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Speech recognition boosts productivity in BC

KELOWNA, B.C. – It could have turned into the perfect storm. As in most places across Canada, the volume of medical exams at Interior Health was rapidly rising, and physicians were dictating more reports than ever before. At the same time, however, transcriptionists were difficult to recruit, meaning it was harder to produce timely reports.

“We were struggling to keep up with increasing demands for transcription services,” says Malcolm Griffin (pictured), chief information officer at Interior Health, a provincial authority serving 215,000 square kilometres in southeast British Columbia. “We knew that if we didn’t leverage technology, we weren’t going to be successful.”

Indeed, a technological solution that was installed over the past few years not only allowed the region to weather the storm, it has resulted in faster turnaround of medical reports, reduced the need for transcriptionists, and improved patient care.

Interior Health, which includes centres like Kelowna, Kamloops and Penticton, enlisted the assistance of Lanier Healthcare Canada, of London, Ont., to help the region transition from its aging infrastructure to a digital dictation and transcription system.

In particular, the region was the first in Western Canada to make a significant investment in speech recognition systems for radiologists. That was seen as risky by some – after all, few large organizations like to be the first to try a new technology. But the move has paid off handsomely.

After a pilot test and the addition of powerful virtual servers, Lanier’s SpeechQ for Radiology was rolled out to nine diagnostic imaging sites across Interior Health. Radiologists were excited about the ability to edit their own reports, enabling turnaround times of less than an hour.

Lanier’s SpeechQ for Radiology is a flexible solution designed with radiologists in mind. It integrates with radiology information systems and PACS, with custom features to help streamline workflow and facilitate self-editing.

At Interior Health, the system also integrates with an existing hospital information system so that patient demographics are automatically pulled into reports. Radiologists use handheld microphones for dictation with pushbutton controls and a trackball for navigation.

One button sends dictated files to back-end transcriptionists for editing, while another sends them directly to a finished report for self-editing by radiologists. Other buttons are used for commands like “insert text,” so that radiologists can automatically enter standard findings into a report – things like “head normal,” explained John Geistlinger, IMIT project manager at Interior Health.

Even tech-savvy radiologists needed some coaching, however. “We had to hold them back and say, you need to send this amount to transcription for the first two weeks in order to build their recognition, too,” said Geistlinger.

Nevertheless, now that SpeechQ for Radiologists has been up and running, Geistlinger points out that an astonishing 75 percent of all DI reports never require a transcriptionist, as they are produced and self-edited by the radiologists themselves.

“This has significantly decreased the wait time for radiology reports, improving workflow and our ability to provide expedient patient care,” said Geistlinger. “It has also relieved a significant burden within our transcription services portfolio and allowed us to build capacity and provide a level of service that is commensurate with patient care.”

Indeed, Interior Health was able to eliminate the need for external contract positions, which were primarily used for DI overflow. Meanwhile, the goal of 24-hour turnaround for DI reports is easily met and is often reduced to a matter of hours or minutes.

The most telling evidence of improved turnaround times came from one of Interior Health’s IT employees. She had a diagnostic test performed just before seeing a specialist and didn’t expect the report to be there when she arrived for her appointment. Yet, there it was, in no more than an hour’s time. “It shocked this person,” said Geistlinger. “She’s been in healthcare IT for years, but didn’t expect to see the results like that.”

Another notable change is that radiologists are receiving far fewer phone calls from physicians anxiously awaiting reports. “We really went all out to make this work,” says Griffin, who says he simply laid it on the line that without speech recognition, turnaround times were likely to increase due to growing demand. “Lanier really came to the table and helped us ... and now the radiologists would not, under any circumstances, want this taken away.”

Posted October 6, 2011