated trying to make it type what he was saying. When they see how difficult it is to actually have what you are saying appear on the screen, I don't think they will be so anxious to use it.
I forget what platform it was, but one that I used couldn't do numbers properly. If the number one hundred thirty-seven was dictated, it would print out 100 30 7. This was a lot of fun in the lab data paragraph - not.
_________________________
Good grammar ain't easy.
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#104312 - 07/20/08 10:29 AM
Re: Intelligent Language Processing
[Re: Nae]
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Mike
Administrator
Registered: 07/11/98
Posts: 2693
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To me, this seems like one of those fake articles that companies write when they don't want to pay for advertising. ILP has been in SR systems for years. I don't see anything new in what they're talking about.
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#104360 - 07/20/08 07:30 PM
Re: Intelligent Language Processing
[Re: Mike]
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Basset
New Member
Registered: 09/24/04
Posts: 7
Loc: Midwest
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I work at a fairly large hospital which is in the final process of ordering VR. We have over 500 physicians and more than 200 ancillary personnel who would eventually be using it. I am pretty nervous about correcting a machine's work. Whenever another transcriptionist asks me to listen to a blank, I prefer they not tell me what it sounds like to them, as that makes it harder for me to hear anything else. My worst nightmare is overlooking an obvious error because I'm not focused enough; or recognizing an error and listening to the dictation over and over, but not being able to hear anything other than what the machine originally typed.
P.S. I joined this site a while back, but after a computer crash and life in general becoming hectic, it was a while before I was able to surf the net. By that time, I wasn't able to find this site again. Luckly, another board I occasionally visit mentioned this site, so here I am. I missed the useful and extremely informative discussions and articles that are posted on this site. Anyway, I'm excited to be back! I read more than I post, so I probably won't be 'talking' too much. : )
_________________________
A transcriber is a machine; a transcriptionist is a well-oiled machine.
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#104363 - 07/20/08 08:02 PM
Re: Intelligent Language Processing
[Re: Basset]
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Glory1863
Member
Registered: 03/27/08
Posts: 440
Loc: Beyond Antares
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Basset, I've worked on VR for several years now. In my experience, at least one of your concerns is justified. There is just something qualitatively different about hearing, knowing what is meant and creating versus reading while hearing, seeing exactly what you heard and realizing it is wrong. It's so easy to just start going with the flow when the machine is hearing fairly well (kind of like falling asleep behind the wheel while driving through Nebraska). You may find that you need to take more breaks to stay alert. I would love to see a set of brain scans (you know the ones I mean: this is a normal brain on the left and Jack the Ripper's brain on the right and the colors denoting activity are in entirely different places) comparing a transcribing brain with an editing brain. I suspect they wouldn't match up.
Sometimes seeing what the machine thinks it is and trying to figure out what you hear can be difficult. Most of the time, though (at least on my platform), what the machine thinks it hears is out and out junk, and you'll have absolutely no trouble discerning that it is wrong and nowhere near what you're hearing (that is, you'd be having the same problem understanding if you were staight typing).
_________________________
The dogmas of the quiet past are inadequate to the stormy present. Abraham Lincoln
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#104372 - 07/20/08 08:51 PM
Re: Intelligent Language Processing
[Re: Glory1863]
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Basset
New Member
Registered: 09/24/04
Posts: 7
Loc: Midwest
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Thanks for the reply, Glory, you've helped immensely to settle my nerves. The brain scan idea would indeed be very interesting.
_________________________
A transcriber is a machine; a transcriptionist is a well-oiled machine.
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#105268 - 07/28/08 01:49 AM
Re: Intelligent Language Processing
[Re: Basset]
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Jabberwocky
Member
Registered: 08/10/03
Posts: 404
Loc: Mumbai, India
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To me, this seems like one of those fake articles that companies write when they don't want to pay for advertising. ILP has been in SR systems for years. I don't see anything new in what they're talking about.
I think Mike, they're talking about taking it to the next logical level. For example, if somebody says Section Headers, I'd say no big deal, but if it can drill down to the subsections, that would be very interesting indeed - that along with the context discovery for specialties... OTOH, if eScription didn't already have the ability to recognize even the section headers, I'd be very surprised if not shocked.
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#105530 - 07/30/08 12:09 AM
Re: Intelligent Language Processing
[Re: Jabberwocky]
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Mike
Administrator
Registered: 07/11/98
Posts: 2693
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but if it can drill down to the subsections, that would be very interesting indeed - that along with the context discovery for specialties...
Really? I guess I was spoiled by Instant Text and figured it would pull that information in from old reports by the doctor. That seems a lot easier to do than raw context recognition that's dictator independent. Consider that we've had similar tools in our expanders since the 90s.
Here are the excerpts that made me think it was doing a simple search-style comparison with the info in old reports:
“For the software to be successful, it needs to become aware of the context. Who is dictating—an orthopedic surgeon or a visiting nurse? What are they dictating—a letter or an operative report? And where are they in the document—is the dictation about the family history or the diagnosis?”
“As a result, we can interpret and structure disparate specialties and workflows such as radiology, neurology, mental health, etc, without the need to encode specific specialty knowledge to the application...”
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#105617 - 07/30/08 05:28 PM
Re: Intelligent Language Processing
[Re: MTBeach]
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Asugar515
Member
Registered: 11/28/06
Posts: 190
Loc: NYC - where English is the for...
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I thought the following quote from the article was quite the gem.
"We frequently hear that MTs do not want to go back to traditional transcription once they have started using speech recognition and are editing draft documents vs. typing from scratch. They are amazed at the accuracy of the drafts produced and how well the documents are formatted due to intelligent language processing."
LOL...this is a joke right?
Below is a link to a typical report from 1 of the worst offenders I have the displeasure of editing. I've screenshot and posted, removing all PII. Feel free to count up the edits.
I've mentioned plenty of times that SR cannot understand him because he speaks too quickly and he mumbles through his PE and labs. I've begged to have him taken off SR or retrain the system. Unfortunately, he's still on SR.
I sometimes come across reports that need minimal editing, but the bulk of the ones I come across are catastrophies such as this one.
As far as not dictating headers...I have a doc that dictates headings, but sometimes will give info regarding HEENT, general, vitals while dictating abdomen, rectal, lungs sections. SR doesn't know to place it where it belongs for THIS particular doc, but if other docs do that, 8/10 times SR gets it right.
I can't figure out why such drastic differences in SR accuracy. Supposedly where I work the system is always being tweaked to certain MEs, and I was told I'm one of them.
I'm amazed at the accuracy for sure!
Move your mouse over to the picture and wait for the expand icon to show, then click it.
Too bad when these vendors promote their VR/SR systems, they aren't using typical doctors for their promos...really show people what SR/VR program is made of, imagine that.
_________________________
"The patient has history of high per tension."
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#105623 - 07/30/08 06:00 PM
Re: Intelligent Language Processing
[Re: Asugar515]
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ahvasquez
Member
Registered: 02/07/03
Posts: 651
Loc: Texas
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Asugar, the example you posted is very similar to what I see for lots of docs I've edited on 2 different platforms. Some of them are so bad, I end up erasing the report and retyping it. I don't know how kindly this is received, but, geez, sometimes it's just ridiculous!!! OTOH, I have a few docs who require almost no editing at all (I grant you, a VERY few), and they're not necessarily the ones I would consider the best dictators. Go figure!
(Oops, hit Post too soon.)I would definitely be curious to see how the software in question handles it when it's a doc who skips all over the place in a report. I wonder if it would still know where everything goes? If so, it would have one up on me sometimes! <G>
Edited by ahvasquez (07/30/08 06:02 PM)
_________________________
Anne
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#105709 - 07/31/08 11:04 AM
Re: Intelligent Language Processing
[Re: ahvasquez]
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Wordcraftr
Junior Member
Registered: 02/11/08
Posts: 80
Loc: Midwest coast
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Probably everybody's done reading this thread, but I'm going to add a few cents' worth anyway.
Why is it considered a no-no for doctors to be trained how to dictate? Why can't they be given suggestions? Why can't they take a course that teaches them to be effective users of the language? Just because they're doctors doesn't mean they are "above" the need to learn. When they sign up with a service, the LEAST they could do is read a list of basic guidelines on how to dictate. Is it too much to ask that they become conscious of the fact that there is a human being at the other end? A human being that is no less "worthy" than they, medical training notwithstanding.
I don't like hierarchical strata. We are all in this together, and the outcome for all should be quality medical records.
Is that too much to ask?
_________________________
Gravity. It's not Just a good idea. It's the Law.
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#105712 - 07/31/08 11:18 AM
Re: Intelligent Language Processing
[Re: Wordcraftr]
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tropsicleAfter
Member
Registered: 10/30/06
Posts: 2725
Loc: Vicksburg, MS
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The historic and natural barriers to what you desire, Word, are that doctors do consider themselves above the 'typists'. They dictate, by and large, not because they want excellent documentation, but because they are required to by their employers or by the insurance companies that hold the money. Could they read a list of basic guidelines? Sure, and they actually do, so that they can properly (most of the time) enter patient demographics, etc. Likewise, hospital administrators see the doctors as revenue generators and MTs as a cost. Slow down the money-making machine in order to have doctors dictate better? Not cost effective, not in the eyes of the CEOs and bean counters, and probably not in practicality either.
I'm not defending them in the least, but I have made peace with this aspect of this job. Letting go of the angst over poor dictators makes my day much nicer and allows me to keep going in this job.
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tropsicle
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#105718 - 07/31/08 12:00 PM
Re: Intelligent Language Processing
[Re: tropsicleAfter]
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Wordcraftr
Junior Member
Registered: 02/11/08
Posts: 80
Loc: Midwest coast
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Yeah, I guess that's not the hill to die on, for sure. Things aren't going to change, and that's for sure, too.
Given the state of medical care and the bean counters that drive it, I've decided to boycott allopathic providers altogether for my personal medical needs.
_________________________
Gravity. It's not Just a good idea. It's the Law.
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#107098 - 08/11/08 12:57 AM
Re: Intelligent Language Processing
[Re: Asugar515]
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Kimberley
Junior Member
Registered: 11/07/03
Posts: 87
Loc: USA
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I forget what platform it was, but one that I used couldn't do numbers properly. If the number one hundred thirty-seven was dictated, it would print out 100 30 7. This was a lot of fun in the lab data paragraph - not. This is the kind of stuff I get on the SR platform I use, too.
And every time a number ends in an 8, it puts a 0, and if it ends in 0, it puts an 8 (i.e., 78 becomes 70, 70 becomes 78).
This platform is supposed to be so fabulous and do almost all the formatting for you. Well, it doesn't. It puts weird things in headers and doesn't put things in headers that need to be. It puts headers all out of order in an op report and I have to take it all out and put everything in the correct section.
Yeah, it practically does the work for me. Uh huh yeah.
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Moderator: Nae
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