AHS deploys cloud-based medical dictation

EDMONTON – Alberta Health Services has started using cloud-based medical dictation services, enabling clinicians to dictate from virtually any device and to create reports within minutes. That’s reducing the need for outsourced transcription services, which can take days or more to return reports.

AHS is deploying Dragon Medical One, a voice-enabled dictation solution from Nuance. The system runs on Microsoft’s cloud, and is used in conjunction with the new Epic electronic health record system that is being rolled out across the province.

Karen Carlson (pictured), director of health information management, AHS, noted that eight sites are now using the Dragon Medical One system, with about “450 prescribers using the solution on any given day.”

Right now, the strategy is to distribute the new dictation solution to prescribers, including physicians, nurse practitioners, pharmacists, midwives and medical learners, at locations that have deployed the new, Epic record system.

Kathleen Addison, HIM Senior Director at AHS, said the plan is to distribute the Dragon Medical One system to non-prescribing clinicians, too, but there is a gradual rollout occurring.

Alberta Health Services is currently in Wave 2 of its rollout of the new Epic clinical information system, a project that will consist of nine waves and will last until 2023.

Already, the uptake of the cloud-based Dragon solution has been astonishing. “At some sites, there has been a 90 percent drop-off in [outsourced] transcription services within two days,” said Dr. Stuart Rosser, chief medical information officer at AHS, as clinicians switch to the Dragon system.

“Having the cloud solution allows each end user to take their preferred device and to dictate directly into the CIS,” he said. “They can see what they’re dictating as it occurs, they can make the edits they need, and send the final product to whoever needs it, in real-time.”

The ease of using the new system, and its speed, probably has a lot to do with its popularity. “Clinicians used to have to be in front of their computers, at the desktop, which would cause delays in dictating,” said Carlson. Now, using their mobile devices, they can do from anywhere.”

The report goes right into the electronic patient records; moreover, it can be sent right away to others who may require it.

Many clinicians still using the old system have asked to use the new transcribing technology, but they will have to wait until their zone adopts the Epic platform.

Dr. Rosser said that in the future, he’d like to see a tighter integration between the Dragon Medical One system and the Epic solution. Currently, DMO opens in a different window on one’s screen, meaning the user has two applications running; in the future, Dr. Rosser would like to see Dragon become integrated with Epic, so users can open a single application.

Duncan Salt, healthcare GM Canada and VP of client outcomes for Nuance, said that Dragon is capable of driving even greater benefits for clinicians. The company is currently developing an “ambient” technology that can hear the conversation between a patient and doctor and automatically transcribe it.

Artificial intelligence and natural language processing allow the system to make sense of what is being said; Nuance has demonstrated the solution in a preliminary form.

That means clinicians will not have to spend time in front of computers documenting encounters or filling out forms, something that has been contributing to physician burnout in recent years.

And because the system has its own knowledge base, it could also comment on the quality of the documentation, suggesting improvements, the diagnosis and what might be checked further, and even the severity of the patient’s illness.

“This is a foundational technology for Nuance,” said Salt. “We’re innovating on it and around it.”

Dr. Helia Mohammadi, chief data scientist and Healthcare Industry Lead for Microsoft Canada, moderated the webinar. She said that Microsoft recently launched its cloud for healthcare solution and commented that it addresses three major areas: it can enhance patient engagement; empower healthcare teams; and improve healthcare outcomes.

Dr. Mohammadi noted: “Now, more than ever, physicians need to reduce their administrative tasks.”