With a five-year adoption mandate of electronic health records hanging over health organizations, they are faced with many hurdles—but speech recognition may very well be the critical enablement technology they have been looking for.
As health care organizations strive to improve the way they
handle patient records in the digital realm, many are struggling with the
ultimate electronic medical records bugaboo. That is, how the heck do they get
the doctors to actually use EMRs?
“The big challenge is getting the doctors to use the
electronic health records,” says Dr. John Halamka, CIO at Beth
Israel Deaconess
Medical Center,
who cites American Hospital Association numbers that show only about 17 percent
of physicians in the United States
currently use EMRs.
A study by the New
England Journal of Medicine of 3,000 hospitals in April shows even worse
adoption rates—only 1.5 percent of all non-federal U.S.
health care facilities use a comprehensive EMR
system, and just 8 percent have EMRs installed in at least one unit.
Federal lawmakers are trying to promote better adoption of
EMRs in order to develop the infrastructure necessary to reap the benefits of
pervasive EMR use. With the passage of American Recovery and Reinvestment Act
(ARRA) of 2009, the government plans to disperse $36 billion in aid to promote
EMR investments nationwide.
But even though the average 500-bed hospital will expect to
rake in about $6 million of those funds if they implement EMRs by 2011, that
will hardly cover the expense of a full deployment, according to
PriceWaterhouseCoopers consultants.
“PricewaterhouseCoopers’ analysis shows that the stimulus
incentives to comply with the new requirements for purchasing, deploying, and
maintaining interoperable EHRs [electronic health records] do not come near to
compensating the overall costs,” a recent report by PWC reads.
Unfortunately, though, health care organizations are caught
in quite a pickle because if they don’t comply by 2015, they face severe
decreases in Medicare and Medicaid funding as stipulated by ARRA.
That five-year adoption mandate is quite the daunting
prospect considering that the IT departments tasked with supporting EMRs are
bleeding budget dollars by the bucketful in the current downturn. Not only
that, but organizations cannot simply make due with a cockeyed, checkbox
compliance approach to deployment due to the mandate by ARRA that organizations
employ "meaningful use" of EMRs.
Clearly, organizations need to find a way to not only
install EMR systems but to also promote
physician adoption in as economical a way as possible. While there certainly
are a number of back-end IT systems that need to be squared away to support
these efforts, Halamka believes that the key piece of the puzzle lies in the
front end. In other words, how physicians enter their information into the EMR
system. If the system is too unwieldy, it is doomed to collect cobwebs. If it’s
too expensive to maintain, it’ll sink the organization.
Which is why he believes speech recognition very well may be
the critical enablement technology to help organizations meet the ambitious
2015 EMR deadline.
According to Halamka, many hospitals and other health care
organizations face the prospect of either having doctors record patient
information manually via computer terminals or through dictation. Many doctors
despise having to enter information for each interaction through mouse and
keyboard because it cuts into their practice time and because many old-school
doctors are simply not comfortable with computers. Physicians would much prefer
to dictate their thoughts on patients, but there’s a catch: Traditional medical
transcription is extremely costly.
“The challenge is this: The cost of transcription is high,”
Halamka says. “The more people you tell to dictate notes, the bigger your
transcription budget. That is made worse by the fact that sometimes the
doctors’ dictations ramble compared to if you were typing a report where you’d
focus and put it in an orderly template.”
At Beth Israel, Halamka has tackled the problem by focusing
on delivering a way to give physicians an entry method they can live with while
eliminating the costs of transcription. The solution is the deployment of
speech recognition and medical note automation software from Burlington, Mass.-based
Nuance Software.
The server-based program enables the doctors to either call
in reports to the system or dictate with a handheld recorder and upload to the
system without Halamka’s team having to maintain server-based programs. The
software takes disorganized speech and, based on keywords spoken by the
doctors, automatically organizes it into specific templates. And it does all of
this with about 97 percent to 98 percent accuracy.
According to Halamka, the initial implementation cost
$500,000. But since the organization started phased roll-uts five years ago, Beth
Israel has saved more than $5 million in transcription costs alone.
A user comment on this articlePosted on: 10-14-09 | By: Anonymous97 to 98% accuracy? That's horrible. The personal injury attorney awaits for the 2-3% patients who are injured because of omissions and mistakes resulting from many thousands of errors and have grounds to sue for damages. Does the software company have insurance?
Most EHR deal with Voice Rec.Posted on: 09-03-09 | By: LeslieThe overwhelming majority of EHRs listed here: http://www.ehrscope.com indicate that they are compatible with VR.
FYI
-Leslie
Army provider in Afghanistan using Voice RecognitionPosted on: 09-03-09 | By: AnonymousThe Army's tactical medical recording system, MC4, is being used throughout levels of care in 14 countries by military providers, who have found time savings in the use of voice recognition software with teh MC4 system. Recently, CPT Barnstuble wrote about his experiences on this blog -
<a href="http://www.mc4.army.mil/mc4newsletter/2009_4/field_stories.asp">Provider Saves Hours with Voice Recognition Software</a>.
