PITTSFIELD, MA – Doctors at Berkshire Faculty Services, a multi-specialty group practice affiliated with Berkshire Health Systems, are poised to ditch telephone dictation in favor of dictating straight into their PDAs.

That makes the group of 42 physicians and 14 nurse practitioners and physicians' assistants part of a growing trend of clinicians turning to mobile dictation as the preferred way to record their patient notes, say industry observers.

It makes sense, says Donald Burt, MD, president of Berkshire Faculty Services. Dictating into a PDA means doctors have their patient list and other patient information, such as lab results, all on the same device. It helps keep notes timely and accurate.

Berkshire is nearly done with the implementation of its electronic medical record system in the inpatient setting, Burt said. Now, it will turn to the ambulatory care setting, with billing and scheduling technology slated for rollout on June 1, and clinical applications in the fall.

Berkshire will roll out mobile dictation technology from Boston-based PatientKeeper, one of several vendors, including Dictaphone and MedAptus, that offer similar applications.

The traditional telephone dial-in process for dictation is cumbersome, said Stephen Hau, vice president of marketing and business development for PatientKeeper.

Using the dial-in system, a physician has to find a free telephone, dial an 800 number and then punch in a series of 12-digit numbers that include a provider ID and patient ID. If the physician punches any one number in error or is called away in the middle of dictating, he has to start the process all over again.

Dictating on a PDA eliminates the punching. Instead, the physician scrolls down his list of patients, selects the patient and begins dictating. Once he's done, he hits the "done" button, and the audio file is transmitted to the transcription firm. If the physician is interrupted during dictation, he has the option to pause the process or save a draft and return to it later.

"One thing I really like about our solution is we're not re-engineering the process," Hau said. "We're taking unnecessary work out of the process."

For Berkshire, transcription costs total nearly $1 million a year, said Darlene Rodowicz, associate vice president of finance for Berkshire Health Systems. That figure doesn't include costs for patients' progress notes that are currently handwritten on paper charts. Rodowicz expects transcription costs could triple if the notes were dictated and transcribed.

She expects mobile dictation will save money because of its faster turnaround time and reduction of errors.

Mobile dictation is powerful, says David Delaney, MD, vice president of business development at Boston-based MedAptus and a physician at Beth Israel Deaconess Medical Center in Boston.

Mobile dictation makes it more likely that doctors will create an accurate clinical picture of what's happening and also develop accurate charge capture, he said.

"The best time to do dictation is the minute you walk out the room," he said.