As the heaviest "dictators" in healthcare, radiologists are most likely to welcome voice recognition for dictating reports. Thorough planning, ample support, and improved efficiency and turnaround times have facilities talking up voice recognition's capabilities. Long looked at as a futuristic application, for many the future is now.
In on the ground floor
While some hospitals and imaging centers have made the switch recently or are in the process, Next Generation Radiology in Great Neck, N.Y., integrated voice recognition into its RIS-PACS when it opened its doors in 1998. Medical Director David Katz, MD, wanted to bypass the need for transcription altogether. The practice went through some trial-and-error but has been getting near 100 percent recognition with the Dragon NaturallySpeaking solution from Nuance for the past two years. Director of Information Systems Daniel Castaldo calls the product "exceptional. We've tried and tested other products and this offers the highest level of speech recognition."
Voice recognition for the practice's nine radiologists at four locations is second nature, Castaldo says. "Economically it works. It's definitely the way to go." The physicians can have their reports on a web site for referring clinicians - usually within 22 minutes of the study being completed. The efficiency means that the report is usually complete before the patient can even finish changing clothes and leave the practice. There have been occasions where the report results have led to the need for further imaging - and with the patient still at the practice, those additional scans could proceed right away rather than having to schedule another appointment.
Radiologists new to the practice, yet in an older age range, can find voice recognition and the PACS software a bit more challenging, Castaldo admits. But after their first few days of adjusting, "they love it," he says. They quickly appreciate the vast difference in turnaround time. The editing usually takes seconds as opposed to sending out dictation to a transcriptionist, getting the report back perhaps days later, and still needing to read through and edit the documentation.
At United Hospital System, which serves southeast Wisconsin and northern Illinois, PACS Manager Jeff Sculuca is in the process of preparing to add voice recognition in the radiology department. PACS was installed about three years ago with little success. Now, he's working on replacing that system. Once the staff has had some time to adapt to the new PACS, Sculuca plans to integrate voice some time in 2006.
He's getting a mixed response from radiologists about voice recognition while he researches and evaluates vendors. Some physicians are hesitant and some are excited. With that in mind, he's planning for a system that allows the radiologists to use voice recognition but also fall back on transcription if they prefer it or if the voice system goes down. Those using voice recognition will have their reports dictated on the back end. Sculuca hopes to find a transcription vendor that can guarantee a maximum six-hour turnaround time 24 hours a day, seven days a week.
Once Sculuca is further along with the new PACS installation, he plans to schedule on-site demonstrations of voice recognition solutions for the radiologists. They can explore the various capabilities over the course of about a week and provide their feedback. "I know that these systems are learned over a period of time," he says. "One week may not be enough time, but it's enough to give some sense of which system is easier to use."
Patience pays off
Jean Plummer, manager of radiology informatics at Baylor Health Care System in Waco, Texas, has been watching the advances in voice recognition capabilities since 1997. In 2000, her organization decided to first pilot speech recognition within its radiology department. The goal was to improve turnaround time and reduce transcription costs. With an ongoing shortage of experienced, qualified transcriptionists across the country, Baylor was paying high rates for outsourced transcription. They also wanted to ensure that the voice system was fully integrated into PACS so that radiologists could pull up exams and start dictating reports right away.
Voice recognition has been in use at a small imaging center since May 2003 and throughout the health system since January 2004. The organization deployed PACS and made sure the staff was comfortable with that before introducing