The Switch to Speech Recognition

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Photo: MedquistCommunication, set goals and good service make the difference

You don’t have to search too long or hard to find stories about failed speech recognition implementations. However, the tide continues to turn toward the technology. Make a new year’s resolution to focus on adequate preparation, your expectations and the service you need, and the technology can offer dramatically improved turnaround time, better patient care and more satisfied clinicians.

Community Health Systems, Inc. (CHS) based in Brentwood, Tennessee, is the leading operator of general acute care hospitals in non-urban markets throughout the United States, generally in areas with low managed care. CHS operates 73 hospitals in 22 states.

Northeast Regional Medical Center (NRMC) in Kirksville, MO, is one of 73 hospitals in 22 states operated by Community Health Systems Inc, based in Brentwood, Tenn. The facility implemented SpeechQ speech recognition from MedQuist in September 2005.

Aside from wanted to improve report turnaround time, the hospital had gone from using the same local radiology reading group for more than 40 years to a string of locums, says Julie Atchley, SpeechQ administrator. That led to new dialogues from the reading radiologists that were harder to decipher. “We thought speech could aid with that,” she says.

Hospital administration decided on SpeechQ and MedQuist sent in a team to set up the system and train the users. NRMC specifically implemented speech recognition for radiology but at any given time, only two radiologists were in house. Atchley and a coworker learned the system so that they could catch the radiologists on the fly and train them. She says that’s all it took to get them using the system proficiently.

One of the biggest proponents of SpeechQ at NRMC was a veteran doctor who had been with the original reading group. He was used to using a handheld device and was leary of the new system. However, he quickly realized the advantages of SpeechQ and spread the word among the other radiologists. “He is very positive about SpeechQ,” she says. “I thought he would have the biggest hesitation but he latched right on.” Even though some of the locums complained about creating their own reports and self-editing, they’ve seen this doctor efficiently producing reports which has gone a long way to sell the benefits. Atchley also made every effort to sit down with the complainers to help them learn the system and figure out how to get it to do the tasks they want. “It was a really great process.” Between her efforts and all the perks of the system, “basically we’ve won over all the physicians,” she says.

Within two weeks of implementation, “we were dedicated to SpeechQ,” she says. After a couple weeks, she was able to take away all of the old handheld dictation devices. Now, report turnaround time is less than 30 minutes during the week and averages seven to eight hours when considering the weekend as well.

Another CHS hospital went through a speech recognition implementation at the same time as NRMC, Atchley says, but they failed. She attributes the difference to her facility’s administration knowing exactly what they wanted to get out of the system.

NRMC eventually signed with a new radiology reading group. The doctors like SpeechQ so much that they bought a system for their practice.

Ready for prime time

Many clinicians tracked speech recognition waiting for the technology to mature before implementing it. After watching it develop over several years, Alan Hecht, MD, chairman of the radiology department at Mt. Sinai Hospital in Chicago, IL, says he never thought it had come far enough along to be usable. After testing PowerScribe he quickly changed his mind. That was two years ago. Now, about 15 radiologists are using PowerScribe and experiencing turnaround times of hours compared with the days a report took before implementing the tool.

The hospital installed PACS and then added PowerScribe a few months later. Although considered one big project, the staff knew they wanted to give the PACS a little time to get up and running smoothly before introducing the physicians to speech recognition.

One of the biggest concerns was report turnaround time, especially for emergency patients. As a level one trauma center, every second counts so turnaround time is tracked every week. With speech recognition, 80 to 90 percent of ED cases have dictation available in the medical record within one hour from the time the patient entered the room for