South Infirmary - Victoria University Hospital

Background

South Infirmary Victoria University Hospital is a voluntary general acute hospital based in Cork city. The hospital has a total of 192 beds and caters for up to 38,400 admissions and 72,500 outpatient attendances each year.

Traditionally, dictations were recorded by clinicians on tapes and then transferred to and from multiple locations across the hospital to medical secretaries. The correspondence was then typed up by the secretaries and printed out for approval by the clinician before copies were posted to GP's, patients or other agencies.

Managing dictation for the workforce presented several challenges. The first was workload.

A second challenge was the risk of damaged tapes, which meant that dictations would have to be redone. This was becoming an increasing problem with the age of the technology and the difficulty and expense of sourcing new tapes. Finally, tapes presented a security risk. They contain private patient information, and it was important to protect the confidentiality of the recordings. Given the constant movement of tapes and recording machines there was a significant potential for loss.

Solution

SIVUH began looking at digital dictation solutions, most of which involved replacing tape recorders with digital recorders. But this would have only partially solved the problem as digital recorders still had to be physically returned to the medical secretary. In addition, purchasing a whole new fleet of digital recorders would have been very expensive. So the hospital took a different tack. It deployed T-Pro Dictate, a customised digital dictation and clinical correspondence solution that replaces tape and paper based systems used in
medical dictation, transcription and transmission; as well as allowing them to leverage additional options such as speech recognition.

The system is a central platform for managing dictation, staff productivity, turnaround processes, and report distribution - all while helping the hospital manage quality assurance and meet compliance.

• Using a smartphone, clinicians dictate directly from a pre-generated clinic list (pulled from PAS), meaning each dictation is automatically and correctly tagged per patient.
• The sound file is then routed securely to T-Pro’s server-side speech recognition.
• The resulting draft letter is returned to the relevant medical secretary who, on opening the file, is presented with the transcribed text within an editor.
• This editor has a feature set designed to maximise the efficiency of proofreading and editing; words are highlighted as the playback is controlled with the foot pedal and the auto-text function speeds up any required changes
• Changes made in the editor are sent back to the T-Pro servers for learning and improved accuracy over time.
• The automated demographic retrieval populates relevant address and GP details, ensuring document accuracy, and accelerating the transcription process.
• On completion of the editing stage, the work is submitted back to the clinician who can rapidly check and electronically sign/approve documents via web or mobile app.
• The final step then includes some intelligent routing and interfacing with the hospital electronic document management system.

"Clinicians would have to wait until the end of the clinic for them to drop off a tape with their secretary. The secretaries ended up with one or two tapes and didn’t know how many dictations were on them, and if any urgent letters were on the tapes then the secretary would have to search through the tape until they found the relevant patient's letter which proved to be very time consuming. Once the technology was put in front of our staff, they immediately saw the benefits and how easy it is to use. The training received from the T-Pro team was exceptional, and meant that we were up and running very quickly. Before T-Pro, I had no way of seeing how many recordings were in the backlog and couldn’t re-assign recordings to other secretaries."

Mary O’Farrell
Administration Services Manager, Victoria University Hospital

Benefits

The hospital has been using T-Pro’s Digital Dictation and Speech Recognition for over a year now and feedback from users has been really positive.

T-Pro provides several advantages over the previous tape-and-paper system. Clinicians can manage dictations, prioritise their work, and access and report on patient information, using their smartphones. The hospital was not required to invest in new devices, and data security was enhanced compared to analogue tapes, which are not encrypted and easily misplaced.

Furthermore, the T-Pro solution has improved workflow management. Turnaround times have improved because clinicians no longer have to hand over tapes. With T-Pro’s integrated speech recognition, time spent on transcription tasks has been reduced dramatically. The number of letters that secretaries are able to process per month has doubled and significant improvements in turnaround time have been felt across departments. The solution has also contributed to better workload allocation.

Finally, all these improvements are expected to generate significant cost savings, as there are no costly analogue dictation devices and tapes to buy. Also, due to a reduced backlog and better allocation of existing secretarial resources, the hospital will avoid the cost of temporary staffing when secretaries are on leave.

SIVUH is planning on introducing the T-Pro Distribution Hub module which will allow the hospital to electronically send letters to the patients' GP, and deliver cost and efficiency savings throughout.