Is Dictation or Typing the Most Efficient Documentation Method?

If there's one thing we can agree on as nurse practitioners, it's that time is a commodity. We're constantly pressured by the clock. Completing documentation can fall by the wayside as we move from patient to patient. I have a strict rule for myself - I must complete a patient's chart before I move on to the next visit. But, even so, I still find myself falling behind and scrambling to identify documentation shortcuts. Many of my coworkers dictate rather than type. Is dictating a better bet for charting efficiency?

There's not much objective data our there to shed light on the dictation vs. typing question. Creators of dictation software naturally tout its superiority. One study published by the Journal of the American Medical Informatics Association looked at the best way to produce quality electronic medical records. After studying 18,569 patient visits, the study concluded that quality of care appeared worse for dictators than for free typers or users using structured documentation formats. Another study published by the Journal of Medical Internet Research found that physicians using speech recognition had a 26% increase in documentation speed and logged longer notes. In a conflicting study in the Western Journal of Emergency Medicine, researchers found no statistically significant difference in time spent charting between typed data entry and voice recognition.  

When it comes to time spent charting, overall, the answer to the question seems to be a largely personal one. How fast of a typer are you? Does narrating a patient chart aloud in front of coworkers make you squirm? How well is your practice's EMR system set up to accommodate dictation? Dictating does require that the user re-read through the chart to correct any misinterpretations or misspellings which often necessitates a more thorough editing process compared with typers. 

If you aren't sure which documentation method is the most efficient given your personal skills and practice setup, take this documentation challenge. Time yourself completing a number of patient charts, say 20, with free typing/checkboxes (of course this time will be in pieces throughout the day - don't save 20 charts to complete back to back). Then, repeat the process on 20 diffeent patient charts with dictation. You'll want to include a sufficient number of charts in your calculations so one complex patient doesn't throw off the experiment. Which method is most efficient for you? Which did you personally prefer?

I'm a typer and plan to stick to my method. Typing works more seamlessly for me and I hate hearing myself dictate. Which documentation method do you find most efficient?

 

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