Tuesday, December 27, 2011

If you are a medical provider and you do this, we hate you

...Dropping the humor mask for a moment, folks. Please take a look at the following post over on the excellent Dr Grumpy's blog: http://drgrumpyinthehouse.blogspot.com/2011/12/beware-of-dragon.html

It seems providers using front-end speech recognition--sending the dictated drafts straight to the chart without proofreading or editing--have finally been forced to unhappily recognize what we at Horse HQ have been illustrating for a while now: Despite the urgings of VR vendors waving fistfuls of dollars in sweet cost savings, VR's vaunted low error percentage is nowhere near what's advertised; the much-touted learning algorithms are not all that, either.  (At my hospital, e.g., VR software remains unable to recognize the word "gout," after over two years and literally thousands of corrections. But I digress). 

So some medical providers now must recognize that there are errors in the speech-recognized reports on their charts. Oh, dear. What do they do? Do they decide to take  time out to proofread each report, or have an experienced professional do it for them, or have someone, anyone do it for them? 

No. That might increase costs. Can't do that. Instead, they make the obvious choice: A magical solution. They accept the errors; nay, they embrace them, for  powerful magic exists that can make mistakes disappear: A disclaimer!  Who cares if bizarre VR errors make a well-educated medical professional appear sloppy and careless at best, and at worst, compromise patient care? There's a disclaimer!  Right there on every report! Powerful juju against disrespect, bafflement, expanding confusion, and lawyers! All they need to do is be up-front about it: Tell the world their reports are generated by speech recognition, and then... any errors or omissions are not their fault.  

It will be interesting to see how this disclaimer thing plays out...sure, technologic change is a juggernaut that can't be stopped, but even so, reason must step in, here. Magic, not so much. 

Wednesday, December 21, 2011

Self-control during the holidays... often a problem

"Ms. Patient sustained a mechanical fall last night. She reports she was getting up from a binge at a restaurant."

("... getting up from a bench...")

Where there's smoke there's... oh, wait

"Discharge diagnosis: Tobacco habitation."

You know how there's "green" housing? Well, I think we can safely say this is the opposite of that. (It was "tobacco habituation," BTW).

Monday, November 21, 2011

A unifying diagnosis will be challenging

"He has had 2 prior stents and no sex."

Maybe they're trying a new type of cardiac rehab. You never know.

Those darn patients, always with the drama

"This elderly female has dramatic heart disease." 

(Dictated was "rheumatic heart disease"... much less dramatic)

Sunday, October 16, 2011

This might raise a few eyebrows over at the pharmacy

In med list: "Narcotic 800 mg q.d."

(Dictated: "garlic...")

Dr Obvious: He knows more than you do

"The patient was born in Localtown, to her biological parents." 

Glad we cleared that up. Because sometimes, people are born to... wait, never mind. 

Tuesday, October 11, 2011

Sunday, October 2, 2011

I'm not as think as you drunk I am

"The patient had ultrasound used to guide the placement of her wine." 

Tuesday, September 27, 2011

There might be a problem with this EEG

"The background consisted of 20 to 40 microvolts, to death." 

Wednesday, September 21, 2011

We're gonna need a bigger brace

This just in: Healthcare benefits extended to tall buildings!

"The patient wears elastic braces on his 28th floor."

(Dictated: "...braces on his knees for....")

Monday, September 19, 2011

The doctor will see you now, Mrs Bass

"This is a very pleasant 62-year-old widemouth female."

(Dictated: "...white female...")

Tuesday, September 13, 2011

Dr Obvious attends to detail

"The patient lives in Nearby County with his wife, who is still living, and is currently present in the room."

(It's good that she is still living, as zombies aren't yet included in the hospital's Infection Control plan.)  

Sunday, September 4, 2011

Oh, speech wreck, you so silly


Dictated: "Family history noncontributory." Perfectly clear dictation. Why did "gore" appear instead? We are not to know, my friend.

Thursday, August 18, 2011

No bacon for you!

"The patient states he had no more hogs or problems since the early 80s."

(Dictated: "...no more heart problems...")

Sunday, August 14, 2011

Don't be the problem, be the solution

"The patient is a normally dissolved female who is currently resting in the bed."

(Or is she the precipitate? Yes, Horse is still a science geek at heart.  Dictated was: ..."normally developed...)

Sunday, August 7, 2011

You'll find it in the last place you look, you know

"MRI of the brain was performed to relocate this patient's brain."

(Dictate was "re-look at," which makes me grind my teeth, but never mind).

Friday, August 5, 2011

I think we're gonna need a bigger drill


(From a Peds. dentistry note--"early childhood caries").

Tuesday, August 2, 2011

Gone fishin'

"The patient confirms some piscatory preoccupation and delusional thinking." 

(For fishermen, aren't those two the same thing? . . . Dictated was "persecutory preoccupation...")

Sunday, July 31, 2011

Sunday Speech WRx

Latest batch of Speech WRx. They all appeared in draft medication lists, just as you see them below. See if you can guess 'em all. The last one is pretty obscure, so you should just give up.

1. Back to now

2. for a valid 

3. awoke again

4. clipped a real 

5. climbs up 

6. travels first  

7. Pus drained 

8. than the mouth pain 


1. Actonel
2. chlorthalidone
3. amlodipine
4. clopidogrel
5. clonazepam
6. travoprost
7. Fosrenol
8. bendamustine

Thursday, July 28, 2011

Ow. Ow. Ow. Ow.

"She has a burning IUD in place."

(Dictated: "... a Mirena IUD in place.")


... Yeah, so I've caved . . . Never one to be hasty, I've given in after a mere year and a half of horsing around here and gone on Twitter. Why? I have no idea. The blue birdie button's over in the right-hand column somewhere. It's mostly going to be posts from this blog; not sure if I'll be adding anything more... you never know.  But feel free to, you know, retweet, or whatever people do. 


Taking 'sympathy pain' too far

"The patient and his wife were both resting comfortably following Dilaudid."

(Thanks to VR for this one. Finally got around to it).

Wednesday, July 27, 2011

I'd be uncomfortable too

"A very uncomfortable female. She looks like a kidney stone." 

(See, what happened was, while I was looking for a normal boring image of a kidney stone, I found this picture of a kidney stone with William Shatner's face. This is much better, don't you think? No, I'm not going to explain it; you'll have to google that yourself.)

Tuesday, July 26, 2011

Baron Munchausen, the doctor will see you now

"...the latter diagnosis is less likely, as the patient is not exhibiting the full consolation of symptoms." 

(Dictated: "...constellation of symptoms."

I'm feeling bad because I totally missed International Munchausen Day, but at least it provided us with this awesomely bizarre illustration).

Monday, July 25, 2011

Beer. It's what's for dinner.

"The patient underwent paracentesis with 2 beers taken off."

(... 2 liters taken off. Of course, the procedure was for alcohol-related cirrhosis, so we can squeeze a few more snickers out of it. We're pathetic). 

Tuesday, July 19, 2011

Teacher teacher I declare

"Eye movements are conjugate and full, with some psychotic intrusions on her student." 

(Dictated: "...with some saccadic intrusions in pursuit...")

Of Speech Wreck, Censorship and iPhones

There's a whole world of speech recognition software and hardware and apps and stuff going on out there, in case you weary delvers in the medical dungeons hadn't noticed. 

So I thought I'd share this delightful blog post with you; though not new, this matter of the Dragon iPhone app censoring its users was new to me, which is just as good. And the post is funny and well-written (and despite the subject matter, completely SFW, not that you'd be reading this at work, you scoundrel). 

Sunday, July 17, 2011

Plumber, heal thyself

"He has worked as a plumber but is currently unable to void."

(Dictated: He has worked as a plumber but is currently unemployed.)

Thanks to the ever-helpful JP for both the wreck and the caption!.

Sunday, June 12, 2011

Blah, blah, blah... (yawn), blah... wait, WTF?

"Hypokalemia may be mediated by her hydrochlorothiazide. I would expect her lisinopril to kill her."

(Dictated was "expect her lisinopril to counter...")

Thursday, June 9, 2011

Dr Obvious is in the house

... or maybe it was just too soon after watching Hitchcock's "Psycho":

"Social history: The patient takes care of his mother.
*  *  *  
Family history: The patient's mother is still living."

Not a speech wreck. Just to keep you on your toes. 

Thursday, June 2, 2011

Yeah, we've got an outbreak of that here, too

"Patient also has a diagnosis of ringed nose phenomenon."

(Approaching pandemic? ... Thanks to V.R. for this one!) 

Wednesday, June 1, 2011

Doc has a gift for understatement

"The arm and wrist were removed and there was noted to be stability of the joint."

In Soviet Russia, speech wrecks you!

"Mr. Xxxxovich is a pleasant elderly male from unbearable Russia."

Tuesday, May 31, 2011

It could be worse. I think.

"He lives with his wife, who is still living, but who also has some health problems." 

Fun With Names, It's Been Too Long edition

Yeah, it has been a long time, hasn't it? 

Dr Bronco Rhonchi 

Dr. Rub Steroid 

Dr. Scatterbrain

Dr. Is Not In 

CONSULTING PHYSICIANS: Dr. Are Not, Dr. Already Well 

 ...and we have found just the right facility for all these guys:

Failure Medical Center 

Wednesday, May 25, 2011

tough love

"The patient will be kicked in the chest pain observation unit overnight."

Monday, May 23, 2011

Umm... might want to try a different specialist

"He had no response of his wide-complex tachycardia to a dentist in the emergency department." 

(Dictated: "... to adenosine...")

It's probably not contagious

... Culture positive for gram-positive cockeye.

Tuesday, March 1, 2011

Mrs Gingrich, the lawyer will see you now

"Further care pending divorce in the hospital."

(Oh, dear, that was kind of political, wasn't it. How naughty.)  

And he wan't amused either. 

(Dictated: "...pending course in the hospital.")

Coming soon: The Skeletina diet

"I want to lose weight. I want to be faxed." 

(Dictated:  "... I want to be back [to my old self].") 

Thanks to SO for this one!

Friday, February 18, 2011

Docs versus Zombies!

"He is, of course, at risk of acute decomposition."

(Dictated: "...of acute decompensation")

Monday, February 14, 2011

Speech Wreck: Valentine's edition

Speech Wreck has a sentimental side, and what better day for a glimpse of it. 

Check an echocardiogram. 
Sputum culture. 
A little tenderness."

Being the jaded old cynics we are, we happily observe that Speech doesn't neglect the, er... friskier side of things, either:

"Again, special note, I discussed this patient in bed with Dr. Attending."

(Dictated: "...I discussed this patient in depth with Dr. Attending." Thanks to the eagle eye of JW for this one.)

Thursday, February 3, 2011

New diagnosis

The patient has a "history of chronic NERD."

Dunno about you, but I'm guilty as charged.

Sunday, January 2, 2011

Hold the lox

"The patient is a pedestrian struck by a bagel tonight."

Happy New Year, everyone, and watch out for giant bagels in the streets.

("... struck by a vehicle..." And thanks to S.O. for this one!)