Physicians spend up to 30 % of their time typing data into Hospital Information Systems (HIS), which causes financial, qualitative and societal costs. There is growing need to increase quantity of physicians and decrease costs. The population is aging and patients spend less time in care after treatment causing patient visits to increase approx. 2 – 4 % per year. Speech recognition technology is seen as a solution for effective patient document creation, though it has yet to fill its goal. During SME instrument phase I of project REALM we conducted a feasibility study on how to create fault free patient document for physicians for real-time sign-off without them having to use a keyboard and mouse.