Learn the value of speech-enabling your hospital EPR - HFMA Summer Conference 25 June 2021 - Healthcare ...
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Learn the value of speech-enabling your hospital EPR HFMA Summer Conference 25 June 2021
Agenda Introductions from Monica and Terence The clinical documenta on challenge The role of technology Dragon Medical One Customer case studies Demo Q&A © 2021 Nuance Communications, Inc. All rights reserved.
The Challenge of Clinical Documentation
Clinicians are overwhelmed and de-motivated by excessive admin
Nuance research suggests 44% of respondents to the 85% said the burden of
clinicians spend on average NHS Staff Survey reported clinical documentation is a
around 11 hours per week feeling unwell as a result significant contributor to
adding to clinical documentation.2 of work-related stress.2 burnout in a Nuance survey of
NHS healthcare professionals.3
References:
1. Nuance Clinical Documentation Challenge Report
2. NHS Staff Survey 2020
© 2021 Nuance Communications, Inc. All rights reserved. 3. Nuance clinician burnout survey 3
Technology is part of
the problem…
In April 2021, the Journal of the
American Medical Informatics
Association published an
article linking clinician burnout
to increased documentation,
following the adoption of the
EHR (Electronic Health Record)
in the US.
© 2021 Nuance Communications, Inc. All rights reserved. 4
…And also, part of the
solution!
Reduce administrative burden
with AI-powered clinical speech
recognition.
Update patient records, navigate
the EPR, manage email and more
using your voice – at least 3x
faster than typing.
© 2021 Nuance Communications, Inc. All rights reserved. 5
Cloud-based Clinical Speech Recognition
Dragon Medical One PowerMic Mobile
AI-powered clinical speech recognition Secure wireless microphone for
iPhone and Android
Voice to text into clinical notes (e.g. EPRs)
Dictate at the point of cursor
We speak 3x faster than we type
Mature, proven technology – 99% accurate
Smart AI and comprehensive medical dictionary
NO initial speech profile training required
Single voice profile – accessible on different devices in
different locations
Use of speech activated macros to improve quality and
speed of documentation
Microphone can be on smartphone – iOS/android
© 2021 Nuance Communications, Inc. All rights reserved. 6
Customer case studies
NHS Trusts
7Outpatient (OP) Setting – The Challenge
Two large NHS University Hospitals
High clinical correspondence High outsourced transcription costs
volumes: Longer worklists with backlogs
• 3.4 millions letters/year building up
(1.8M OP clinic letters) - Oxford Delays and costs due to complex
Missing national target of OP letter workflows
to GP turnaround time (TAT) of 7 Clinicians:
days:
• Handwritten notes - using
• Average – up to 17 days secretaries to type them
Admin staff shortages: • Staying late to do admin
• Secretarial sickness and vacancies EHR – Cerner Millennium
• No secretaries to support the off-
site transcription workflow
© 2021 Nuance Communications, Inc. All rights reserved. 8Outpatient (OP) Setting – The Outcome (I)
Two large NHS Hospitals
Paperless outpatient letter workflow: Clinicians: better level of care & less
administration & clinical. catching up on paperwork after
70+ clinical specialties clinic
Turnaround time of letters: reduced from 17 Secretaries: focus on patient contact
days to 2-3 days (Oxford) rather than typing letter backlog
• Sent real time if no results awaited Patients: Leaving clinic with letter –
few lost or missed FU appointments
• Patient could leave clinic with OP letter
Initial pilots resulted in business case
Financial savings: for organisation-wide deployment
• Eliminating outsourced digital dictation: • Incremental roll out across all
£180,000 per year (Homerton) clinical specialties
• Staff costs - 1/3 reduction in spend on Homerton Case Study
medical secretariat costs (Homerton):
Oxford Case Study
• Medical secretaries who left not replaced
• Bank and agency staff costs reduced
© 2021 Nuance Communications, Inc. All rights reserved. 9Money is saved as outsourced transcription is replaced
140%
120%
100%
80%
60%
40%
20%
0%
External Transcription % Reduction
DMO lines % Increase
2 per. Mov. Avg. (External Transcription % Reduction )
2 per. Mov. Avg. (DMO lines % Increase)
© 2021 Nuance Communications, Inc. All rights reserved.Time saved with Dragon Medical One Autotext templates
45 (COVID 19
1st wave)
41
40 36.8
38.7 38.6
36
34.8
35 In 2020, users (representing about
30
29.7
22% of active users) collaboratively
26.6 26.4
25.8 26
24.8
25.5
26.5
saved 48 Full Time Equivalent days
25 23.1 23.5
by taking advantage of Dragon
21.6
20.7
20 17.2
Medical One Autotext functionality.
16.1
15.4
15
14.5 14.7
13.1
10.4
FTE days
10
100
31 48
6.5
4.8
5 4.3 4
2.9
50
3
2.4
0 Jul-18 Aug-18Sep-18 Oct-18 Nov- Dec-18 Jan-19 Feb-19 Mar- Apr-19 May- Jun-19 Jul-19 Aug-19Sep-19 Oct-19 Nov- Dec-19 Jan-20 Feb-20 Mar- Apr-20 May- Jun-20 Jul-20 Aug-20Sep-20 Oct-20 Nov- Dec-20 Jan-21
18 19 19 19 20 20 20
0
Hours saved with DMO Autotexts 2018 2019 2020
© 2021 Nuance Communications, Inc. All rights reserved. 11“Dragon Medical One has resulted in a dramatic change in clinic letter
turnaround times. As a result of time being freed up from letter
reviewing, this has also permitted secretaries to expand the
variety of their tasks and work on their continued professional
development (CPD).”
- Dr Paul Altmann, Chief Clinical Information Officer, Oxford University Hospitals
© 2021 Nuance Communications, Inc. All rights reserved. 12“We’ve seen considerable month on month cost savings as we
replace our transcription services with real-time speech recognition.
We have also saved expenditure by not having to invest in additional
hardware or recruit scarce and expensive technical resources to run
the software day to day. ”
- Paul Adams, Head of Clinical Information Systems, Homerton University Hospital
© 2021 Nuance Communications, Inc. All rights reserved. 13Clinical Adoption:
100% utilisation of Dragon Medical speech
recognition licenses in 2020. Workflow and speech
recognition adopted across 26 medical specialties.
Dragon Medical Workflow Manager and Reduced TAT:
Speech Recognition at East Kent Average Turnaround Time (TAT) for all documents is
now below 5 days. 224,000 documents (around 60%)
DMWM is a cloud-based clinical correspondence platform,
have been completed within 48hrs.
supporting timely and effective creation of clinic letters and is
speech-enabled with Dragon Medical, AI-powered technology.
Cost Savings:
Outsourced Transcription reduced by 80% in 2020.
NEXT STEP: The trust is making significant savings by replacing
East Kent to speech-enable their Allscripts EPR with outsourced transcription with DMWM + speech.
Dragon Medical One
© 2021 Nuance Communications, Inc. All rights reserved.The impact of Dragon Medical speech recognition on
Outsourced Transcription (Lines Analysis)
700000 (COVID 19
1st wave) 578,527
600000 575,325
534,018 531,899
502,783
488,564 491,304
500000
449,710
400000 373,492
387,422
425,486
5,705,236 lines
301,730
335,198 completed with
300000 261,056
Dragon Medical
200000
147,346
177,768 speech recognition
136,872 131,219
100000 76,497
90,501 in 2020.
59,388
36,972 32,255 39,529 40,437 31,993 33,119
16,839 16,084 21,182
0
Outsourced Transcription Lines Dragon Medical Lines
© 2021 Nuance Communications, Inc. All rights reserved. 15“So useful with timely clinic letters... My turnaround time with
clinic letters is much shorter… I have to say this is the best
voice recognition/dictation application I have used. It worked
with our IT systems and was transferable. I think I will start
using it for minutes of meetings.”
- Clinician at East Kent Hospitals University
© 2021 Nuance Communications, Inc. All rights reserved. 16Mental Health & Community Setting
East London NHS Foundation Trust and Worcestershire Health and Care NHS Trust
• East London NHS Foundation Trust - Q4 2020/21
• ROI £2.01p per £1 invested
• 63 days administrative time saved per month
• Users of DMO Auto-text save 30 minutes per day
• Worcestershire Health and Care NHS Trust - 2018
• Elimina ng backlog
• Notes updated within work hours
• ↑ EHR adop on
• More time to care
Worcestershire case study
© 2021 Nuance Communications, Inc. All rights reserved. 17“Dragon really helps me be much faster at writing. This
has a big impact on my day-to-day work life. It means I
can do more work in less time and that reduces a lot of
anxiety and stress.”
- Dragon user at East London
© 2021 Nuance Communications, Inc. All rights reserved. 18“The mountain of admin became oppressive to the
point I just didn’t want to do the job anymore. Then
Dragon Medical speech recognition came along and I
caught up with a backlog of 2 years work in just 3 weeks.”
- Karen Edwards, Occupational Therapist, Worcestershire Health and Care
© 2021 Nuance Communications, Inc. All rights reserved. 19Nuance solutions help to optimise EPR workflows © 2021 Nuance Communications, Inc. All rights reserved. 20
Summary of the benefits of Dragon Medical One
Improve governance and Reduce correspondence Reduce spend on
quality of patient notes and administrative lead outsourced transcription
whilst increasing use of times; improve Transfer- services and free-up
the EPR of-Care metrics admin staff time
Improve staff utilisation Support remote working
and reduce the burden of with secure cloud
clinical documentation technology that can be
used anytime, anywhere
© 2021 Nuance Communications, Inc. All rights reserved. 21DEMO Time to see Dragon Medical One in action!
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