DIGITAL DICTATION Reporting on the benefits of digital ... - BCS

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document to the author for online review and sign-off. The process becomes one of e-letters, e-processed. A more advanced option is to replace the secretary with a background computer and the person who dictates the report edits it via online access – but the consultants want to keep their secretaries. A further option, in radiology, has the consultants dictating directly onto the screen using voice recognition technology; they can verify their reports, sign them off and send them to the GP practice the same day. Both these options present cultural challenges. Responses vary with exposure to change, IT awareness etc. Digitised reports and letters enable the concept of an integrated clinical communications hub between hospitals and GP practices, routing electronic letters to the right place. Cheshire trusts are using this approach to send e-discharge letters. Consistency is all Typing errors can arise due to the author of a letter typing and sending it off without a proof reader. You do see what you hear yourself say. Some radiologists will dictate, leave it for a while, and come back to their reports as a batch at the end of a session. Systems are voice-profile based and very quickly pick up the profile for new users. Consistency is a factor. The systems are very accurate. Microsoft Windows 7 includes free voice recognition software. Basic professional voice recognition software is commercially available for about £300 to £650. What is the difference between digital dictation and speech/voice recognition? The more established approach is to dictate to a tape and give it to a typist. Tapes are then stored until the typist has time to get round to them. If the consultant wants a particular report to be found and typed urgently, it can take the typist hours to search all the tapes to find the right one. Work scheduling is disrupted. This technology uses analogue recording to tape. Most of the NHS is still on this old technology. Going digital Digital dictation, which really came in with PACS, produces a ‘digital tape’ instead of an analogue tape. Digital recordings can be stored on a computer network and made available wherever is most appropriate for typing. The consultant talks, a digital recording is produced and the secretary types it. The secretary gets an indexed list of dictated letters with priority reports highlighted in red at the top of the list. Management can provide performance statistics on turnaround times etc. 08 HINOW Autumn 2010 Speech-to-text Speech-to-text technology allows a secretary to open up some hard-tounderstand reports to find keywords that are converted to text – the words are typed out for the secretary – allowing the secretary to edit this into a proper report. <strong>DIGITAL</strong> <strong>DICTATION</strong> Digitised reports and letters enable the concept of an integrated clinical communications hub between hospitals and GP practices, routing electronic letters to the right place. Speech/voice recognition takes it further and provides a full process. The words come straight back on screen for the clinician to read and edit on the spot. For further information please visit: www.hinorth.bcs.org.uk
BCS HEALTH COMMENT A NEW DIRECTION FOR HI? BCS Health wants to place itself in a position to have a positive influence on government policies relating to healthcare in the future. Matthew Swindells, Chair, BCS Health, considers the areas the health informatics community need to prioritise over the coming months. The publication of the white paper, ‘Equity and excellence: Liberating the NHS’ in July 2010 promised ‘an information revolution’ to drive better care and reduce cost. It also promised an information strategy for the NHS, which is being written at the moment, due for publication in the autumn. This presents an opportunity for the NHS to adopt an approach that places information at the heart of transforming the delivery of health care, the planning of health services and, perhaps most importantly, the empowerment of patients to take control of their own health, the care they receive, and to hold the NHS to account. BCS Health wants to place itself at the forefront of this revolution. We see the contribution that we can make through the expertise of our membership to help the government develop a coherent information strategy, help the NHS implement that strategy adroitly, and help informatics professionals rise to the challenge of leading the information revolution. But, we don’t want the BCS agenda to be determined entirely by publications emanating from Whitehall. Consequently, BCS Health’s Policy and Strategy Community, under the leadership of Dr Justin Whatling have prioritised three areas for work in the next 12 months: 1. Preparing for information being mission-critical to the NHS We all know that the data upon which the government wants to build its information revolution is not of as high a quality as we would want. However, BCS Health believes that the only way to improve data quality is to expose it to clinicians, managers and the public. However, this is a risky approach, with the potential that the public or media may jump to conclusions that can’t be sustained by the data. BCS will proactively try to smooth progress and build an understanding in the NHS, the supplier community and the public, anticipating and expecting that information will be wrong at first, but that we have to work through that phase to get the benefits, without a witch hunt. We will also support the creation of a robust information governance and consent policy – no one has yet achieved this and it is critical to progress. 2. Driving integration and interoperability through opening up systems Alongside open information comes the need for open systems. The redesign of health systems, optimising care pathways and delivering more care outside hospitals will all require collaborative working between institutions and the sharing of information. This cannot be done by simply standardising the software vendors; it will require integration and interoperability. BCS will encourage the mandatory use and publication of interfaces (APIs) for all informatics systems used in the NHS. BCS will pragmatically support the use of existing standards to release rapid benefits. 3. Patient engagement and self service The step change in productivity that the NHS needs will require patients to become more involved in managing their own illnesses and reducing their health risk. Patients will expect and need tools for self-service of the same standard that they see in other sectors. BCS will help articulate the value proposition for patient engagement, helping them understand the benefits and risks and enabling them to take a balanced view on their level of engagement. This is an exciting agenda for informatics professionals in health. BCS will be doing its best to advise the government, support the NHS and develop informaticians to meet the challenge. I hope you will look for ways in which you too can contribute. ADDITIONAL INFO For more information regarding BCS Health please visit: www.bcs.org/health AUTUMN 2010 HINOW 09
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