Speech-enabling the Healthcare System

In today's convoluted healthcare world, physicians are constantly bogged down with the administrative tasks of transcribing charts, losing valuable time and sacrificing accuracy. John Burke had witnessed enough. As chief information officer of the Caritas Christi Health System in Boston, Burke sought a way technology could impact his organization. Now, through careful planning and restructuring, the hospital is saving money and everyone is benefiting benefiting - doctors, patients and hospital employees. Using a solution created by AM Technologies called WhyType?®, clinicians have decreased the time spent transcribing documents and are creating more accurate records. Now, a physician assistant (PA) working in Cardiology, for example, carries a laptop during rounds. After meeting with a patient, the PA will go to a nursing station or other suitable area, put on a headset, and using Dragon's NaturallySpeaking with a layer of WhyType?, begin dictating their notes from that visit at the point of care. The laptop is already connected to the hospital's information system, so once dictation is complete, the physician simply copies the text and drops it into the existing network. "The real benefit here is accuracy," said Burke, a 20-year veteran of the technology sector. "As a clinician does their rounds, they may see a large number of patients. At the end of the day when they dictate reports, it is very difficult to recall every intricate detail on every patient. So, what we're seeing is that the information captured at the point of care is much more detailed, which translates into better billing. There are people who code billing from what doctors dictate for billing purposes. If the doctor's notes are more precise, then so will be the coding. Therefore, the billing will be more accurate. This is an enormous benefit." While accuracy is an invaluable result of this deployment, let's not overlook the cost savings. No longer does Caritas Christi have the expense of medical transcripionists at 22 cents a line. Burke estimates the implementation of the Why Type? system cost $4,500. Burke's biggest hurdle with this system has been convincing the medical professionals who are leery of the speech systems and may be scared of the technology. This is an area where Burke feels the speech technology vendors can help, by continuing to produce higher quality products in order to alleviate this issue in the future. The PA that is currently using the system is technically savvy and is getting over 98 percent accuracy out of the system. However your accuracy will vary with the amount of time you train the system. "We have between six and eight clinicians currently using dictation software, although not in the mobile computing environment," said Burke. "They instead use the WhyType? software on their office system. As long as physicians take the time to train their systems, they will soon see time savings." PAGING DR. JONES
Caritas St. Elizabeth's Medical Center, one of the full service teaching hospitals in the Caritas Christi system, was looking for another way to increase efficiency and reduce costs. As part of its "Service Excellence Plan," Caritas St. Elizabeth targeted its internal voice and paging system. A major element of this plan included efforts to speech-enable the employee directory of the hospital in order to cut the costs of staffing a full-time operator to transfer calls within the organization. When it came time to do some re-engineering on how to access and extend the functionality of the current voice and paging system, Burke realized the benefits speech technology might bring to the situation. He wanted a way to automate the legacy communications infrastructure to make it more accessible and efficient for users and provide the hospital major cost benefits. Caritas contracted with Parlance Corporation to provide its NameConnector Service, which allows companies to automate their internal phone directories so that calls can be routed to the appropriate personnel via spoken commands. This alleviates the need to remember extensions for departments or other employees. The service was installed and operational in one day. It enables on-site employees to dial a single extension, say the name of their destination and get automatically connected. With NameConnector, the directory running 24 hours a day, seven days a week. Remote employees can access the service from anywhere by dialing a designated hospital number that connects them with the system. It removes the burden of having to remember phone numbers, department extensions or pager numbers. "The employees love it," said Burke. "They can't believe what it can do. Many employees have set up speed dial on their cell phones so that the system is even more easily accessible. This way there is only one number to dial to reach the NameConnector. At that point, all they have to do is say who they would like to speak to. It just makes it more convenient for the staff." The system also allows a caller to not only say the name of a staff person but also different areas of the hospital. For example, a caller can say, "connect me to the nurses station on the sixth floor." Paging is also accessible though the call router. Once in the system, a nurse can say "Doctor Welbe pager," and get connected to the paging system, where he can then enter the callback number using a phone's numeric keypad. This function really offloads calls to the page operators. NameConnector has a set of administration tools that automate the process of collecting and editing imported names from multiple data sources in order to generate the database. System administrators are provided with access to the tools from their desktop to facilitate basic maintenance tasks. The hospital's directory is now stored in the system and is constantly updated. "We no longer have to print phone directories, since the directory is available by the service," said Burke. "Phone books are rather expensive to print and distribute, only to find that they are out-dated a week later, due to changes and so forth. By using the Web interface, administrators can keep the directory dynamic." The system has separate numbers for employees and the general public. The employees get a greeting that is very brief since they are familiar with the system. While this saves time for the employee who doesn't need to be given specific directions on how to use the system, the interface that meets the general public is more detailed and customer friendly. Long distance toll charges are also diminished. Previously a call to another hospital within the same healthcare system would incur long distance fees. By incorporating the NameConnector Service with the hospital's existing data network, the fees incurred for inter-hospital calling have been virtually be eliminated. After one year of use, NameConnector has reduced the number of calls to the switchboard by 30 percent. The NameConnector service offloads more than 350 calls each day, all of which are answered on the first ring and connected within two seconds at an accuracy rate of 96 percent. While an evaluation of the actual cost benefits and ROI has not yet been completed, Burke is confident that the numbers will be astounding. He sees a future for his organization that involves many technologies working together in order to increase efficiency for the staff members while cutting costs for the healthcare system - benefits that eventually translate to better service for patients. "Healthcare lacks automation and the efficiency that technology can bring," said Burke. "My goal is to introduce that technology into the healthcare environment to help people be more productive, which will in turn save time and cost. We want to give doctor's and nurses more time in their day - time they can spend with their patients."

If you have comments about this article please e-mail Dave Kaplan at dave@amcommpublications.com.

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