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Dictation Technology in Healthcare
Simon Howard
Dictation Solutions Director, Nuance
Contact: simon.howard@nuance.com
2
Healthcare Technology Award
3
NHS – The Landscape (1)
Why Speech?
 Connecting For Health - £6-30 Billion NHS IT
Project
 AKA “The Biggest Computer P...
4
NHS – The Landscape (2)
Why Speech?
 Many NHS Trusts in financial crisis
 Admin and Secretarial resource targeted
 Cl...
5
Speech is Ubiquitous
Speech Solutions :
 The Healthcare Professional
 Departmental
 Hospital-wide
 Trust-wide
 Clus...
6
Speech is Modular
Modular Solutions :
 Desktop Recognition
 Digital Dictation
 Server based recognition
 Server/Desk...
7
Speech is Mobile
Input Solutions :
 Handheld microphones
 Wireless headsets
 Telephony
 Digital recorders
 PDA’s
 ...
8
Reduced
Overheads
Speed and Faster Cycle Time
Data Access
Speech is Effective
Benefits :
 Improved Data Access (CfH)
 ...
9
Desktop drivenTranscription Assisted
Speech Recognition
Two types of speech dictation
10
Productivity Gains
Transcription Assisted Desktop Driven
 50% avg.
productivity gain
from best practice
customers
 60...
11
Dictaphone Healthcare Solutions
All Powered by Dragon technology:
 Dragon Medical Solutions (UK)
 Dictaphone PowerScr...
12
Dragon Core Technology
Flagship LVCSR technology:
 DNS has 90% share of desktop based dictation
market
 25 years of l...
13
Dragon Offerings
Dragon NaturallySpeaking Professional
Solutions V9
 MAJOR NEW FEATURES INCLUDE:
 No Enrolment Traini...
14
Dragon Offerings
Dragon Medical Solutions V9
 No Enrollment Training
 Broad Compatibilty with Clinical Systems
 Cont...
15
Dragon Healthcare Penetration
 200 + NHS Trusts
 40% Pathology Labs
 40% Radiology Depts
 40+ Secondary Care Specia...
16
Dragon Healthcare Case Studies
SE London Cancer Network
Cancer report turnaround times reduced from:
 6 days to 3 days...
17
Comparison of conventional dictation against voice recognition
West Suffolk Hospital
0
2
4
6
8
10
12
lab. path. absolut...
18
Accuracy
         Voice
• Minor errors = 31
• Major errors = 0
           Tape
• Minor errors = 16
• Major errors = 6
R...
19
         Voice
• Minor errors = 86
• Major errors = 12
           Tape
• Minor errors = 143
• Major errors = 23
Referen...
20
Dragon V9
Demo
Clinical Productivity Demonstration
21
Dictate Distribute
RecogniseCorrect
Process
The Workflow Process
Server Based Recognition
22
Measurable increases in productivity - digital dictation only
MT Productivity – Industry Average 130 lines per hour
MT ...
23
Speech Enabled Productivity Gains
0 1 2 3 4 5 6 7 8 9 10 11 12
mean productivity (speech recognition)
mean productivity...
24
Server Based Workflow
INTERNET
Firewall
Remote Dictation
Workstation
Remote
Transcription
Digital
Dictation
Print/Fax
E...
25
Server Based Recognition
Importance of Server Based Recognition:
 No change in User experience
 Encourages widespread...
26
A unique Dragon feature
Dragon Inference Engine
Through careful analysis and review of
secretarial transcription, Drago...
27
Server Based Recognition
Importance of Server Based Recognition:
28
Dictation
100% Conventional
Transcription
100% Conventional
Clinician dictates
Into handheld/PC
Manual
Transcription
Sp...
29
Nuance Dictaphone PowerScribe
 PowerScribe Workstation is optimised
for high-accuracy, real-time speech
recognition an...
30
Nuance Dictaphone PowerScribe
 Web browser based
 Lets physicians dictate, self-
complete recognised text, and
electr...
31
Nuance Dictaphone PowerScribe
 Enroll and train the system very
quickly by reading a few reports.
 Edit speech-recogn...
32
A true all in one Trust
wide solution
 Browser-based EWS, lets physicians
dictate, self-correct, and
electronically si...
33
ASP Based Workflow
 Dictaphone ichart from Nuance is a
new way for healthcare organisations
to acquire leading speech ...
34
ASP Based Workflow
 Benefit from the most advanced
Digital Dictation, Speech
Recognition, and Natural
Language Process...
35
Key Healthcare Drivers
Speech Based Dictation Offers:
 Individual clinician to Enterprise wide solutions
 Total Modul...
36
Key Healthcare Drivers
Speech Based Dictation Offers:
 A compelling business case
INVOLVING
 Dramatically improved re...
37
Questions?
38
Why not join us on the 2007
Dictaphone Healthcare Battle Bus?
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  • <number>
    Introducing automation to today’s manual documentation process creates 3 critical benefits:
    Creating cost savings through reduced transcription labor and better transcriptionist productivity
    Significantly speeding the end-to-end document production cycle
    Providing greatly enhanced access to key patient information
  • <number>
    First, let’s look at the cost savings driven by speech recognition.
    Dictaphone offering flexible. Gives customer options to use transcription-assisted speech, fitting easily into today’s typical workflow or to use more automated dictation in which physicians control their own documentation with “once and done” speech.
    Customer choice.
  • <number>
    In radiology, customers are routinely realizing cost savings in the hundreds of thousands of pounds due to the reliance on provider control of editing. Reports are being completed in minutes rather than days –critical in the demanding radiology environment.
    Automated transcription through speech is producing 50% gains in transcription output when best practices are followed.
    On the provider automation side outside of radiology where the transcription step is bypassed, we are seeing major gains, and we now have physicians relying heavily on the technology, showing it can be adopted.
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  • Transcript of "Slides from presentation"

    1. 1. 1 Dictation Technology in Healthcare Simon Howard Dictation Solutions Director, Nuance Contact: simon.howard@nuance.com
    2. 2. 2 Healthcare Technology Award
    3. 3. 3 NHS – The Landscape (1) Why Speech?  Connecting For Health - £6-30 Billion NHS IT Project  AKA “The Biggest Computer Programme in the world …Ever!”  A National programme designed to deliver effective management, storage and analysis of electronic patient data  Q. BUT HOW DO YOU GET THE DATA IN?  A. Speech will play an increasingly pivotal role in inputting data into 21st Century electronic healthcare systems
    4. 4. 4 NHS – The Landscape (2) Why Speech?  Many NHS Trusts in financial crisis  Admin and Secretarial resource targeted  Clinical reporting labour intensive and slow  Increasing demand for speech based solutions  Speech delivers significant productivity benefits (TAT)  Speech delivers significant admin savings (ROI)  Increasingly, NHS Trusts are turning towards speech as an enterprise wide solution
    5. 5. 5 Speech is Ubiquitous Speech Solutions :  The Healthcare Professional  Departmental  Hospital-wide  Trust-wide  Cluster-wide  Nationwide
    6. 6. 6 Speech is Modular Modular Solutions :  Desktop Recognition  Digital Dictation  Server based recognition  Server/Desktop recognition  ASP
    7. 7. 7 Speech is Mobile Input Solutions :  Handheld microphones  Wireless headsets  Telephony  Digital recorders  PDA’s  Notebooks  Tablets
    8. 8. 8 Reduced Overheads Speed and Faster Cycle Time Data Access Speech is Effective Benefits :  Improved Data Access (CfH)  Reduced Transcription Costs  Improved TAT  Improved Morale!
    9. 9. 9 Desktop drivenTranscription Assisted Speech Recognition Two types of speech dictation
    10. 10. 10 Productivity Gains Transcription Assisted Desktop Driven  50% avg. productivity gain from best practice customers  60% - 100% transcription cost reduction through direct bypass
    11. 11. 11 Dictaphone Healthcare Solutions All Powered by Dragon technology:  Dragon Medical Solutions (UK)  Dictaphone PowerScribe  Dictaphone EWS  Dictaphone iChart
    12. 12. 12 Dragon Core Technology Flagship LVCSR technology:  DNS has 90% share of desktop based dictation market  25 years of leadership in the field of desktop SR  Desktop & Server based recognition models  Integrates into any Windows application  Maximises Microsoft Office Productivity  NO initial speaker adaptation required  Desktop = Maximum ROI
    13. 13. 13 Dragon Offerings Dragon NaturallySpeaking Professional Solutions V9  MAJOR NEW FEATURES INCLUDE:  No Enrolment Training  15% More Accurate  Enterprise Ready–Install and manage across Network  Facilitates Roving Profiles  Supports Citrix Thin Client Environments  Broader Application Support
    14. 14. 14 Dragon Offerings Dragon Medical Solutions V9  No Enrollment Training  Broad Compatibilty with Clinical Systems  Contains 14 Medical Specialties: Radiology, Pathology, Cardiology, General Medicine, Paediatrics, Emergency, Mental Health, Ob/Gyn, Oncology, Orthapedics, Surgery and others  Includes over 60 sub-specialties
    15. 15. 15 Dragon Healthcare Penetration  200 + NHS Trusts  40% Pathology Labs  40% Radiology Depts  40+ Secondary Care Specialty Departments  Broad GP Practice Coverage
    16. 16. 16 Dragon Healthcare Case Studies SE London Cancer Network Cancer report turnaround times reduced from:  6 days to 3 days (Histopathology) Kings College Hospital  5 days to 1 day (Radiology) Kings College Hospital  Reduced patient waiting times, accelerated diagnosis, better outcomes  50% less typing time needed by consultants PA’s  £11K cost savings per consultant pa
    17. 17. 17 Comparison of conventional dictation against voice recognition West Suffolk Hospital 0 2 4 6 8 10 12 lab. path. absolute March June   Total cases Laboratory  phase Pathologist  phase Absolute  turnaround time              March 487 2.4days 7.8 days 10.2 days      June 373 2.2 days 1.2 days 3.4 days Dragon Healthcare Case Studies
    18. 18. 18 Accuracy          Voice • Minor errors = 31 • Major errors = 0            Tape • Minor errors = 16 • Major errors = 6 References from Radiology Dept at Norfolk and Norwich Hospitals 140 reports Dragon Healthcare Case Studies
    19. 19. 19          Voice • Minor errors = 86 • Major errors = 12            Tape • Minor errors = 143 • Major errors = 23 References from Radiology Dept at Norfolk and Norwich Hospitals 500 reports Accuracy Dragon Healthcare Case Studies
    20. 20. 20 Dragon V9 Demo Clinical Productivity Demonstration
    21. 21. 21 Dictate Distribute RecogniseCorrect Process The Workflow Process Server Based Recognition
    22. 22. 22 Measurable increases in productivity - digital dictation only MT Productivity – Industry Average 130 lines per hour MT Productivity – Dragon MT Average 180 lines per hour Average productivity increase 30% MT Productivity – Industry Average 130 lines per hour MT Productivity – Dragon MT Average 180 lines per hour Average productivity increase 30% Figure 1: MedRemote MT Productivity By MT Group 0 50 100 150 200 250 300 350 1 2 3 4 5 6 7 8 9 10 MT Group Each group represents 10% of MTs, from most productive to least productive LinesPerHour Estimated Industry Average Transcription Platform Impact
    23. 23. 23 Speech Enabled Productivity Gains 0 1 2 3 4 5 6 7 8 9 10 11 12 mean productivity (speech recognition) mean productivity (transcribing) Average Time (minutes) to transcribe/edit 1 minute of dictation transcribing without speech recognition editing with speech recognition Impact of server based speech recognition The average (mean) transcriptionist types 1 minute of dictation in about 4 minutes  The best editors can edit 1 minute of dictation in less than 2 minutes
    24. 24. 24 Server Based Workflow INTERNET Firewall Remote Dictation Workstation Remote Transcription Digital Dictation Print/Fax E-mail Portable Reporting Desk Based Reporting LAN Speech Recognition Speech Recognition RIS / PACs/ HIS / EPR Integration Telephone Reporting Transcription Pool
    25. 25. 25 Server Based Recognition Importance of Server Based Recognition:  No change in User experience  Encourages widespread adoption  Silently eliminates ‘growing pains’ of Desktop  Introduces user to Desktop in optimal condition  Best route to maximising ROI through higher self- edit adoption
    26. 26. 26 A unique Dragon feature Dragon Inference Engine Through careful analysis and review of secretarial transcription, Dragon technology can, by repeated inference, develop a set of pre-processing, author dependent rules to accelerate the transcription process.
    27. 27. 27 Server Based Recognition Importance of Server Based Recognition:
    28. 28. 28 Dictation 100% Conventional Transcription 100% Conventional Clinician dictates Into handheld/PC Manual Transcription Speech servers learn from transcription Speech Editing Speech servers perform recognition (for select users) Speech servers learn from corrections Speech servers accumulate audio data clinician uses Front-end speech recognition Screening • Speech Servers produce clinician ratings • Administrators select clinicians for backend speech based upon ratings Scorecards • Scorecards identify reasons for poor performance • Administrators provides feedback to clinicians • Administrators re-screen clinicians Front-end screening • Scorecards give projected scores for front-end speech recognition • Administrator selects candidates for front-end speech rec • ** User profile automatically migrates to clinician desktop Dictation 100% Conventional Transcription 60% Conventional 40% Speech Edit Dictation 100% Conventional Transcription 50% Conventional 50% Speech Edit Dictation 98% Conventional 2% Frontend Speech with MT Edit Transcription 40% Conventional 60% Speech Edit Dictation 80% Conventional 10% Front end Speech with Self-Edit 10% Front end Speech with MT Edit Transcription 20% Conventional 80% Speech Edit Continuous screening, learning, feedback • Speech system continues to learn from corrections • Speech system continues to provide feedback to users • Administrators continue to perform screening & migrate more clinicians to backend / front-end speech rec • Speech engine continues to improve The Process Migration to Speech Recognition
    29. 29. 29 Nuance Dictaphone PowerScribe  PowerScribe Workstation is optimised for high-accuracy, real-time speech recognition and self-editing to meet the demanding turnaround requirements of the order driven reporting environment.  Highly accurate speech recognition  Powerful physician self-editing tools  PowerScribe Workstation offers dramatic cost savings and speedy report turnaround.
    30. 30. 30 Nuance Dictaphone PowerScribe  Web browser based  Lets physicians dictate, self- complete recognised text, and electronically sign reports from any Internet-connected PC.  Allows radiologists "once-and- done" control over the report creation process.  Radiology language model - PowerScribe Workstation offers high recognition accuracy for a broad range of users.  Enhanced MS Word version
    31. 31. 31 Nuance Dictaphone PowerScribe  Enroll and train the system very quickly by reading a few reports.  Edit speech-recognised reports by voice or keyboard.  Deferred editing option  Use speech recognition in batch or real-time mode.  Create standard reports and fill- in templates quickly with voice- driven "Short Cuts".  View patient and order information on screen through direct interface to the RIS.
    32. 32. 32 A true all in one Trust wide solution  Browser-based EWS, lets physicians dictate, self-correct, and electronically sign reports generated by Nuance’s speech recognition applications.  Leverages a mix of best practice technologies, including - Dragon Speech engine - Seamless HL7 interfacing - Automated document distribution  Offers Total administrative control over system security (HIPAA), job distribution and prioritisation, MPI (ADT) feeds etc
    33. 33. 33 ASP Based Workflow  Dictaphone ichart from Nuance is a new way for healthcare organisations to acquire leading speech recognition and dictation technology through a comprehensive Internet subscription- based ASP service. Gain Internet access to industry standard Speech Recognition and Dictation/Transcription software that integrates easily with your present workflow.  Reduce the need for on-site equipment and capital investment.
    34. 34. 34 ASP Based Workflow  Benefit from the most advanced Digital Dictation, Speech Recognition, and Natural Language Processing technology located remotely at our ichart data centre facility.
    35. 35. 35 Key Healthcare Drivers Speech Based Dictation Offers:  Individual clinician to Enterprise wide solutions  Total Modularity = 100% adoption  DD, Desktop and Server based recognition  No enrolment  Very accurate clinical language models  Supports mobile dictation opportunities  Web Browser based workflow  Powerful automated shortcuts  Enhanced MS Office productivity  Seamless interfacing with clinical systems
    36. 36. 36 Key Healthcare Drivers Speech Based Dictation Offers:  A compelling business case INVOLVING  Dramatically improved report turnaround times  Significantly reduced administrative overheads ENABLING  Improved generation of/access to patient data MEANING  Improved delivery and quality of patient care
    37. 37. 37 Questions?
    38. 38. 38 Why not join us on the 2007 Dictaphone Healthcare Battle Bus?
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