Experts Discuss Speech Recognition & EMR Synergy

Experts Discuss Speech Recognition & EMR Synergy In the latest issue of For the Record Magazine, a panel of industry experts including Eric Fishman, MD, founder of, Nick van Terheyden, MD, chief medical officer at Philips Speech Recognition Systems and Kathy LePar, RN, MBA, a senior manager at Beacon Partners, discuss the role of speech recognition & EMR integration as a response to the ever-growing-healthcare-documentation-mountain issue; a very instructive “state of the union” address providing answers to healthcare organizations’ questions on the subject, from challenges and benefits to pitfalls and trends. Here are a few interesting extracts.

SR’s Resurgence

“The medical profession is overwhelmed with data,” says van Terheyden, who estimates the amount of data doubles every 18 months. “A typical patient looks to his healthcare provider to know what is best for him. But the idea that they know the latest and greatest information is impossible.”

The EMR is a critical piece of technology that can corral patient data into one complete record. Implementation of it, however, is often difficult for financial reasons, as well as because of resistance from physicians who fear substantial interruption in their workflow. But according to Eric Fishman, MD, founder of, the EMR acceptance rate “goes up astronomically when physicians know that speech recognition will be part of the implementation.” …

Implementing Speech Recognition (SR) With the EMR

While experts agree that the use of SR in conjunction with EMRs is an important technology, they have varying opinions on exactly how SR can best serve the physician, patient, and healthcare facility. Nonetheless, experts concur that from their experiences, improving workflow and patient care and reducing costs are among the top benefits.

“There is no one perfect solution,” says Fishman. Finding technology that works best for an organization can include using a combination of dictation, SR, templates, and revisionists (also known as medical transcriptionists).

Additional Applications

Applying the dictated information directly into the EMR for physicians is another way some healthcare facilities are using SR technology. According to van Terheyden, voice recognition used solely as a narrative note doesn’t achieve optimal results following EMR integration because it doesn’t always link data points to the record and can’t be queried.

Egerman believes that a balance of textual and objective data can be the most valuable, as there is always anecdotal data from a patient consultation that can’t be captured on a typical “point-and-click” screen that physicians use. He points out how a patient’s social situation is an important aspect that can’t always be captured in the objective data. “For example, a healthy, 96-year-old woman may be at the physician’s office for her yearly check-up,” says Egerman. That noteworthy anecdotal data is important to be aware of, but, nonetheless, may not be included on a physician’s transcript if only EMR objective data is used.

Possible Pitfalls

“Physicians are so comfortable with SR and the dictating process that, often times, the narrative documentation replaces the point-and-click process of entering data elements, which is necessary to derive outcome data,” says LePar. Many programs already have the capacity to extract meaningful data embedded into their systems, and therefore, it is important to use the narrative fields in conjunction with inputting the data points, she says.

Improving Patient Care

Because information is documented immediately, patient information can be sent in real time to doctors, referrals can be made quickly, and the possibility of medical errors is reduced. From a management standpoint, transcription costs are reduced, and billing can be done in a timelier manner because documentation is completed sooner.

SR, when integrated into the EMR, “ties it back to clinically actionable data,” says van Terheyden, and can tie it in with clinical coding. He believes this is the future of SR because it drives actions that physicians are desperate for. It also keeps physicians up-to-date on the most current information, thus improving patient care.

Benefits to Healthcare Organizations

At first, physicians may view integrating SR technology with EMRs as a cost because it appears to take more time. However, reports are actually turned around more quickly and have better data from which to draw patient care information. In addition, because patient information is delivered to the EMR more quickly, physicians can bill almost instantaneously. “The reality is, you have to pay bills, so now you don’t miss any information and get fair compensation for work done by capturing it at point of care,” says van Terheyden.

Evolving Process

The latest versions of SR technology for use in conjunction with EMRs have “made more of an impact than what was available several years ago,” according to LePar. While she says it takes on average five to 10 hours of use to “train” a physician’s voice, the time spent is well worth the effort in the long run.

“I see it being used much more frequently than in the past. This technology is what many of the physicians are requesting,” says LePar.

> Read full article


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