Pain medicine dictation software for consults, injection procedures and opioid follow ups

A pain practice writes two kinds of notes. Consults and follow ups are narrative: where the pain is, what makes it worse, what has been tried and how the patient is getting through the day. Procedure notes are short and exact: level, approach, needle, contrast spread, injectate. General dictation tools were not built for "transforaminal", "spondylolisthesis" or "tapentadol". The Healthcare dictionary in VoicePrivate has 615 pain medicine terms, with neurology, orthopedic and surgical terms alongside.

Notes pain physicians dictate

New patient consult

Pain history with location, quality and radiation, numeric rating scale scores, the Oswestry Disability Index, prior conservative care, imaging findings such as Modic changes or ligamentum flavum hypertrophy, exam and plan.

Interventional procedure notes

Epidural steroid injections by transforaminal or interlaminar approach, medial branch blocks, radiofrequency ablation, sacroiliac joint injections, stellate ganglion blocks and trigger point injections, with fluoroscopy and contrast findings.

Neuromodulation

Spinal cord stimulator trial and implant notes, and follow up visits after the trial.

Medication management follow up

Response to gabapentin, pregabalin or duloxetine, opioid dose in morphine milligram equivalents, urine drug screen results and the prescription drug monitoring program check.

Letters

Prior authorization letters for procedures and letters back to the referring clinician.

Pain medicine words general dictation gets wrong

The Healthcare dictionary stores the mishearings it corrects. A few from the pain medicine list:

• "spondilolisthesis" to spondylolisthesis
• "fibromyalgea" to fibromyalgia and "polynueropathy" to polyneuropathy
• "tapentidol" to tapentadol and "oxymorfone" to oxymorphone
• "radiofrekwency rhizotomy" to radiofrequency rhizotomy
• "breakthrow pain" to breakthrough pain
• "kinesiofobia" to kinesiophobia
• "cervicalgea" to cervicalgia

A real drug name is never swapped for a different drug: the app drops any correction that would turn one drug into another.

What choosing Pain Medicine does

On Mac, open Settings and set the Medical specialty to Pain Medicine. Recognition is then primed with its core terms: radiculopathy, epidural steroid injection, transforaminal, interlaminar, fluoroscopy, facet arthropathy, medial branch block, radiofrequency ablation, neuropathic pain, gabapentin, pregabalin, duloxetine, buprenorphine, morphine milligram equivalent, urine drug screen, spinal cord stimulator, complex regional pain syndrome, stellate ganglion block, sacroiliac joint and trigger point injection. A long misheard word that is a near miss of one of those terms is matched to it first. On Windows there is no picker and the full medical dictionary is used for every note.

Example: a lumbar transforaminal epidural steroid injection

Click into each field of the note, press the hotkey, speak, and press the hotkey again. The text is pasted when you stop.

1. Indication. Press Command+Shift+Space and say: "Fifty eight year old with left L5 radiculopathy from a paracentral disc protrusion at L4 L5. Pain 7 out of 10 despite 8 weeks of physical therapy and gabapentin." Press the hotkey again.
2. Procedure: press Command+Shift+Space and say: "Left L5 S1 transforaminal epidural steroid injection under fluoroscopy. 22 gauge spinal needle. Contrast outlined the L5 nerve root and the epidural space with no vascular uptake. Injected dexamethasone 10 milligrams." Press the hotkey again.
3. Post procedure: press Command+Shift+Space and say: "Tolerated well with no complications. Pain 2 out of 10 before discharge. Discharged ambulatory." Press the hotkey again.
4. Plan: press Command+Shift+Space and say: "Follow up in 2 weeks with a pain diary. Continue gabapentin 300 milligrams three times daily and the home exercise program." Press the hotkey again.

Opioid follow ups

The CDC Clinical Practice Guideline for Prescribing Opioids for Pain (2022) recommends reviewing state prescription drug monitoring program (PDMP) data when opioids are started and periodically during long term opioid therapy, and it expresses opioid doses in morphine milligram equivalents (MME). Both checks end up in your note. VoicePrivate does not query a PDMP or calculate MME. You do both, then dictate what you found, for example: "Prescription drug monitoring program reviewed today, no other prescribers. Total daily dose 30 morphine milligram equivalents. Urine drug screen consistent with prescribed buprenorphine."

Into your EHR

VoicePrivate pastes through the clipboard and then puts back what you had copied, so there is nothing to install inside the EHR. It works in any text field that accepts a paste: Epic, Oracle Health (Cerner), athenahealth, eClinicalWorks and the procedure note fields of most practice systems. If your EHR runs in Citrix or another remote desktop, the session must allow clipboard redirection from your computer. The EHR dictation guide covers each one.

Procedure notes repeat the same sentences, such as the time out, prep and drape, and the complications line. Text shortcuts expand a short phrase into that full paragraph, which you then edit for the level and the patient in front of you.

On-device facts

Speech is processed on the Mac or Windows PC that runs VoicePrivate. Audio never leaves that computer, and nothing is sent to a cloud service for transcription. There is no recording of the visit: you dictate the note yourself after or between patients. With Auto-save transcriptions on, which is the default, each dictation is also kept in the app's Library on that computer. Turn it off in Settings if you want the record system to hold the only copy.

Price

Healthcare Edition is $297 a year or $34.99 a month per clinician. There is no free trial. Individual monthly and annual plans have a 30-day money-back guarantee on the first payment. Group practices of 2 to 20 clinicians can buy team seats.

Pain medicine dictation FAQ

Pain medicine overlaps with anesthesiology dictation, orthopedic dictation for spine and joint referrals and neurology dictation for neuropathy workups. Many of your patients also see a physical therapist, who can use physical therapy dictation with the same app.