Archive for October, 2007

Speech Recognition Podcast

Speech Recognition Podcast Here is a rather fascinating interview of Dr. Nick van Terheyden, Chief Medical Officer for Philips Speech Recognition Systems, on the challenges facing healthcare today and the role of speech recognition, EHR and thin-client technologies in the fail-safe delivery of high quality care. Far beyond the technical aspects, Dr. van Terheyden makes us take a realistic look at healthcare today and think about what tomorrow’s hospital should look like. Here’s a sneak peak:

Douglas Brown: What does an industrial grade system deliver to the software industry that on that off-the-shelf product doesn’t?

Nick van Terheyden: You want to optimize the workflow and throughput for an entire organization. An off-the-shelf product that you install on a single desktop isn’t scaled or designed to actually deliver that. It is designed for the individual user. As soon as you start to move across an organization and need to transfer your profiles, you start to run into trouble.

We’ve focused on the professional market right from the very beginning, constantly delivering on those changing market requirements, specifically in healthcare. The breakthrough of the Citrix of application delivery infrastructure has been one of these events that triggered advances for speech recognition technology. And the other one that’s driven a lot of change is the Electronic Health Record – EHR or EMR as it’s referred to, which is aimed at improving availability and accessibility of medical information. That’s really a key component of safer, more value-added care, which is suffering in the US setting. One of the numbers that’s bandaged around fairly frequently from the Institute of Medicine report from some years ago, is the 98,000 medical errors that occur killing patients in the US every year. If you equate that to the airline industry, that’s approximately one aircraft crashing with all people on board every day.

So anything that we can do to enhance the delivery of quality information to our clinicians is going to be a key factor in that. And enhancing the EHR with the seamless integration of speech recognition, speech being the most natural form of communications, brings some significant benefits. Specifically, we’re going to bring that information to be instantly available to all the members of the team. Medicine used to be an individual specialty, where one physician treated patients. Now it’s a team approach. (…) We’ve got multiple clinicians, and not just physicians, delivering care and the communication of that data to all of the team members as quickly as possible and as accurately as possible is a key factor in delivering high quality care. Much of the errors that occur actually occur in the hand off of that information.

…Users who have access to dictation devices – either handheld devices or even PCs – with thin-client technology are more mobile and therefore can be more efficient in the delivery of that care.

…One of the failings of speech recognition historically has been the desire to take what we do with the mouse and the keyboard and try to automate that using voice. And that’s really not the optimal way to voice enable an application.

> Listen to podcast


HIMSS 2007 Leadership Survey Results

HIMSS Logo Fall 2007 is definitely harvest season for market intelligence in our sector of interest: healthcare IT. After the MRI’s and HealthImaging Surveys, now comes the HIMSS 18th Annual Leadership Survey results. The survey “reports the opinions of information technology (IT) executives from healthcare provider organizations across the U.S. regarding the use of IT in their organizations. The study was designed to collect information about IT priorities, technology adoption, application usage and other crucial factors in the use of IT to enhance healthcare.” Here are a few interesting findings…

IT priorities

Implementing technology to reduce medical errors and to promote patient safety continues to be a top priority (35%), both now and for the future. This is being driven by a focus on quality of care and patient satisfaction, which were identified most frequently as the healthcare business drivers having the most impact in the next two years.” Workflow redesign still scores 30%.

Current IT Priorities

Technology adoption

Speech recognition is on the list of technologies that survey respondents intend to implement in the next two years, although Intranet and high-speech networks have become the number one priorities:

Technology Adoption

Security technologies

Electronic signature appears as one of the top technologies to answer respondents’ primary concern regarding the security of data at their organization:

Security technologies

IT budgets

Nearly threequarters of respondents reported that their IT operating budget will increase in the next year. Many respondents attributed this to an overall growth in the number of systems and technologies.

Vendor satisfaction

In general, respondents were satisfied with the overall IT products/services they receive from suppliers, application vendors and consulting firms—60 percent of respondents indicated that they were satisfied.

>> Read full Survey from the HIMSS web site

How to Purchase SpeechMagic?

How to purchase SpeechMagic I thought I’d clarify this point since I am asked this question on a regular basis. The SpeechMagic speech recognition engine from Philips is not a standalone solution that can be purchased on its own; it is typically integrated by a number of selected software vendors as part of their respective portfolios of dictation and workflow systems, EMR or PACS. These vendors bring in the equation the dictation interface and workflow management components that are as critical as the speech recognition engine itself for a complete, powerful documentation platform.

Only a selection of software companies serving the medical industry were allowed to integrate the Philips speech recognition technology with their respective systems and applications to date. Depending on each vendor’s resources and expertise, some will offer more advanced features than others, although they all have to follow strict integration guidelines upon being accepted as a SpeechMagic partner. SpeechMagic partners typically exhibit at all major healthcare IT tradeshows (i.e.: HIMSS, AHIMA, RSNA, MGMA, eHealth, JFR, etc.) and can be identified through the following logo:

Powered by SpeechMagic

And now: Australia…

Now Australia… Freshly inked article from Australian IT magazine reads: “Voice recognition in medico lingo”. Editor Karen Dearne interviews Chief radiologist K.C. Fan from the Westmead Children’s Hospital in Sydney West.

The artcicle starts with a bit of history on professional speech recognition, quoting Dr. Fan’s experience:

…the technology has taken a while to achieve the accuracy they require. Fan says early versions were inaccurate and too slow. The processing time for computers to turn voice into text reduced the potential for productivity gains.

Tailored dictation products began to surface a couple of years ago, and the most successful voice recognition applications have been in structured environments, in which vocabulary and context can be built into transcription engines.

The author goes on to describe the actual project in place at the Radiology Department of the Children’s Hospital, with a very accurate insight from Dr. Fan on “how the limitations of general speech systems are actually strengths in specialised applications, such as radiology reporting:”

In day-to-day usage, short words such as to could also be two or too. The software has to guess what you mean and try to put the correct word into the context of your sentence. That’s not a major problem in radiology because specialist medical terms are long and complex. That’s an advantage, as it’s easier for the speech recognition system to pick them up.

A word such as interceception (inverted gut) comprises five syllables, for example, providing a clear, machine-readable pattern. Conversely, Fan says, most people unfamiliar with the term would misspell it. That sort of accuracy is a challenge to humans, but not to the system software.

When it comes to the difficulty of finding skilled medical transcriptionists, the situation in Australia seems very similar to that in the USA:

A good medical typist will get it right most of the time, but it’s hard to find skilled people.

On the dictation side, Dr. Fan stressed the importance of a dictation etiquette:

It is important for users to be consistent in their dictation. If you change the way you speak, you can teach the system bad things and the accuracy will drop. If people are consistent, it doesn’t matter whether they have an Indian, Chinese or Irish accent, the system will adapt.

You can read the full article, with further details on RIS integration and benefits, directly from the Australian IT web site.

MRI’s 2007 Survey on EMR and Speech Recognition Adoption

MRI 2007 EMR Survey More survey results! The Medical Records Institute just published the results of its ninth annual survey of Electronic Medical Records Trends and Usage, “an annual poll of IT usage among healthcare providers of various sizes and types.” This year, the survey was co-sponsored by Philips Speech Recognition Systems, with a total of 1011 respondents. The MRI to increase relevancy and diminish bias, responses from vendors and consultants are not included in the results, reducing the total database to 819. Here are a few interesting highlights:

Why EMRs are being implemented

The following are most cited as priorities for strategic decisions in IT.

  • The need to improve clinical processes or workflow efficiency.
  • The need to improve quality of care.

Speech recognition technology adoption

The following are most cited as very important factors driving installation of speech recognition (SR) technology.

  • Improve productivity
  • Reduce turnaround time
  • Reduce transcription costs
  • Facilitate real-time healthcare documentation
  • Improve clinical workflow

The types of SR reported as most in use are

  • Dictation system with SR that automatically uploads to EMR
  • Direct dictation into EMR (seamless integration)
  • Stand-alone SR (no integration with EMR)

The majority of those using speech recognition to generate reports report using only front-end SR with no medical editor or other person involved.

> More survey results

Top Trends in Health Imaging & IT Revealed

Health Imaging & IT Magazine In the October issue of Health Imaging & IT, Lisa Fratt analyzes the top trends and priorities in healthcare IT for the year to come. Here is a sneak peek at the survey results:

Workflow as a top priority

Nearly 70% of respondents rated improving workflow as a “very important” priority, and large hospitals (500+beds) rate it the #1 priority. Most aim to tackle patient scheduling and registration and many plan to focus on physician and technicians’ productivity.

The importance of workflow

First time investment

68% of facilities that do not have clinical IT yet say they are currently evaluating speech recognition technology:

Technologies under evaluation

Replacements / upgrades

IT solutions that rank high in the 2008 purchase or replacement cycle include enterprise image management, voice recognition and enterprise data storage (to handle that extra image volume). Voice recognition ranks second with 33% of responses:

Clinical IT Technologies

Ways to improve productivity

Number 3 on the list is physician productivity.

Improving workflow

Nearly 40% of healthcare facilities claim DRA cuts encourage them to try to work more efficiently by investing in technology designed to increase productivity/efficiency.

> Read full survey

Philly Cheese Steak anyone?

Philadelphia Skyline Live from the Philadelphia Convention Center, where AHIMA is being held this year, you will find me at the Crescendo booth (#855) from October 8 to 11. On the menu: speech recognition, speech recognition and more speech recognition. Dressings to your liking, as always: front-end, back-end, PACS interfaces, workflow management, electronic signature, and more. Also, not to be missed, our new interactive module for clinical notes, an industry first that concentrates voice commands, front-end SR, macros, drop-down menus, check boxes and templates into one single application. I look forward to seeing you there!

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