The practice of healthcare in the United States is faced with a double-edged sword: reimbursement is declining year-over-year, while the cost of providing medical services remains constant or increases. The implementation of enterprise-wide healthcare information technology (HIT) systems, such as electronic medical record (EMR) applications, promises to provide more cost-effective care in the future.

Information systems such as RIS and PACS have seen widespread deployment in radiology and their adopters have reaped the benefits of reducing costs while bolstering their practice’s capability to handle increased patient volumes. The addition of speech recognition technology (SR) to these systems can further reduce practice overhead, while providing a competitive advantage to the groups that implement them, according to Nick van Terheyden, MD, chief medical officer at Laytonsville, Md.-based Philips Speech Processing.

“Speech recognition can reduce costs by 30 to 40 percent, and early users will have a very high competitive advantage” van Terheyden said during a presentation at a recent American Healthcare Radiology Administrator (AHRA) conference in Orlando, Fla.

According to van Terheyden, the next 10 years will see more medical information learned and developed than has been captured in the whole of medical history. Radiology, in particular, is bearing the lion’s share of this information glut. According to van Terheyden, James Thrall, MD, of Massachusetts General Hospital in Boston projects that the radiology workload will increase approximately 50 percent by 2010.

As exam volume continues to grow, transcription costs will match pace; although reimbursements for the performed procedures may not. According to van Terheyden, approximately $12 billion is spent annually in the U.S. on medical transcription, making it one of the top five line-item costs of hospitals and healthcare systems.

“I think the question for everybody is not if, but when you should use speech recognition,” van Terheyden said.

He outlined five goals for automating clinical documentation:

1. Reduce physician time documenting
2. Improve availability of documentation
3. Re-use standard phraseology
4. Improve quality and consistency of documentation
5. Decrease the cost of documentation

The U.S. is the largest speech recognition user in the world, van Terheyden said. He stated that there are approximately 40,000 active physician users generating about 18 million lines per month with SR technology. As the need to reduce costs in healthcare delivery accelerates, van Terheyden believes that this user base will increase.

In addition to slashing transcription costs, SR technology provides the capability to deliver radiology reports faster than digital dictation. Quicker report delivery can result in better patient care, and can be a competitive differentiator for groups seeking to carve out or sustain their market niche.

As the practice and delivery of medicine becomes more complex, and the demand for services increase, currently employed workflows that rely on old-school technologies and systems will not be able to keep pace.

“Approximately 90 percent of healthcare in the U.S. is still managed by paper; be it mail, fax, or Post-It notes,” van Terheyden said. “That particular situation is unsustainable.”