Without a doubt, doctors are constantly inundated with advertisements and promotions for new devices and software products aiming to better their practices. But no one wants to invest in expensive technology that's only going to go belly-up in six months. To get a better idea of which technologies have recently undergone a technical leap, but still look like they'll be around for a while, we plumbed the knowledge of three healthcare technology experts. Here's what they had to say about seven classes of technologies and tools.

1 Transcription Tools.
When it comes to high-tech tools, Maxwell IT President Tracy Maxwell's favorite category is the latest generation of voice-recognizing medical transcription systems. "They've improved the technology drastically. There's still a learning curve of a month or two to train it to your voice, but once you do, it can be used with EMRs and it can be used without them," she says.

The new class of voice-recognition devices does a much more accurate job because they've been programmed with medicine-specific vocabularies, Maxwell explains. In addition, the programs can be taught to recognize a spoken abbreviation such as "RC" but type out "radical cystectomy." The most popular product is Dragon by Nuance, but GE Healthcare also sells a solid product, as does Microsoft, Maxwell adds.

2 Electronic medicalRecords Systems.
Sure, not a day goes by without an expert declaring that now is the time to go digital. But a few things are happening in the EMR market that might cause you to consider the technology a bit more seriously nowadays, say Erica Drazen and Walt Zywiak of Falls Church, Vir.-based healthcare information technology consultancy Computer Sciences Corporation.

First, relaxation of the Stark regulations limiting hospitals' subsidies to physician practices make EMR systems cheaper for some doctors, while the technology itself has generally improved and implementation has become more rapid, Drazen says. Recent improvements the pair mention include: off-site databases that allow practices to pay for EMR systems as an ongoing service, rather than as a single big purchase; better EMR integration with hospital systems; and more of them deal with both financial and clinical information. At the same time, the Certification Commission for Healthcare Information Technology has put a floor on the market, says Drazen. With a large number of EMR solutions on the market, doctors had neither the time nor the expertise to differentiate among them, she says, but CCHIT sets a high bar for the whole market.

3 EMR-Compatible Medical Devices.
For those doctors who have made the jump to EMR systems, Maxwell suggests taking a look at the clinical devices you can plug into them. You'll find number of familiar tools with updates that allow them to not only smoothly add their data to patient records, but also do their own calculations; EKG devices; Holter monitors; blood-pressure cuffs; and temperature and weight tools. "My favorite one is the spirometer from MidMark Diagnostics," Maxwell says. "The system automatically calculates the respiratory information so that the medical assistant doesn't have to calculate it by hand ... and it checks to make sure that the test was done accurately," eliminating some appointment rescheduling, she says. They've even become a little bit fun, Maxwell adds: "It's incredible how they've automated these tools in the office to make them almost like a game-they also have a video screen where people have to blow monkeys off of a tree."

4 E-Prescribing PDAs and EMRs.
With payer incentives and even an upcoming Medicare bill in Congress urging doctors to adopt e-prescribing, the technology looks like it might soon be a necessity. "PDAs, definitely, are useful for e-prescribing," says Maxwell, mentioning the popular Dr. First brand as an example of vendor software that can teach your PDA new tricks. "But e-prescribing that's bundled with an EMR is going to be better," she adds.

"It saves the health plan money because it enforces formulary management and switching to drugs that are on formulary," explains CSC's Erica Drazen. "Also, if you have all the doctors online, you can do things like check for duplicate prescriptions and you can, in theory, figure out if the patient ever picked up their prescription," she says. The technology is also useful for catching patients who are doctor-shopping for drugs of abuse, she adds.

5 Check-in Kiosks.
Check-in kiosks don't make practical sense for small offices with minor patient flow. But if your practice gets a fair number of people coming in daily, kiosks can save a lot of time by handling much of the initial patient-visit "paperwork" automatically, say CSC's Drazen and Zywiak. Asked how much traffic it takes to make kiosks useful, Drazen says, "It depends-we see oncology clinics that are 20-person practices that are using them, just because they have so many people who come back regularly." And they're inexpensive and usually easy to implement, Drazen adds. "Many of these technologies are pretty easy to implement-they're standard technologies-they're available through non-healthcare companies, so they don't mark up the price tremendously."

Smaller practices might consider Web-portal style Internet services that allow pre-registration and pre-certification, suggests Zywiak.

6 Patient E-Communication Systems.
"Patient e-communication systems are like using e-mail, but they don't use existing e-mail networks-instead, they use secure networks," Zywiak says. Most of the patient e-communication systems allow you to do several routine tasks remotely that would ordinarily eat into a physician's or staff member's time, including scheduling appointments, transferring lab results, sharing immunization records, and even accepting payment, say Drazen and Zywiak.

"There are practices that are using service providers to do just the e-communication with patients and the billing, but most of the stuff that's happening is around people that have EHRs in place," Drazen says, mentioning Relay Health's e-communication products as examples. "You can actually get started with e-communications without a huge infrastructure and IT department," she says. Many of the technologies in this category can be packaged as part of a patient Web portal, "and I think that's going to be big," she adds.

7 Outbound Messaging Systems.
"A lot of people are hesitant to invest in outbound messaging systems," says Maxwell. "I think the greatest fear they have is that the system won't provide a warm and feeling voice for their patients," she explains. "They should take a second look, because of the increased sophistication in personalizing the messaging system, and also the cost savings involved-just the labor cost alone in making calls makes this a huge return on investment." While most of the familiar messaging systems of yesterday relied on computer-generated, robotic sounding vocals, the new generation can be programmed to speak in anybody's voice.

The newest outbound messaging systems also have extended capabilities, and they can be tied into an EMR system or into plain scheduling systems for even greater automation. "For automated tasks, they can do call reminders on the day before a patient's appointment, or they can do lab results," says Maxwell. With such a system tied into a practice's EMR, which itself receives lab results directly from the source, you can arrange to have the messaging system call patients automatically to deliver lab-result information to a specific phone number. Security is handled up front with a form that allows patients to designate a phone number where it's OK to call with medical results. "It can also leave messages in text-message format on a patient's cell phone," Maxwell adds, noting that the most popular outbound messaging system is made by TeleVox.