College of Radiologists

Voice RecognitionWhat it should

And can doFor radiology

Introducing Myself

• Malcolm Grant

• GHG Software Developments Ltd

• Working with VR in radiology > 5 years

• Installed a number of NHS VR Systems

What it Should Do

• Save time and money?

• Shorten turnaround times?

• Improve reporting quality?

• If possible deliver all 3 together!!!

What it Can Do

• Save time and money

• Shorten turnaround times

• Improve reporting quality

• So why is it not in more universal use? ….

Unwelcome Technology?

Unwelcome Technology?

Stethoscope

Unwelcome Technology?

Stethoscope

PC

Unwelcome Technology?

Stethoscope

PC

PACS

Unwelcome Technology?

Stethoscope

PC

PACS

Voice Recognition

Cultural Change?

• Authors need RIS and VR knowledge– not just PACS – therefore learning curve

• Authors take full responsibility for Report– Second language speakers, mumblers– Full proof reading burden

• Appropriate workflows– Scanned request cards, barcodes, worklists

Reputation?

• “I tied voice recognition bee 4 and it did not walk”

• This is not a demo day, but …

• The technology is proven to deliver

• What is needed to succeed?

What is Needed

• High accuracy and fast editing

• Tight integration with RIS and PACS

• Network solution

• Good ergonomics

• 1:1 training

What is NeededHigh accuracy and fast editing

• UK Radiology Vocabulary essential

• Speech Engine dependency is high– Near monopoly

• Voice friendly report box– Not evident in most RIS systems

• Can all be checked in a short demo

What is NeededTight integration with RIS and PACS

• Authoring must be time-neutral– Benefits are not directly for the Author– RIS designed for typists, not authors– Measurement is for report + verification

• RIS overheads must be minimised– E.g. “No bony injury seen”, “Heart and lungs

are clear, no abnormalities of note”

• Drive must be easy to use– Simple accurate commands, fast drive

What is NeededNetwork solution

• Speech engines designed for single users

• Radiologists need to move around

• Shortcuts need to be shared and individual

• Voice files need to be network managed

• Back-end recognition also required– E.g. Breast clinic

What is NeededGood ergonomics

• Choice of Microphone– Accuracy, portability, durability, comfort

• Foot-pedal controls (mike control)– Needed to remove mike control issues

• Focus controls– Dictation, PACS RIS (mouse free)

• True hands-free use– Keyboard to be an option only

What is Needed1:1 Training

• Trainer - Expert in VR– Every speaker is different– Broad experience needed

• Trainer – Conversant with RIS and PACS– Able to advise on best practice– Good experience in radiology

Successful implementation

• Choose an experienced specialist vendor• Check recognition accuracy, speed, editing and

shortcut capabilities at the demo stage• Sign-off an integration specification

– Detail RIS and PACS issues– Test in a pilot (e.g. 4 users)

• Roll-out in stages with full training– 2 1:1 sessions with each author (approx 6 hrs/author)– Review management issues at each stage

What VR Users Say

Consultant

Radiologists

& Registrars

Reporting

Radiographers

Sonographers Reluctant

users

Typist

Reductions

Norwich 40 2 0 12 50%

Truro 17 6 12 3 Yes

MK 4 7 0 2 50%

What VR Users SayPreferred

Reporting

method

Accuracy

v

Expectation

Training Tight Integration

Turn back

Clock

Overall

OK

Norwich None Variable Essential Essential No Yes

Truro VR Better Essential Key No Yes

MK VR Better Most

Important

Very

Important

No Yes

Users - Stated Benefits

• Faster turnaround

• Immediate verification

• Workflow improvements

• 24-7 working

• Encouragement to standardisation

• Improved user satisfaction

My stated benefits

• Verification time saved (10%)

• Large savings in typing costs

Users - Stated downsides

• Up to 50% slower reporting initially

• Users take up to 3 monthsto get up to speed

• Proof reading of long reports can be weak

• Minority of users do not succeed

Conclusion

Voice Recognition

can and does do, what it should do

with considered implementation

System Comparison

Reporting

Direct VRTape/Digital

Dictation

Typing

Correction

Verification

Verification

Shortened QBacklog

inTyping Q

No typing savingsNo Speed up

50% typing savingsSome Speed up

100% typing savingsImmediate availability