Flinders stays vocal on radiology reports

July/August Edition, 2007: Imaging equipment is still running hot at the Flinders Medical Imaging department but radiology transcriptionists are running out of work. A voice recognition tool built into their medical imaging systems now allows radiologists to not only think their reports aloud, but also transfer them to screen automatically.

There are plenty of images being processed and analysed at Flinders Medical Imaging. As a department of the 500-bed Flinders Medical Centre, about 130,000 imaging procedures are achieved every year across seven speciality units including CT, mammography, MRI as well as general and emergency X-ray.

With 12 specialist radiologists working amongst the 130 full-time staff, a radiologist’s report was a significant processing effort within the department. Be it a CT scan, X-ray or ultrasound, a radiologist would record their report on the image, pass it on to a transcriptionist to type, send the report back to the doctor to proof-read and finally release it for clinical review. All up, it was a process that could take up to 72 hours, significantly delaying answers on patient care while burning up costs in the process.

While the department had already enabled a Picture Archiving and Communication System to provide digital ‘filmless’ radiology images, accessible via a secure network, Flinders was still looking to further reduce processes alongside their state-of-the-art digital system.

The department moved to implement the Dictaphone Powerscribe Workstation from Nuance Communication to eliminate the transciptionist from the process and speed up the processing of reports by radiologists. Automatically linked in with PACs, the South Australian department is on to a voice activated reporting interface which is currently a major talking point of radiologists around the world.

Flinders has put a price on the cost-savings the information management system has produced. Chris Pilkington, divisional manager at Flinders Medical Imaging believes the Dictaphone Powerscribe Workstation will save around $250,000 every year. He bases this figure on the cash saved on transcription services and processes.

For a medical imaging department, the Workstation’s true benefits are in its ability to understand the language of radiology. “It’s good at recognising medical terminology, specifically radiology language, so most of our radiologists are getting a fairly accurate response,” says Tanya Boeje, the PACs manager at Flinders Medical Imaging.

Of course after using the keyboard for so long, there is still the instinct to revert back to it as the system is learning. “We do try to encourage them to edit using the microphone to minimise the keyboard use,” says Boeje. “We tell them what they get out of it is how much they put in, you really do need to train the product.”

It’s also a matter of being patient with the machine because the more attention it’s given, the better it performs. “The initial training session to use it is only about half an hour to an hour, to then allow the system to fully adapt to a voice it usually needs to collect around 30 minutes of audio. It could really take a couple of months before it’s really working, depending on how much they’re using it.”

However once a radiologist puts in the initial voice recognition work, it isn’t long before they start benefiting from the improved turn-around time. “When I first started the median time for interim reports was around 26 hours with the actual time to authorise them closer to 72 hours. Now it’s more like 5 or 6 hours and often just an hour during the day,” says Boeje.

But like any recognition system, the initial learning process can be difficult. “It can be frustrating,” says Boeje. “But we do have registrars who have never used any recognition system and they’ve taken it really well. They do need to follow up and input over time, particularly in the first three months and it’s important they are using it fully.”

Although the workstation is making short work of difficult radiology terms making overall processes more efficient, Boeje believes it’s the increased information access levels that are really transforming the department, especially as the reports can be shared via OASIS with other South Australian hospitals. The Canadian OASIS solution integrates Lab and radiologist reports, allowing patients to have a smoother transition between health centres throughout the state.

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