Speech Recognition Turns Up the Volume

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Physicians across the enterprise are turning to speech recognition and reporting a number of benefits. Consider:

  • Sarasota Memorial Hospital Radiology Associates in Florida trimmed completion time for stat reports to less than 22 minutes after deploying Dictaphone Corp.'s PowerScribe speech recognition solution. Standard report turnaround time dropped from 24 to 36 hours to less than eight. What's more, the practice eliminated $300,000 in annual transcription costs.
  • The pathology department at Bronson Memorial Hospital in Kalamazoo, Mich., found that speech recognition filled the gap when two of its four transcriptionists retired. ScanSoft Inc.'s Dragon NaturallySpeaking also facilitates instant turnaround once dictations are complete.
  • Mayo Clinic Jacksonville, a large integrated group practice in Jacksonville, Fla., trimmed turnaround time to less than two hours with SpeechMagic from Philips Speech Recognition Systems. Turnaround time is important; however, the real gains are improved efficiency and enhanced quality and patient safety, says Reginald D. Smith, EdD, vice chair, department of applied informatics.
  • University Medical Center of Southern Nevada in Las Vegas deployed MedQuist's SpeechQ for Radiology as a key enabler of its paperless/filmless department. Voice recognition is necessary for maximum efficiency, says Carl A. Recine, MD, chief of radiology. The department bettered its turnaround time from 12 to 24 hours to one to two hours within weeks of implementing SpeechQ.

There are a number of points to consider when entering the world of speech recognition. Integration with existing information systems - particularly the RIS, but also PACS - is critical. How does the practice or department or enterprise plan to introduce speech? Will all users adopt the new technology in one fell swoop? Or is a gradual introduction more appropriate? And what process will the practice use?

Speech can be implemented in two flavors - front-end and back-end. Front-end speech recognition removes transcriptionists from the process, producing a more dramatic effect on costs and turnaround time, but it requires physicians to assume complete responsibility for dictations and self-corrections. Back-end speech recognition is closer to conventional dictation processes and relies on transcriptionist/editors as middlemen in the process.

It's all about (report) turnaround

Sarasota Memorial Hospital Radiology Associates, a 14-radiologist practice serving an 828-bed medical center, maintained an average turnaround time with an outside transcription service. Average, however, doesn't necessarily cut it for 21st century medicine. In addition, efforts were duplicated for ER reads. "ER physicians want immediate reports, so radiologists would dictate into the transcription service then write or call the wet read to the ER," recalls Kirk Conrad, MD, medical director of neurointerventional services. Labor duplication isn't the only drawback of this method; decoding hastily hand-written notes can be trying and represents a potential patient safety concern.

Early in 2004, the practice deployed Dictaphone's PowerScribe speech recognition system to create a more efficient and safer reporting process. Radiologists dictate directly into the system, which sends the report to the RIS. The system is configured to autofax results to the ER. "ER physicians are very happy with the system, especially with CTs of the chest, abdomen and pelvis and ultrasound [exams], [which can be lengthy with multiple findings]," claims Conrad.

Sarasota Memorial Hospital Radiology Associates opted for the 'cold turkey' approach to speech recognition - pulling the plug on transcription services when it deployed speech. "There was some rumbling, but most radiologists learn the system very quickly," says Conrad.

Speech recognition features can sell reluctant users. Because radiologists proofread their own reports, future review of transcribed reports is eliminated. And macros represent another hefty time-savings.

Vendors typically supply some macros such as "normal chest x-ray." The radiologist says the three-word phrase to produce a report. This takes less time than a 15-second dictation, and as results are always the same, there is no need to proofread. Users also can customize macros and create canned reports.  For example, a customized macro for a kidney ultrasound includes x, y and z as blank fields. The radiologist dictates patient-specific x, y and z measurements. Conrad