Archive for the 'Speech recognition & the EMR' Category

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

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 EMRconsultant.com, 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 EMRconsultant.com, 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

Speech Recognition Prototype for EMR Interoperability

Interoperability Physicians know it best: entering and processing EMR (Electronic Medical Record) data is still very much time-consuming and unreliable due a lack of integration between systems and a large volume of manual entries involved. Royal Philips Electronics and Health Language have launched a prototype called interop 6.1 designed to advance system interoperability in healthcare with the help of speech recognition. The idea is to automate the conversion of free text into consistent medical terminology to enable direct storage in the (EMR), thereby providing physicians with a central, reliable source of medical information.

Interop 6.1 extracts findings, diagnoses, drugs, allergies and other relevant information from dictated reports. Subsequently, the information is formatted for upload to the EMR. The system generates codes that support the classification of medical conditions and the structuring of clinical data, such as the World Health Organization’s International Classification of Diseases (ICD) codes and the Systematized Nomenclature of Medicine (SNOMED) codes.

Interop 6.1 also identifies medical terms from the history of present illnesses (HPI) to be indexed n the EMR. The indexed terms can be used for statistical evaluation, thus helping to improve hospital procedures related to patient safety, medication and continuity of care.

“Healthcare communities need to standardize existing systems and augment them with new integrated solutions focused on the patient” said Marcel Wassink, managing director for Philips speech Recognition Systems. “The ability to exchange data accurately, effectively and consistently is key to eliminating cross-organizational boundaries and ensure the uniform and secure availability of critical information. This will eliminate documentation errors and improve the quality of care.”

A prototype system which extracts information from freely-dictated text and allocates it to the corresponding fields in the EMR is available.


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