Instant Text in the Press

WINDOWS TECHNOLOGY
Adds Visual Skills to the MT's Ear

by Robert T. Hill

ADVANCE for Health Information Professionals - September 9, 1996
Special to Advance

LAST MONTH saw the first anniversary of the release of Windows 95, the much ballyhooed operating system that is running increasingly more of the world's computers. Although Windows 95 is only one year old, Windows as a product line and the graphical user interface (GUI) as a concept are certainly not new ideas, GUIs have been in development for decades, and Windows was a latecomer in 1985 with the release of Windows 1.0.

By 1993 or so, most of the computing world had switched to the Windows GUI or one of its competitors — most of the computing world, but not medical transcriptionists (MTs). To date, the majority of MTs have resisted the pressures to switch to Windows, becoming one of the last bastions of DOS-based word processors and abbreviation software. However, as the medical records industry pursues the electronic patient record, Windows-based OLE-compliant software is required.

AS A result, medical transcriptions are starting to use Windows word processors and other Windows " productivity software," replacing the DOS systems of yesterday. Windows may not be new, but it is encountering new users in the medical transcription field.

Certainly, there are advantages and disadvantages to consider when choosing DOS or Windows professional transcription tools. Indeed, the are never-ending discussions about this taking place in Internet forums and office lunchrooms. While Windows systems do require faster processors and more memory, these are getting cheaper by the day. While DOS word processors may offer bare-bones efficiency for lightning-fast keying, Windows documents can be embedded in other Windows applications, a vital feature as computers move to a uniform interface for all applications and X-ray images on the same computer screen.

While some people still enjoy the option of deciding which system to use, others are realizing they must move to Windows. Whatever the reason behind the move, there are certain advantageous features in Windows that DOS does not have. Perhaps the greatest of these is the potential relief from the memorization and recall paradigm in favor of the visual recognition paradigm that is inherent in GUIs.

BY ITS very nature, Windows presents information visually, which is then recognized, as opposed to being recalled from memory. Many user actions are directed by visual cues. Rather than remember the sequence for opening a file, for instance, the user sees the File/Open pull-down menu and follows the clue. Or, rather than type out the name of an .EXE file one merely clicks on the icon for it.

This principle is also found in Windows transcription programs. And what is it that is presented for visual recognition? The words, phrases and terms of art are the stock and trade of medical language, our specialized vocabulary.

Consider the medical dictionary. Pick up a dictionary and turn randomly to any page that is mostly word entries (as opposed to images, charts, etc.). Scan the entries and see how many of them you can recognize or at least deduce an accurate meaning. Most people find they can recognize perhaps 70 percent of the words on a given page. If you assume a conservative figure of 400,000 words in a medical dictionary and compute 70 percent recognition, you have a potential vocabulary of about 280,000 words. Yet, our working vocabularies are perhaps 10,000 or 15,000 words, a fraction of the potential.

THE KEY is not to know every possible word but instead be able to use reference materials as necessary to invoke the words we need when we need them. We already use paper dictionaries and glossaries for this purpose. When transcribing, we may hear a word that we can't remember how to spell, perhaps "capsulorrhaphy." Traditionally, we have turned to glossary reference manuals to help jog the memory. On seeing the word in print we can deduce the information we need and go on. It is by such recognition skills that we wield extremely large vocabularies. It is often not necessary to define the word, only see it.

Windows abbreviation expansion programs like Instant Text (Textware Solutions, Burlington, MA) can use electronic glossaries to replace the paper ones. Up to 256,000 words and phrases can be on tap, ready to be displayed based on the guess of a few letters. Once displayed, the appropriate word or phrase can be selected. It's that simple. The model of using a reference manual no longer need be limited to flipping paper pages. Most words and phrases needed for the transcription task can be made available as visual cues in electronic, and therefore faster, format.

TAKE THE example of "capsulorraphy" in Instant Text (see Figure). By guessing a few letters like "cprr," the transcriptionist is presented with a display of all words in the current glossary that match the input clue "cprr." This word can then be selected for inclusion in the text being generated. It is not necessary to open a book or even remove the hands from the keyboard to find a visual memory aid and arrive at the correct spelling of the word.

Transcriptionists can use Windows technology to expand their working vocabulary by allowing them instant access to the thousands of words and phrases that they can recognize but perhaps do not remember. This is particularly useful for highly specialized vocabularies like medical language, where one often comes across arcane names like Rothmund-Thomson syndrome or complicated drug names like pHiso-Hex. With Windows, transcriptionists can use entire dictionaries as their working vocabularies, and both words and phrases can be made available for quick recognition and use.

Transcription still requires "the ear," but with Windows, transcriptionists can add "the eye." Windows programs excel at presenting information visually. For transcriptionists, this means that the words and phrases found in our reference materials can now be found before our eyes as well as at our fingertips.

THERE IS a vast difference between the number of words in our working vocabularies (those that we remember) and the number of words in our potential vocabularies (those that we can recall). The visual recognition paradigm that is inherent in Windows transcription software exploits this difference and dramatically increases the number of word and phrases that the transcriptionist can use. The bottom line for the medical transcription industry is that this may help to reduce the time it takes to turn a novice transcriptionist into an experienced veteran.

About the author: Robert T.Hill is a self-taught medical transcriptionist from New York who beta tested Instant Text.
He is also a free-lance writer and a Fossil Explainer with the American Museum of Natural History in New York.