Speech Recognition:The State of the BusinessVR = Voice Recognition

Resources InterviewedBill Grube (Agfa Talk Technology)

Tim Fagert (Dictaphone Powerscribe)

By Rex OsbornSr Manager

Digital Imaging Practice

2©2003 First Consulting Group

Why Transcription is an Issue

Transcription, and our ability to distribute a diagnostic report has been a key to measuring the management success of Radiology

“Turnaround time equals Hospitals perception of how efficient Radiology is.”

3©2003 First Consulting Group

The 7 Steps (Manual)

1. Analysis of the study2. Radiologist dictates study3. Transcriptionist types

dictation4. Radiologists signs report5. Professional billing and

clinical coding occurs6. Diagnostic (dx) report is

printed7. Dx report; fax and mail

Ordering physician Medical records File room copy Radiologist copy

Analysis

Dictation

Transcription

Sign Rpt

$ & Coding

Print Report

FAX & MAIL

4©2003 First Consulting Group

Why Conventional Transcription Needs Help…

Transcription costs are rising Preliminary reports not promptly available

“The driver for VR technology is PACS related, the Images are available immediately, where is the Dx Report?”

Error-prone, Re-dictations Signature Delays

5©2003 First Consulting Group

Key Components For a VR System

Language Model Acoustical Model (engine) Input Device (microphone) Post Processing of recognized text

6©2003 First Consulting Group

Key Features: Language Model

Language models are a set of rule-based statistics that increase the accuracy of speech recognition

A language model anticipates the user’s vocabulary and style of speech

Language models are the key ingredients that enable applications to achieve high accuracy rates

7©2003 First Consulting Group

Language Model Provided by Speech Recognition Vendors

Speech Recognition Application

for Radiology

Speech Engine built with Radiology Language Model

Radiology Vocabulary

Speech Engine built with Radiology Language Model

Radiology Language Model

Radiology Data

8©2003 First Consulting Group

Key Features: Acoustic Model

Acoustical models are created by comparing sounds, or acoustic data

Acoustic data provides most of the information required for human speech to be recognized by software

Acoustical models are typically adapted (refined) after a given period of time

9©2003 First Consulting Group

Key Features: Input Device

Noiseless button technology

USB technology which eliminates sound cards

Primary device for dictation – microphones and headsets

10©2003 First Consulting Group

Key Features: Post Processing

AI for recognized speech Designed to minimize extra

dictation Designed for easy editing and

navigation via key strokes Allows Radiologists to retrain

system to enhance vocabulary recognition

11©2003 First Consulting Group

Who are the Pioneers of VR?

VR Application Vendors Language Model Innovators Speech Engine Designers

12©2003 First Consulting Group

Who Should I Trust?

Technology and Workflow Innovators

A vendor that has an integration strategy and approach

A proven record of successful implementations

13©2003 First Consulting Group

How Can They Ensure Success?

From a Vendor Perspective… Experienced team that has been

successful with the deployment of this technology

Clinical knowledge Joint deployment strategy Test environment for education and

integration validation

14©2003 First Consulting Group

How Can You Ensure Success?

From A Client Perspective… MUST have a Project Champion

(Radiologist) Must have support of Radiologists RIS and PACS Integration must be

outlined to ensure tenable workflow Removal of Legacy Dictation System Do a small group at a time, this way you

can have measurable outcomes

15©2003 First Consulting Group

How Do You Measure success?

ROI Strategy Did we save money? Are we more efficient?

Report turn-around time reductions Is the report getting to the people

ordering the studies? Have phone calls asking for reports

been reduced? Physician productivity

16©2003 First Consulting Group

Road Map Items for VR Vendors

Hardware USB microphones (elimination of sound

card) Portable dictation devices

Software/integrations Desktop integration (Physician

Workstation) Remote capabilities Integration to SR DICOM in Future

17©2003 First Consulting Group

Drawbacks of Technology

Perception of being a transcriptionist rather than a Radiologists because of on-line editing prior to signature

Vendors efforts to place within workflow a place for a full time Correctionist

Easy to break Sound Cards and Microphones Software stability Recognition accuracy will improve but will

require Radiologists’ patience…

18©2003 First Consulting Group

The VR Workflow

Report is dictated and voice recognition creates diagnostic report Radiologist must read

through report and correct (on average 3-8 words)

Sign report (electronically)

Dx report distributed via existing integration with appropriate results outbound transactions

ANALYZE, DICTATE,SIGN

Dx REPORTDistributed Via

RIS - HIS - EMR - CDR

19©2003 First Consulting Group

To MAKE VR Successful:

Set realistic expectations Transcriptionist don’t have to go away

immediately PACS workflow should drive integration with

VR solutions for optimal efficiency Target areas where the greatest impact and

can show acceptance... don’t fight with the Radiologists

“Identify where success is likely, and build momentum”

20©2003 First Consulting Group

VR Integration; Agfa Example