Good day all,
I have been using Dragon Naturally Speaking for a number of years, and currently use DNS 10.1 Medical with a Plantronics CS55 wireless headset purchased from KnowBrainer a couple of years ago. This is an expensive setup but I have been very pleased and am able to use it in a fairly noisy office. I have a solo FP office and do my own coding.
Last year I started using the DNS Command Browser to translate clinical diagnoses into the ICD-9 codes that I can't remember. For example, for the clinical diagnosis of "Trochanteric Bursitis", the ICD-9 description is "Enthesopathy of hip region", and the code is 726.5. To create a new command, I click "Tools", "Add New Command". In the "MyCommand Name" field, say or type "code trochanteric bursitis". In the "Description" field I put the actual ICD-9 description "Enthesopathy...". For "Goup" click "User Defined". For "Availability" I make it application specific for Amazing Charts(Note: Amazing Charts will show up as an option only if AC is open at the time you are adding the new command), although you could also leave it global. The "Command Type" is "Text and Graphics". In the "Content" field I put in the ICD-9 code 726.5. Click "Save" and you are done.
Then, with a patient chart open, I am ready to input the diagnosis code in the "Diagnoses" window. Say "code trochanteric bursitis" and "726.5" shows up. Click the "Search Dx" button and the "Search Database" window opens with the appropriate code highlighted, ready to be added to the chart.
The way I have written this sequence it sounds like a cumbersome process, but in reality, once I have looked up the ICD-9 code it takes less than 30 seconds to create the new command in DNS and then input it into AC. From that point on it saves a lot of time by not having to look up the code again.
Variations on use:
1. Some clinical diagnoses have multiple names, so you can create a new command for each of these names at the same time with very little added effort (e.g. I might make one for "code trochanteric bursitis" and another for "code hip bursitis", each one inputting "726.5").
2. Some codes are body region specific using 5th digit coding. In this case you can either create a command for each region (e.g. "code joint pain shoulder", "code joint pain elbow", etc) or simply create a "code joint pain" using only the 4th digit specificity "719.4". Then when you input this in AC and click "Search Dx" it will bring up all the "719.4_" codes to choose from.
3. My trigger for creating a new command is whenever I have to go to the ICD-9 book to look up a code.
4. It is easy to later look at and edit your user defined commands by clicking "Tools", "Command Browser", "User Defined", then highlighting the code in question.
5. You can use this same idea to organize other user defined text. I am getting ready to create a list of "ROS ____", "Exam____", "Plan____".
6. This same process could also be used with a keyboard macro program such as "Shortkeys"
I now have probably 200 of these in my database, and it has saved me many hours of work and frustration by not having to dig through the ICD9 code book.
Hope this helps,
Paul
