Health Imaging & IT - October 2008 - (Page 38)

Speech: From Radiology to the EMR can be time-consuming and inefficient. “Early on, speech recognition was difficult and time-consuming to use, but there have been many improvements over the last five years making speech much more accurate and easy to use.” As a teleradiology company providing final interpretations, with approximately 30,000 to 40,000 studies per year, Athas wanted a scalable solution that would fit his growing practice. Using M*Modal’s AnyModal CDS Speech Understanding technology, integrated into NeuroStar’s Virtual Radiology system since August 2008, the practice plugs into any imaging system to establish a comprehensive worklist for their radiologists. “We can add readers, track cases and give the service we need to, in an organized fashion—because radiology is all about that now,” he says. AnyModal CDS Live captures and comprehends clinical information from dictation and can populate the medical record—creating a kind of “off-ramp” to the EMR. Physicians can elect to self-edit and use the real-time service or back-end approach to send drafts for editing by a medical transcriptionist. Neurostar essentially provides an overlay image distribution platform that can integrate with any system to route cases and provide a unified worklist for a team of radiologists. He says that what is impressive about the technology is the concentration on natural speaking and its ability to reduce cut-and-paste macros and prefabricated template reports. “Any speech recognition technology can generate a report or insert a macro and notes—M*Modal just does it better by allowing you to speak quickly and naturally, creating a more desirable and accurate radiology report,” Athas notes. emr + speech recognition is a valuable combo With more than 250 doctors providing healthcare services in 24 medical facilities, Fallon Clinic is the largest multispecialty medical group practice in Central Massachusetts. Two months ago, they went live with version 9.5 of Dragon NaturallySpeaking Medical from Nuance and are currently conducting a pilot test to see how it integrates with the practice’s Epic EMR. Lawrence Garber, MD has gathered a mix of 10 “real world” physicians within the practice, including neurology, rheumatology, orthopedics, internal medicine and pediatrics, with a wide range of computer skills and language accents—to participate in the study. According to Garber, just prior to seeing a patient for a visit, the physician typically reviews the patient’s electronic chart, including prior notes, test results and other clinical information. Then in the exam room, the physician can review and input information with the patient right there. Patients can see the screen with their electronic medical record, which is particularly useful for sharing graphs that show trends of tests results over time. Subsequently, the physician documents the visit using the strengths of both Dragon and the EMR. “Dragon is remarkably accurate at documenting free-text notes from the first day a physician uses it,” says Garber. During the dictation, Dragon also can activate Epic’s macros to take advantage of the EMR’s power. For example, if a physician dictates “Insert current meds,” Dragon sends “.takemed” to Epic and the EMR will insert the current medication list into the note. “There are a lot of shortcuts that maximize the power of the EMR, yet at the same time, Dragon allows you to do free-text transcription in areas where the EMR is weaker,” Garber adds. “The EMR is great for some structured information, but you also want to be able to have a discussion about the history of an illness, and what the possible treatment plan might be.” Additionally, utilizing speech recognition in conjunction with an EMR is going to save money. Garber notes that it was costing the practice $10,000 to $20,000 a year per physician for medical transcriptions. With approximately $2,000 in startup costs and approximately $300 per year after that, the return on investment is “a couple of months,” compared to other investments a practice might consider. “One of my missions is to get docs to use the EMR,” Garber says. “Everyone talks about barriers to adoption and really, it comes down to two factors—EMRs are expensive and they take up scarce physician time to implement. What I am seeing is that by using Dragon for speech recognition, you can quickly recapture the savings you need to pay for the EMR while reducing the amount of time it takes to become proficient.” Healthimaging.com 38 Health Imaging & IT | october 2008 http://www.NICAL.com http://www.NICAL.com http://www.HealthImaging.com

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Health Imaging & IT - October 2008

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