Archive for January, 2008

Meet with a speech recognition visionary at HIMSS 2008

Wireless Speech Recognition in the ER Visitors to the HIMSS Annual Conference & Exhibition will have the opportunity to meet Dr. Stephen Rosenthal, the first in North America to implement a wireless speech recognition and patient administration solution in an ER setting.

We introduced PDA devices that interface with the emergency and patient index system, as well as the speech recognition server. Physicians can now access up-to-date patient data and record their findings all from one single device,” explains Dr. Rosenthal.

Having turned his vision of a 100% future-proof system into reality, physicians now have access to a 24-seven solution. Document turnaround time has been accelerated significantly and the ER now has documents that are readable, searchable and that deliver suitable information for the electronic chart, making it much easier for physicians to make split-second decisions.

The ER is a fast-paced environment, says Rosenthal. We need to be with patients, we need to be mobile; we can’t be tied to a desk.

Dr. Rosenthal is credited with the initiation, development and implementation of medical informatics projects and has implemented electronic records, mobile speech recognition and digital dictation at his hospital. A member of the standards committee for interoperable Electronic Health Records (EHR) at Canada Health Infoway, Dr. Rosenthal has a vision that reaches far beyond the Montreal hospital’s walls.

“Standardizing information with the help of speech recognition can provide physicians with better decision support across provinces, even countries”, he noted.

Visitors to the conference will be able to share Dr. Rosenthal’s vision and experiences on the Crescendo booth (#6843) on February 26-27, 2008 (between 10.00 am and 4.00 pm). Meetings can be booked directly from the Crescendo web site.

Offshore, onshore, speech recognition: MTSO latest trends

Offshore, onshore, speech recognition: MTSO latest trends The latest KLAS study on Medical Transcription Services Organizations (MTSOs) sheds more light on the role of speech recognition in the onshore/offshore dilemna. Michael K. Smith and Stacilee Whiting analyze the latest trends in the ever-changing world of transcription outsourcing in this month’s Advance Magazine:

Providers have begun to evaluate if editing services should be engaged domestically or offshore. KLAS has observed the beginning of acceptance of offshore transcription but preference for domestic, onshore editing. Providers who accept offshore transcription expect the editorial staff to be onshore to enhance the language proficiency, but there is not sufficient experience to determine the extent at which this is occurring. Some providers indicate they are willing to redirect some of the speech recognition operational cost savings to shifting offshore MTSO work back onshore.

The need for transcription is increasing due to :

1) electronic medical records and the need to populate them quickly and

2) speech recognition services needing editing on the back end. For these reasons, many MTSOs are increasing their capacity.

> Read full article

Speech Recognition 2008: Crystal Ball Predictions…

Crystal Ball Predictions… In a recent article published by US magazine For The Record, speech recognition is listed as one of the hottest issues for 2008 by healthcare industry leaders themselves. Here’s a sneak peek:

Brenda J. Hurley, CMT, FAAMT, director of industry relations and compliance at Medware

Institutions and medical transcription services will continue looking at speech recognition (SR) technology in 2008. In the transcription world, that’s OK. We look to use technology for better efficiency. But don’t put transcriptionists in a world where we’re just correcting the same errors every day and then expect increasing productivity.

For the new year, Hurley is hoping to see SR implementation that incorporates two main cost-effective strategies: standardization of healthcare documents and following dictation best practices format. By applying these two factors, she believes greater efficiency will be achieved with traditional transcription, as well as the technological investment. “Why wait? Prepare now for technology to move ahead. Tackle the basics, and meanwhile, you can reap the benefits.”

Amber Doster, vice president of marketing at HealthPort:

Technology will be a valuable tool in the hands of healthcare organizations. More and more, we are seeing that providers want access to an increasing detail of information. In 2007, we experienced a spike in requests for product functionality and services that centered around pulling information from areas that have never before been accessed. Paper records don’t just need to be in the provider’s hands, they need the ability to quickly search through many types of documents for certain terms or procedures for patient care. In 2008, this need will only grow, and it will help drive solution development from a vendor perspective.

> Read full article

Interesting Radiology Case Study

Interesting Radiology Case Study Implementing speech recognition for radiology reporting before a hospital mandates can be advantageous for radiology practices, Dr. John Floyd of Radiology Consultants of Iowa told attendees at an informatics scientific session the RSNA 2007 meeting. The session was reported by Editor Cynthia Keen in the AuntMinnie Radiology Magazine:

Radiology Consultants of Iowa in Cedar Rapids serves two urban hospitals, seven rural hospitals, and one imaging center. In 2005, with a 37% error rate for internally transcribed reports at one hospital, and a report turnaround time of three to 10 days at another, executives at both hospitals were discussing the purchase and adoption of speech recognition systems as a way to alleviate the problems.

A Single SR System

Floyd said that he and his colleagues recognized the inevitable, and offered to take over all aspects of radiology report transcription, processing, and distribution. After evaluating different systems for six months, the practice purchased a single speech recognition system to be interfaced with five different RIS and three different PACS.

The benefits of having a single system were that the radiologists and transcriptionists/editors would only need to learn how to use one system, rather than several, and would only need to work with one database with respect to adding vocabulary and teaching the system to correct errors.

The radiologists planned to phase in usage in the first hospital to go live over a several-month period. “However, the speech recognition system launched abruptly in March 2006 when the transcriptionists learned what was being planned and walked off the job,” Floyd said.

A Majority of Free-Text Reports

“We self-edit 97% of approximately 1,000 unstructured reports each day,” Floyd said. He believes that the practice’s ownership of the speech recognition system contributes to this high level of self-editing compliance.

Approximately 90% of the reports generated are free text, with less than 10% using standardized responses. Transcription editors are available from 6:00 a.m. to midnight, but are typically used only when a report is particularly complex or when data need to be entered with the report. “This can add an additional five to 10 minutes of time,” Floyd explained.

Comparing Error Rates

Concern about high error rates of SR systems reported at RSNA 2006 convinced the practice to conduct an analysis of accuracy of SR-generated reports as compared to reports still being generated through traditional dictation at one rural hospital. The group compared 493 SR reports with 283 traditionally transcribed reports. The total number of errors for the SR reports was nine, compared to 13 for the traditionally transcribed reports, and 0.6% of the SR reports had a significant error, compared to 2% of the traditionally transcribed reports.

Productivity Gains

Although a direct correlation cannot be attributed to the implementation of speech recognition, Dr. Floyd said that during the remaining months of calendar year 2006, productivity increased 12% as it related to reporting. In the first eight months of 2007, productivity increased by 28%. Floyd attributes financial ownership to making the project a success.

Integrating Dictation with PACS

In the RSNA same session, a group from Santa Barbara Cottage Hospital reported that by integrating a dictation system using structured templates with its PACS, a reduction of 45% in full-time employee (FTE) transcription was achieved within 90 days from implementation in February 2006. Compared to the same months of the prior year, report turnaround time for STAT exams improved by 70% and overall turnaround time improved by 8%.

> Link to AuntMinnie web site


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