Now just may be the right time to add voice recognition — after all, VR has matured to a point that it is ready for prime time and recent feature upgrades make systems more accurate and efficient than ever. But, is your facility prepared for what it takes to ensure successful implementation? Those with experience, from major health organizations such as Mass General to smaller community hospitals such as the 48-bed Goodall Hospital in Sanford, Maine, agree that what is essential — no matter how tech-savvy, big, or small an organization might be — is a carefully drafted implementation plan.
For years, implementing voice recognition was limited by its technology and lack of support from radiologists. That is changing. In the past couple of years, VR systems have advanced to become an essential component of medical dictation and transcription, as well as an effective workflow management system. They are credited with saving time, money, and work. However, what remain issues for some hospitals and imaging centers are how to turn reluctant radiologists into fans and how to minimize the bumps in the road during the implementation process.
Do your homework
Implementing voice recognition begins with doing your homework, says Paula Crosbie, RHIA, director of health information management at Goodall Hospital. When she joined the staff at Goodall in 2005, she sought to bring radiology IT up to date, which included adding VR. “I read [about VR], attended conferences, talked to vendors and other users,” says Crosbie.
Armed with information and administrative support, Crosbie formed a 12-member multidisciplinary team last year. After looking at systems for over a year, they selected Crescendo Digi--Scribe-XL (back-end system) with a Philips Speech-Magic speech engine, with the option of adding MD Center-XL (front-end system) later this year. “Because we are small, we wanted a vendor who could give us customer service,” she says. Goodall performs about 35,000 imaging procedures yearly.
Joining Crosbie to lead the actual implementation was Cherie Edris, CMT, transcription supervisor, who came to Goodall five months ago. Her homework included the evaluation of workflow, and the standardization of formatting prior to a January installation date. Additionally, nearly all transcription has been brought inside, with outsourcing only as a backup. Transcription will see further changes when the front-end mode goes live in June.
Last year, on the other side of the country, Inland Imaging implemented VR in their three locations in Spokane and Seattle, Wash., and Phoenix, Ariz. Jeff Kelly, IT project director, knew cross-sectional support within the organization was essential. “We created a [16-member] task force composed of radiologists, IT, and operational staff to evaluate several systems,” he says. Inland has 58 radiologists and archives 450,000 images in their PACS.
“We had vendors demo the system to the task force. We had many discussions with their technical teams exploring their IT capabilities and willingness to work with us.” They selected MedQuist SpeechQ for Radiology, also powered by Philips SpeechMagic and made two site visits. “SpeechQ attended our IT task force meetings that met monthly. These meetings allowed the radiologists to provide feedback directly to those in SpeechIQ who can implement requested changes.” says Kelly. “We then had continual, weekly conference calls to address these issues and SpeechQ delivered.”
Know your needs
Implementing a voice recognition system at Massachusetts General Hospital was not simple, but neither was it new. The teaching hospital, with more than 200 radiologists, performs 750,000 imaging procedures annually. Keith J. Dreyer, DO, PhD, vice chairman of radiology, has been involved with voice recognition since its early days 12 years ago. He was one of 45 members of the Boston hospital’s project management team to implement VR. To prepare, they considered the size of the hospital, their workflow, who they serve, and their goal of using only a front-end VR system for all reporting. Key to selecting the right VR system, they also evaluated server hardware, client hardware, PACS and RIS training, and user training.
“Until the entrance of Commissure into the market, we felt the other offerings were incapable of meeting our needs,” says Dreyer. “Commissure [RadWhere] includes workflow orchestration so that we can read cases from numerous hospitals from various PACS and RIS all with