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Using speech recognition technology to improve efficiency in general practice

Speech recognition systems can save GPs' time, boost note-taking accuracy and put patients at the centre of consultations, writes Dr Ivan Camphor.

An average GP or secretary types 40 to 50 words a minute and we speak three times faster than we type
An average GP or secretary types 40 to 50 words a minute and we speak three times faster than we type

Many busy practices can relate to the challenge of dealing with increasing patient numbers, while honouring their QIPP responsibilities. At Heatherlands Medical Centre, Merseyside, our team of three GPs treats more than 4,000 patients a year, each doctor managing approximately 15 patients every morning and 12 in the afternoon, Monday to Friday.

Like other practices, we are required to record high quality, in-depth information about each patient consultation. This was becoming increasing difficult using analogue recording devices, combined with secretaries typing up dictated reports; it was no longer an effective or efficient process. Sound quality was unacceptable and there were issues around the recurring costs of dictation tapes and the length of time required for secretaries to type up letters and notes.

I identified that a speech recognition solution had the potential to create better quality recordings, which would lead to better quality reports, also speeding up turnaround times for patient correspondence. There has been an additional – if unexpected – benefit which I will come to, shortly.

Investing in technology

To implement the technology, we consulted a provider (VoicePower), which recommended a system that comprised a Philips SpeechMike Premium USB dictation microphone, used in conjunction with front-end speech recognition technology; in this case, Nuance’s Dragon Medical Practice Edition 2.

The theory behind pairing up these complementary technologies was that they would enable important details to be recorded accurately during a consultation, without any need for typing. Based on the premise that most GPs or secretaries type at 40 to 50 words per minute, and that we talk three times faster than we can type, the solution promised considerable time savings. After an initial training session with the provider, we were ready to introduce the new workflow.

Does speech recognition work?

The questions many GPs will ask is, does speech recognition work? Is it accurate? Does it really save you time? The answer to all three questions is an emphatic ‘yes’.

An immediate benefit to patients is that the verbatim capture of information encourages more data and detail to be added to a report or letter in real-time during the consultation. The more detailed and accurate the letter or report is, the sooner the patient can receive not only the next level of treatment, but also the right treatment.

With speech recognition, it’s like having another assistant on hand during the consultation and I estimate that I am now saving up to five hours a week.

With respect to its accuracy – which is aided by the tailored medical dictionaries supplied with the speech recognition software – it is astonishing. I know some GPs have had experiences of earlier versions of the software without the medical vocabularies, but I have learned to trust the latest speech recognition implicitly. You have to be patient with it initially, but the more you use it, the better it gets. Now, I wouldn’t be without it.

Compassionate care

The introduction of speech recognition has freed up my secretary to help provide administrative follow up around chronic disease management; she can check patients are still planning to attend the medical centre for their blood tests or for flu vaccinations, or that they are receiving their treatment for diabetes. It frees GPs to spend more time with patients and to provide more compassionate care.

In fact, it is in the delivery of compassionate patient care where I have seen the most benefit. Speech recognition means that the letter or report can be prepared with the patient present. This means the consultation becomes a special and powerful interaction that encourages the patient to participate, with them seeing and hearing me create their report and updating or correcting any treatments in their presence. Seeing this for themselves reassures them that their report is created accurately and faithfully.

In this scenario, speech recognition is  not just about faster, more accurate reports, but it becomes the glue that creates a trust-based bond between patient and doctor, making the relationship stronger and closer and putting the patient where they should be – at the centre of care.

Combine this with the speed and overall efficiency benefits, and I believe speech recognition delivers on its promises. It is not just a compelling solution, but an essential one for busy and pressurised practices across the country.

  • Dr Ivan Camphor is senior partner at Heatherlands Medical Centre in Wirral and medical secretary, Mid-Mersey LMC.

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