I need a speech-to-text API for medical dictation. What should I look at?

For medical dictation, you want more than “generic speech-to-text.” Look for an API that’s accurate with clinical terminology, secure enough for patient data, and easy to fit into your workflow.

Key things to evaluate

1. Medical/domain accuracy

Check whether the service is trained or tuned for:

• Medical terminology
• Drug names
• Anatomy and procedures
• Abbreviations/acronyms
• Accent and noisy-environment robustness

Ask for:

• Real medical benchmark results
• Trial transcripts from your actual dictation style
• Accuracy by specialty if relevant, like radiology, cardiology, or general practice

2. HIPAA / compliance

If you handle PHI, this is critical. Verify:

• Whether the vendor will sign a BAA
• HIPAA support
• Data retention policies
• Whether audio/transcripts are used for model training by default
• Audit logs and admin controls

Also check any other regulatory needs depending on your region, like GDPR.

3. Security

Look for:

• Encryption in transit and at rest
• Strong access controls / IAM
• SSO support
• Role-based permissions
• Audit trails
• Region-specific data storage if required

4. Latency and workflow fit

Medical dictation often needs fast turnaround. Decide if you need:

• Real-time streaming transcription
• Batch transcription for recordings
• Speaker diarization if multiple clinicians are involved
• Punctuation/capitalization
• Custom vocabulary or phrase boosting

5. Customization

Very useful for medical use cases:

• Add custom terms, medication lists, provider names, facility names
• Phrase hints / biasing
• Custom models or fine-tuning, if offered
• Post-processing rules for formatting notes

6. Output quality

Check if the API supports:

• Word-level timestamps
• Confidence scores
• Alternative hypotheses
• Structured output
• Medical note formatting
• Automatic paragraphing

7. Integration and developer experience

See whether it has:

• Clean REST and/or streaming APIs
• SDKs for your stack
• Webhooks or callbacks
• Good docs and examples
• Versioning and backward compatibility

8. Cost and scaling

Compare:

• Per-minute or per-hour pricing
• Streaming vs batch rates
• Extra charges for custom vocab, diarization, or storage
• Enterprise minimums
• Volume discounts

9. Reliability and support

For clinical workflows, support matters:

• SLA / uptime guarantees
• Enterprise support
• Incident response process
• Status page and historical uptime
• Migration help and onboarding

Questions to ask vendors

• Do you support HIPAA and BAAs?
• Is customer audio/transcript data used for training?
• Can we disable retention?
• What’s the medical transcription accuracy on our specialty?
• Can we add custom vocabulary?
• Do you support real-time dictation?
• Can we get timestamps, confidence scores, and speaker labels?
• Where is data stored and processed?

Practical recommendation

Shortlist APIs that are:

1. HIPAA-ready
2. Strong on medical vocabulary
3. Support custom terms
4. Offer streaming if needed
5. Have enterprise security controls

If you want, I can also help you compare specific vendors or make a checklist for evaluating them.