Patient Records: Speak it, See it, File it With New LRMC Voice Recognition System
January 9, 2009
LANDSTUHL REGIONAL MEDICAL CENTER, Germany- It\'s faster, more accurate and highly maneuverable. What may sound like the latest weapons system is actually a new way of doing business for doctors at Landstuhl Regional Medical Center. With the introduction of Dragon Medical speech recognition software, the process of documenting patient medical records can be accomplished in minutes rather than days. Not only is the process faster, but it allows for a more detailed, accurate and cost-effective way of doing business, said Army Major (Dr.) Hamilton Le, a surgeon who has mastered the program in less than a month. "In the end, it's all about patient care, taking care of Wounded Warriors coming through LRMC, taking care of family members and all the servicemembers who are stationed locally," Le said. Speech recognition software is helping accomplish heightened patient care, he said, by reducing the hours spent on reviewing medical records and increasing the amount of time available for patient care. Before, Le would dictate his inpatient surgery notes into a telephone recording machine and wait two to three days for them to return from a transcribing service that costs about 17 cents per line. Reviewing and signing notes for 10 patients could take as long as one hour to complete, and even longer if changes or corrections are made. For outpatient visits, Le typed the visit details into the Armed Forces Health Longitudinal Technology Application (AHLTA), the military electronic medical record. But with speech recognition software, Le can dictate notes into a microphone attached to a mobile laptop and watch as his words appear on-screen almost instantaneously. Changes are made on the spot and the record is signed electronically. Inpatient records are then electronically stored locally and outpatient records are sent to the AHLTA clinical data repository where they remain on file for other medical facilities to access. For patients seeking further treatment with a provider who doesn't have access to the records electronically, such as a patient referred to a specialist on the local economy, Le said records dictated with Dragon Medical provide a more detailed patient record to be printed and hand-carried to the appointment. Patient reaction has been favorable, Le said, noting one of his recent patients said, "I want one of these," after seeing the speech recognition system in action. Le can record patient notes anywhere in the hospital with his remote laptop thanks to wireless connectivity installed at LRMC about three months ago. Doing so allows patients to see and hear what's being logged into their medical file, allowing further opportunities for on-the-spot changes or corrections. "Patients can become more involved in their medical care, and this is the way it should be," Le said. While speech recognition software has long been used by radiologists, the technology is now accurate enough to expand to other medical disciplines. A pilot program at the Heidelberg Medical Department Activity demonstrated the capabilities of speech recognition to enhance care documentation in the primary care and orthopedic departments. Major General David Rubenstein, the Army Deputy Surgeon General, was impressed by the Heidelberg pilot program results and recommended expansion of the program throughout the Army Medical Command. As a result, 10,000 copies of the speech recognition software were purchased by the Surgeon General's office and distributed to 42 facilities worldwide. The system should pay for itself in less than a year because of savings such as transcription fees. Speech recognition software is currently being deployed throughout the European Regional Medical Command and should be fully implemented by summer. In addition to the software deployment, the initiative also includes nine trainers to help field the system, said Dr. Bob Walker, a Heidelberg MEDDAC physician and the ERMC AHLTA consultant. Having trainers on hand helps ease any apprehensions about learning the new system. Le said speech recognition adds a new instrument to his medical toolbox. "Incorporating current technology into clinical practices is part of our culture. Medicine is always going to change and we need to keep with the changing times. This is just a natural extension of that," said Le.