However, the technologies have not yet proven to be reliable in noise-intensive real-world environments in the context of emergency medicine. A mobile platform based on ASR technologies has the potential to enable hands-free documentation by extracting medical information from the incoming audio stream without hand-operated input devices. Given the necessity of seeking solutions that will not degrade the clinical workflow, technology solutions using automatic speech recognition (ASR) have been explored for hands-free clinical documentation. The loss of time for direct patient care is often prohibitive in emergency environments as medical personnel have to continuously conduct hands-on interventions for patients to save their life and limb. A new challenge has arisen from the PDA-based design interrupting the flow of care when entering electronic health record (EHR) data using keyboards or a stylus. In the past, the United States Army Medical Research and Development Command has successfully deployed a PDA-based mobile platform that enabled efficient data entry to the electronic patient record and transmission of patient information through a wireless network. Adequate prehospitalization documentation plays a critical role in ensuring casualties’ maximal chance of survival in the operational environments. The US military has demonstrated an ongoing interest in potential technological approaches that enable efficient prehospitalization documentation at the point of injury in advance of a patient’s arrival to a field hospital. However, prehospitalization documentation is a challenging task and prone to loss of information, as paramedics operate under urgent and disruptive environments requiring their constant attention to the patient. Failure to report initial findings and interventions in the field may result in clinical errors such as inadvertent overdose due to duplicate administration of the same medication by paramedic and emergency department physicians. Complete and effective documentation of prehospitalization care informs clinicians and staff of presenting vitals and symptoms, the initial assessment of the condition, attempted prehospitalization interventions, and observed response to the interventions. A patient record documented in the field promotes a continuum of care, playing a vital clinical role in the subsequent treatment of patients in emergency rooms, trauma centers, or other receiving facilities. Prehospitalization information provided by the first responders is often essential to subsequent treatment efforts including the accurate assessment of a patient, medical diagnosis, and rationale for treatment decisions in the emergency care settings.
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