Frank Talk on Speech Recognition

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University of Southern California Hospital uses Dictaphone’s PowerScribe.Speech recognition is providing radiologists and other specialists with improved efficiency for much quicker reports turnaround times — as long as they’ve chosen the right system. Success also requires good training and the right attitude across the facility.

After a disastrous first outing with speech recognition that lasted just eight days, Janet Korgeski, system administrator, clinical technology, at Moses Taylor Hospital in Scranton, Pa., didn’t give up on the technology. She is in the process of implementing SpeechMagic from Philips Speech Recognition Systems. For the most part, the physicians are “willing to give it a whirl,” she says. “They’re giving me another chance, and I wouldn’t be trying it if I didn’t think the product was worth it.”

Using SpeechMagic required writing an interface for the product between RIS/PACS and transcription. While that was an extra step, Korgeski says it worked out to their advantage because “by writing our own interface, we could customize it to work the way we needed it to.”

Saving time, increasing revenue

All of the radiologists at Moses Taylor are using SpeechMagic on the back end. They dictate their reports into the computer. Text is created and sent to a transcriptionist. The transcriptionist makes corrections and sends the report back to the physician for signature. That process alone has saved the hospital 30 percent of transcription time. Some physicians do not send their reports to a transcriptionist for editing and instead review them and sign off on them. That saves 70 percent in transcription time. The report is sent directly to the units and referring physicians. Either way, speech “is still saving us time,” Korgeski says.

While many hospitals look to speech recognition technology to save on transcription costs, Moses Taylor is taking a different approach. “We’re not looking at cost savings but revenue enhancements,” she says. The goal is to increase business by having more physicians order their tests at the facility. The institution is feeling the competition from two other hospitals in the same market as well as standalone facilities popping up in the area. The biggest goal right now is providing same-day service, where, for example, a physician can order an MRI and have the procedure performed the same day. That is a service some of the smaller imaging centers offer, and Korgeski says Moses Taylor wants to compete with that service.

So far, the hospital has been able to increase its revenue by about $400,000 in the past six months just by bringing in more outpatients. Transcription FTEs have not decreased; rather, the department is now offering more services to physicians. For example, they have created the shell of a discharge summary, which means three-quarters of this thorn-in-the-side task is already done for physicians. “It is a real feather in our cap as far as a service we offer. It has attracted new physicians,” Korgeski says.

Meanwhile, Korgeski will move individual physicians to front-end use of speech over time. Not everyone is a good candidate, and scheduling issues will slow down some progress, but quite a few physicians who have experienced time savings have talked up the technology. “Word is getting out, which helps us,” she says.

Fighting preconceived notions

Some physicians feel that speech recognition is an attempt to turn them into transcriptionists. Korgeski fights this view by explaining to physicians that they can easily review and sign off on 20 reports several times a day rather than slog through more than 100 reports all at once at the end of the day. “I encourage them to go into their inbox throughout the day,” she says. “You can get rid of 20 reports relatively quickly, but 150 reports is a little overwhelming.” Aside from that convenience, the more quickly a radiologist signs off on a report, the more quickly it gets back to the clinician who ordered the study.

Another plus of SpeechMagic, according to Korgeski, is that when a new physician starts dictating, the product looks for word patterns and intonations. “Every time a report comes over and corrections are made, it learns. Some products don’t have that continual learning curve.” That helps Korgeski sell the technology to physicians. “Physicians aren’t real patient with this. They want it almost perfect, if not perfect. They don’t want to put a lot of time into it.”

Aside from a couple of holdouts, the physicians are anxious to move forward with speech recognition, Korgeski reports.