Chris Lancelot on ... How to stop typing forever

What does your computer do for you? Get in the way of the consultation, I suspect. A few weeks ago our server crashed and we were computerless for five days. Suddenly consultations seemed easier and more relaxed. We could look patients in the eye. There was more time available: notes were easier to make on paper, and their contents more relevant.

So why do doctors use computers? The notes are more legible; and the computer will check for drug interactions and remind us about overdue or missing information. But the downside is considerable, especially for those clinicians who are one-finger typists: as a result, computerised records are usually more brief and less detailed than paper ones. In short, the computer gets in the way of the consultation.

What we need in general practice IT is what computer geeks call a 'killer app' (short for 'killer application'): software that is impossible to do without. Indeed, killer apps sell computers because they make them a necessity rather than a hindrance. For the Mac, the killer app was the graphics program; for personal computers it was the spreadsheet; for the internet it's the Google search engine.

But we do not have a killer app in medical IT. Read codes are all very well; shared and transferable notes are a timesaver; problem-oriented medical records are helpful and much easier to manipulate on the computer than on paper - but there's still no true medical killer app.

Until now. Might I suggest you try voice processing? Voice processors convert speech into on-screen writing. Older versions were haphazard in their accuracy (to put it politely), but modern voice processors can transcribe speech with 99 per cent precision and can even handle dialects and strong accents.

In the future, voice processing will allow doctors to make detailed notes in a fraction of the time needed for keyboard entries: in turn this will allow more eye contact with the patient. In the office, it will make the medical typist redundant, once clinicians start dictating letters directly into the computer. Just think of the financial savings.

Does it work in practice? This article was prepared using a voice processor (Dragon NaturallySpeaking 9) with almost 100 per cent accuracy, just three days after installing it. I'm off to put the same software on my surgery workstation because the future is voice processing.

Dr Lancelot, a GP from Lancashire. Email him at

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