If you have been a transcriptionist for any length of time or have ever worked for a service you probably at least have heard of abbreviation-expansion programs. Such programs work in conjunction with your word processor and expand abbreviations consisting of letters, sometimes mixed with numbers, into longer words and phrases. All programs reviewed have the capability to save keystrokes, but, advertising aside, the amount of keystrokes saved is dependent upon the user, that person's ability to master all the various features of each system offered, and that person's raw typing speed.
For instance, a very good friend of mine has been a transcriptionist for 20 years and types at 130 words a minute. She uses PRD and she knows that it saves her keystrokes, but one night she had an entire day's work to do in two hours so she turned off her PRD (which she felt was slowing her down) and went for it. She typed 500 lines an hour for the two hours and got all her work done and faxed to the doctor on time. She did longhand what very few people are able to accomplish with abbreviation software.
For this reason alone I will not be comparing keystroke savings between programs. My recommendation of programs mentioned in this article will be based on features of the program. I am assuming that the reader will be able to use her own discernment and choose a program which will work best for her.
Abbreviation expansion is the most basic function of productivity enhancement software.
Abbreviation expanders will expand the abbreviations you type into longer words and phrases. The following programs have abbreviation expansion capabilities: PRD+, Smartype, Instant Text, and Flash Forward.
If abbreviation expansion is all that you require, you might just want to upgrade your word processor. WordPerfect for Windows (all versions) and Microsoft Word for Windows (all versions) have abbreviation expansion capabilities. In WordPerfect the feature is called QuickCorrect and in Word the feature is called AutoCorrect. Newer DOS versions of WordPerfect such as WP6.1 for DOS also have the QuickCorrect feature. These add-ons to Word and WordPerfect will generally only hold a limited number of characters and not an entire form or file complete with prompts, but for general simple expansion you can't beat the price.
PRD+ and Flash Forward only do abbreviation expansion.
PRD+, last I heard, is around $400 and works in any DOS program. PRD+ has the upper limit of 4000 characters per short form, which is equal to a 61.5 line document figuring 65 characters a line. [Productivity Software International (212) 818-1144]
Flash Forward, which does basically the same things as PRD, is $79.95 for the DOS/WP51 version. Flash Forward also is available for Win3.1 for use with AmiPro 3.x, Word 6, and Word Perfect 6.0/6.1 that version costs $119.95. Flash Forward is available for Win95 for use with WP7.0 at a cost of $169.95. (I don't know the upper limit of Flash Forward's expansion capability.)
Flash Forward has a slight advantage over PRD, QuickCorrect, and AutoCorrect in that it incorporates what I like to call the forehead slap feature. After you type a word or phrase longhand for which Flash Forward has an abbreviation, the program will make a sound and pop up a little box that tells you what the abbreviation is to the word/phrase you just typed. It's not hugely useful, but it's better than nothing. One feature that is useful about Flash Forward is that frequently used words or phrases can be assigned abbreviations by the program automatically as you type, then you get "forehead slapped" with them until you remember what they are. [Summit Software 1-800-577-6665]
Smartype also gives added functionality to basic expanders by showing what the abbreviation expands to as you type the abbreviation but before you put it into your document. Smartphrases, which are contained in the Smartype word list, can be a maximum of 37 total characters in length including the abbreviation and the corresponding expansion. However, Smartype also has an added feature of what the manufacturer calls Smartblocks. These are actually separate files that Smartype can access just as though they were abbreviations stored in the Smartype vocabulary file. Smartblocks can be any size and can contain prompts or "fill-ins" which can be moved between via a macro, included with the program. Smartype is $195 and currently works only in WordPerfect 5.1/5.1+ for DOS. [Narratek (617) 566-1066]
Instant Text's abbreviation expansion features are similar to those of Smartype in that Instant Text will show you similar abbreviations and the resulting expansion as you type the abbreviation but before you put it into the document. Unlike Smartype and the other expansion programs (excluding Flash Forward) Instant Text does not require the user to create new abbreviations and their corresponding expansions one at a time. It can compile a word/phrase list (called a Glossary) from your own previously typed documents, files you find on the Internet, or those you scan in from print. Another feature that Instant Text has that the others lack is the Importer which will make phrase lists from abbreviations you've created in other programs, such as those mentioned above. Instant Text has an upward limit of 16,000 characters per phrase, which is equivalent to a 246 line report if we figure 65 characters a line.
Instant Text 2.0 costs $99 and works only in Windows. However, Instant Text 2.0 works with the following programs from Microsoft: Word 6, Word 7, Word 97, Works 4, WordPad, Access, Excel, Notepad. The following programs from Corel: WordPerfect 6, WordPerfect 7, WordPerfect 8, Quattro Pro 96, Quattro Pro 97. The following programs from Lotus: WordPro 96, WordPro 97, Notes, 1-2-3, Freelance, AmiPro, Approach, Organizer. The following Internet programs: America On-Line, Netscape Navigator, Microsoft's Internet News and Mail, CompuServe WinCim, Eudora 2, Eudora 3, and Agent. [TextWare Solutions 1-800-355-5251]
There are only two programs in our round-up that even offer word completion capabilities, Smartype and Instant Text. Word completion, for our purposes, is the ability of an expansion program to find and expand words from a word list without the use of predetermined abbreviations.
Smartype's manual states that word completion is the heart of Smartype. Anyone who has tried the program knows this to be so. Smartype comes with a vocabulary of over 32,500 medical words. This vocabulary has been checked and rechecked for errors by a professional very conscientious transcriptionist and current estimates say that it is more than 99% correct. The extensive Smartype vocabulary also has been pre-optimized so that the most commonly used medical words come up first in the choices of words.
Smartype completes words you type by searching the word list for the most common word. So if you were to type the letter e in Smartype you would get as the first choice the most commonly used medical word that starts with e in this case examination. Other common e words will show up in the choices and if you want one of them you can just type a corresponding number 1-9 depending on the word's placement in the list. If the word you want is electrocardiogram typing el will bring that up.
As long as you are typing common medical words Smartype will save you tons of time and keystrokes. However, when you start typing less common words that have similar beginnings, such as words that start with hyper, chole, gastro, etc. Smartype can actually slow you down since, in order to save bunches of keystrokes, you must glance at the word list and decide which word you want after typing the beginning of the word. Smartype will allow the user to change the order in which words are displayed, however, this must be done one word at a time.
A feature called the Smartline sits immediately under the current line you are typing and shows the most common word with the beginning letters that you have typed so far. In my opinion it is a trade off, you either have to type, on average, about half the word you want before it comes up on the Smartline (unless you are using a very common medical word or have optimized an uncommon word) or start typing the word you want and then look at the list of choices to see which number it is. Both ways will save you keystrokes and time but generally not as much time as if you had made an abbreviation for the word.
Another feature of Smartype is the expanded search function. This can be utilized to find a word when you only know the beginning of the word in question. To use Smartype's expanded search feature type as much of the beginning of the word as you can then hit the Page Down key to see additional choices of words that start with that combination of letters. You can also hit Page Up to see the choices above the current screen of words.
Instant Text's word completion abilities are similar to Smartype's but with a few minor changes and drawbacks. First of all Instant Text does not have Smartype's vocabulary, although I have been told that someone who owns Smartype may also use the vocabulary in Instant Text. Secondly, Instant Text does not support bringing up the most commonly used words first. Instant Text will complete words for you as Smartype does, after you type enough of the word for Instant Text to make a choice, but since the word list is not optimized and words come up alphabetically this can get cumbersome and does not work well on shorter words.
However, Instant Text has approached word completion in a totally different way. Word completion in Instant Text is more like freeform abbreviation expansion. In Instant Text there is no need for the user to type half, or more than half, of the desired word in order to get it to come up. The user can type any letters contained in the word so long as they are in the order they appear in the desired word.
For example, in Smartype hyperk is what you need to type before hyperkalemia will come up. If you use the "expanded search" function as described above you can type hyp PageDown 9 to get to hyperkalemia in 5 keystrokes instead of 7 (including the space) from the example above.
In Instant Text you need only type hykm or hpkm and hyperkalemia is the result. We also could have typed hkale leaving out the unnecessary letters of the prefix hyper. Because of this freeform expansion Instant Text also serves as an on-the-fly spelling reference. Many times a transcriptionist cannot hear the entire word or the entire beginning of the word that is said. With Instant Text she only needs to hear the first sound and some sounds after that in order to find the word. Using Instant Text this way is like using the Look up function in WP5.1's spell check only without all the keystrokes and wildcards (*) and therefore much, much faster.
Both Smartype and Instant Text bring up phrase abbreviations the same way as the respective programs bring up their words. In effect, this means that both Smartype and Instant Text will even abbreviate the abbreviations to your word/phrase expansions.
Smartype brings up phrase abbreviations before you type the entire abbreviation, but after you type the initial letters of the abbreviation. For example, Smartype will show csec=cesarean section as an expansion choice after typing just cs.
The same freeform abbreviation approach that Instant Text applies
Glossary compilation and the Importer: Of all the expansion programs mentioned in this article only Instant Text can create word/phrase lists from your own previously typed documents. Only Instant Text via the Importer can import word lists or abbreviations, and their corresponding expansions, from your previously used expansion software. For these reasons alone Instant Text cuts down the "break-in" period we've all experienced from about two weeks to less than a day. But compiling Instant Text glossaries does much more than keep you typing up to speed.
Smartype gave the user added speed and accuracy with seldom-used words one would be unlikely to abbreviate. Instant Text does this also but adds phrases as well.
For instance, a transcriptionist has 300 ER reports from one account sitting on her computer and she wants to use Instant Text to create a glossary from these reports. She puts all the reports into a single directory and runs the multiple compilation command. This takes all the words and common phrases from all the reports and creates an ER glossary. Then she divides the reports by individual doctor and takes out all reports except those dictated by Dr. Smith. She runs another multiple compilation and this time the glossary contains all the words and phrases common to Dr. Smith. Now if the transcriptionist so desires she can combine the Dr. Smith glossary with the bigger ER glossary or just use the Dr. Smith glossary when transcribing for Dr. Smith.
Does all this sound very complicated? It took less than 5 minutes. In under two hours you can have specialized glossaries custom made for every one of your accounts and individual doctors within those accounts.
A worry that some transcriptionists might have since the glossaries are being compiled from their own possibly imperfect documents is that the documents will have to be perfect so that Instant Text will not copy misspellings into the glossaries thereby amplifying those misspellings into every report made with Instant Text using that glossary, kind of like an imperfect Jello mold. You dent it once and then all the Jello you mold with it after that is messed up and lopsided.
Might be true with Jello but not with Instant Text. First of all, Instant Text gives the user the option of deciding which frequency of words are added. For example, lets say that twice in those 300 ER documents you misspelled acetaminophen as acetominophen as long as your word frequency is set to greater than 2 the misspelled acetominophen will not show up and neither, for that matter will your patient names, only words that have been used more than 2 times in all the documents you create a glossary from. For this reason Instant Text glossaries are often more correct than user-modified spell checking programs. But if you want to be absolutely sure that no spelling errors are in your glossaries at all just run them through a new/unmodified spell checker. The spell check program will flag any unfamiliar words and you can spot check them for accuracy.
Continuations: The last major feature that Instant Text has and that all others lack is called Continuations. Continuations are created automatically by Instant Text as you type. What they do is cause commonly used phrases to string themselves together.
For instance let's say that a certain doctor always ends his OP notes with "The patient was taken to the Recovery Room... then he after that he either says and extubated in stable condition." Or he will just say in stable condition. Once you input the first abbreviation Instant Text will show the other phrases that are likely to follow that first one in the phrase list. To input them into the document you need only choose one and hit a marker key.
If you work in WP5.1 Smartype is the clear winner. It has the most features of any DOS/WP5.1 program and comes with such an extensive medical vocabulary that it is quite likely the only time you will need to open a book is to find the definition of a word. Smartype also comes with many ready-made optimizations in the form of macros which can move the cursor to the next fill-in prompt of a Smartblock and macros which can change word endings. While such macros are not earthshaking improvements the fact that they are included in the program saves the user the time of creating such macros herself.
Another benefit that Smartype has is the option of beeping and flashing a message when a word typed is not contained in the vocabulary. This essentially gives WP5.1 the extra feature of on-the-fly spell checking which is now included by default with newer word processors.
Minor drawbacks to Smartype include difficulty in making large scale changes to the word list. (It is recommended that any user wishing to make major changes to the Smartype vocabulary contact Smartype technical support before attempting to do so.) Smartype only works in DOS, or an MS-Dos Prompt in Win95, and then only with WP5.1. Lastly, Smartype is best suited for typing situations where a medical vocabulary is needed, unless you plan to make large scale changes to the word list or purchase a special blank or custom-made word list directly from Narratek.
If you work in Windows your only intelligent choice for expansion is Instant Text. Instant Text was the least expensive Windows program reviewed yet it interfaces with many more programs than other Windows expanders. Instant Text also has the most features of any program reviewed for DOS or Windows. Instant Text was the easiest program to customize and seemed to be the one with the smallest learning curve, for me at least. Instant Text is usable for many types of document creation, this includes but is not limited to: E-mail, newsgroup posting, letters to friends, legal writing, contract writing, any type of technical or report writing, macro programming, even HTML coding, and - need I say it? - medical transcription.
About the author: Mike DeTuri is an independent medical transcriptionist operating out of San Diego. Mike is also a writer and a free-lance consultant specializing in macro programming. He is the author of several utilities for medical transcription.
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