(HealthTech Wire / Interview) - In the run-up to Smart Healthcare in London, the UK’s largest event for public health ICT, Nuance is focusing on the efficiency and quality aspects of speech recognition. “The, still, very high rate of analogue dictation is a major obstacle in enabling the clinical documentation process to become more efficient and cost-effective”, says Simon Manley, the company’s Sales Director for UK healthcare. He outlined to HealthTech Wire how the NHS QIPP programme and the increasing cost-awareness of the government will help him get all NHS Trusts to “wholeheartedly” embrace speech recognition.
Mr. Manley, you joined Nuance Healthcare in January of this year. What is your impression of healthcare speech recognition after your first few months with the company?
I was struck by the vibrancy and passion that Nuance employees expressed about their products. I sensed there must be a great opportunity building here. We see consumer products lead on the fact that they have speech recognition. Professional healthcare products are following this trend. Why? Notwithstanding the fact that healthcare professionals are historically familiar with creating dictations, speech recognition delivers efficiency and productivity gains that can satisfy the sometimes competing aims for service and quality improvement whilst lowering costs. With the UK government now looking for significant efficiency savings in the NHS, I believe these are key factors that will drive the adoption of speech recognition.
But analogue technologies are still widely spread…
Yes, statistics show that around 84% of the Trusts still use analogue technologies; this means that doctors dictate on a tape, put it in an envelope, send it to a secretary who then transcribes the dictation and returns the document to the doctor and so on… It is inefficient and it is costly.
A digital dictation workflow, with built-in speech recognition technology, substantially speeds up the documentation process meaning an end to the serious patient safety issue of long typing backlogs, the cost of expensive agency staff and overtime to clear these backlogs as well as stressed workers. Furthermore with the steady decline in secretarial staff, these solutions will not only sustain but significantly improve upon current productivity. This is because speech recognition drives efficiency and that’s why I have been taking the issue to the highest level from day one, to get governmental, ministerial and political buy-in for the technology. We now have to involve the senior people within the NHS to show what is available and get them to embrace the solution. It will make their lives easier and save money.
At the beginning of the year, Smart Healthcare featured an article on the topic, highlighting that “Digital dictation (DD) systems have gained a reputation for involving big upfront costs, for both software licenses and hardware.”
I agree. However, with Nuance’s eScription platform, which is currently being deployed at 4 NHS Trusts, this has changed. With eScription we recognise that money is a limiting factor and therefore have introduced a “payas- you-go” service model. There “Speech recognition answers NHS efficiency call” are little or no upfront costs for NHS Trusts. The uptake of eScription should therefore be wide ranging and quick, because software-as-a-service is the future.
In the US, where Nuance is based, outsourcing typing to transcription companies is a common workflow. Is Nuance facilitating outsourced transcription in the UK with eScription?
eScription is an end-to-end, cloudbased transcription platform. It has intelligent speech recognition software behind it that creates fully formatted documents and delivers them to the medical secretaries. These speech recognised and formatted documents might need editing, but no typing, which already represents huge savings. We see some interest from Trusts in offshoring the secretarial work, as is happening in the US, but this is not what we do with eScription. We are talking about an entirely UK-based product running over the secure NHS N3 VPN network.
Talking about N3, has the National Programme for IT encouraged the adoption of speech recognition?
Not really, because the focus was on electronic patient records and PACS. The initiative that will impact speech recognition adoption is QIPP. Amongst many other excellent guidelines, QIPP advises healthcare organisations to apply the knowledge of national and international best practice to support the NHS drive for quality, innovation, productivity and prevention. Nuance and our customers have truly global experience in demonstrating the cost-saving and productivityincreasing power of speech recognition. The university hospital of Oslo in Norway, for example, saves more than GBP 700,000 annually. I also believe our eScription solution will be an outstanding example of how to leverage mature and proven US transcription Best Practice and convert it into faster clinical reporting and huge efficiency savings for the NHS. With QIPP, we will even see the NHS push the private sector to take up speech recognition faster.
How does eScription fit into Nuance’s product portfolio for healthcare, which also includes Dragon Medical and speech recognition for integration with third-party solutions?
It fits very well because it gives our customers greater choice. Nuance acknowledges that there is no “one size fits all” approach to the NHS as no two Trusts are exactly the same. Our assessment of the situation in a hospital will allow us to offer the best possible approach. eScription is an additional and powerful tool to do so. What we really want is the NHS to embrace speech recognition wholeheartedly. I want NHS Trusts to go all the way in digitising their dictation workflows – because it is only when they adopt speech recognition as an integral part of the process that the truly significant cost-savings will kick in. I am confident that three years from now, we will have 100% of the hospitals in the UK using speech recognition in one way or another.
Mr. Manley, thank you for your time and answers. (HTW)
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