a manual control input, for example by means of a finger control on the steering-wheel, enables the speech recognition system and this is signaled to the driver by an audio prompt. Following the audio prompt, the system has a "listening window" during which it may accept a speech input for recognition. Simple voice commands may be used to initiate phone calls, select radio stations or play music from a compatible smartphone, MP3 player or music-loaded flash drive. Voice recognition capabilities vary between car make and model. Some of the most recent car models offer natural-language speech recognition in place of a fixed set of commands, allowing the driver to use full sentences and common phrases. With such systems there is, therefore, no need for the user to memorize a set of fixed command words. Health care Medical documentation In the health care sector, speech recognition can be implemented in front-end or back-end of the medical documentation process. Front-end speech recognition is where the provider dictates into a speech-recognition engine, the recognized words are displayed as they are spoken, and the dictator is responsible for editing and signing off on the document. Back-end or deferred speech recognition is where the provider dictates into a digital dictation system, the voice is routed through a speech-recognition machine and the recognized draft document is routed along with the original voice file to the editor, where the draft is edited and report finalized. Deferred speech recognition is widely used in the industry currently. One of the major issues relating to the use of speech recognition in healthcare is that the American Recovery and Reinvestment Act of 2009 (ARRA) provides for substantial financial benefits to physicians who utilize an EMR according to "Meaningful Use" standards. These standards require that a substantial amount of data be maintained by the EMR (now more commonly referred to as an Electronic Health Record or EHR). The use of speech recognition is more naturally suited to the generation of narrative text, as part of a radiology/pathology interpretation, progress note or discharge summary: the ergonomic gains of using speech recognition to enter structured discrete data (e.g., numeric values or codes from a list or a controlled vocabulary) are relatively minimal for people who are sighted and who can operate a keyboard and mouse. A more significant issue is that most EHRs have not been expressly tailored to take advantage of voice-recognition capabilities.