Speech Users Speak Out on Newfound Efficiencies

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  Radiologist Scott Fargher, MD, dictates as he reads PET images on a GE Healthcare Centricity RIS-IC workstation at Radiology and Imaging Specialists’ Lakeland in Florida. The facility recently added M*Modal’s Advanced Speech Understanding speech engine that is embedded in the RIS.

While speech recognition technology has proven its ability to reduce transcription costs and improve report turn-around times, these benefits are clearly becoming old news. Healthcare facilities now demand front-end and back-end systems that do more than just replace dictation and transcription, offering add-on tools that help with overall workflow in a format that is easy to use. After all, the key to speech recognition’s success is its adoption among radiologists and physicians.

Many speech offerings are integrating dictation software into various systems, touting the capability to expedite the radiology workflow and empowering the user with more control. This is due in part to easier to use interfaces, auto texts and templated reports and single worklists from which to streamline workflow. Report creation is quicker as is communication with referring physicians and specialists. Speech recognition is clearly gaining traction across imaging facilities large and small.

Orchestrating from the telerad cockpit

At University Radiology Group in central New Jersey, the reason for adopting speech recognition goes beyond traditional speech capabilities, bringing to the user interface and the ability to consolidate orders from multiple systems into one single platform, says CIO Alberto Goldszal, PhD.  They chose RadWhere for Radiology from Nuance. “The key factor for us was the Workflow Orchestration function to create a single cockpit for dictation,” he says, adding that they have been using the system for 18 months.

Covering six hospitals and eight imaging centers throughout the state, with a wholly owned teleradiology subsidiary performing nighthawk coverage for ERs, University performs approximately 850,000 reads each year. All eight imaging centers use the front-end speech recognition system for remote reading services.

The difficult part about reading for multiple locations is the consolidation of multiple dictation systems, to get a single platform from which to dictate all incoming orders, Goldszal says. From RadWhere, users can open incoming orders from multiple sites while returning reports to the appropriate hospital or facility RIS from a single workstation. Reports can be created in a variety of dictation styles, and data extraction tools can allow for productivity and outcomes analysis.

“With remote reading, it is impractical to use hospital A’s dictation system, hospital B’s and so on, simply because of the incompatibility of these systems since you would have to use a separate dictation workstation for each and establish separate VPN connectivity to those hospitals—which becomes very messy, very fast,” he says.

With RadWhere, all orders from multiple sites are consolidated into a single platform and then speech recognition is used to dictate. “Most worklists are hospital-centric and we wanted a global enterprise-wide view of all the sites we are connected to in a single interface with a single voice recognition system to dictate,” he says.

Adding ‘understanding’ to speech

While many recognize the promise of speech recognition, a primary challenge that remains is compliance, as many radiologists are reluctant to transition to speech or self-edit because they believe it will slow workflow. Many eye speech recognition with skepticism, questioning whether it truly can be an aid or an interruption. Lines have been drawn and people have taken sides, some touting front-end recognition systems as the answer while others prefer back-end recognition systems. And yet, some heads are turning toward a system that is less about speech recognition and more about speech understanding.

At Radiology Imaging Specialists Lakeland in Florida, COO and CIO David Marichal, says that since their speech solution—M*Modal’s Advanced Speech Understanding speech engine—is embedded in the Centricity RIS-IC from GE Healthcare, it makes reporting part of the natural radiologist workflow. “It has to do with the fact that it’s not really forcing the radiologist to change the way he or she has to dictate. From a physician acceptance perspective, it has been very smooth,” he says.

Since radiologists have different types of workflows, there