NHE talks to service improvement manager of Doncaster and Bassetlaw Hospital NHS Foundation Trust, Julie Ekins, about the integration of digital dictation.
dictation into their workflow, allowing secretaries and clinicians to access and process recordings much more quickly and easily. The shift from analogue to digital has also offered benefits in terms of speed, accuracy and clearer dictations.
D
Julie Ekins, service improvement manager for the trust, explained the process of this change and the technology of the future.
She said: “Before we had this, we just relied on tape dictaphones. A clinician would dictate in clinic and then there would be a delay before the secretary received the tape, because they’d have to manually get the tape from the clinician. That was a problem especially because as it’s quite a big trust, we work across several sites and the secretaries aren’t always at the same site as the clinicians.”
Further delays were caused when the letter was taken to the clinician to approve and sign before posting the hard copies. The electronic system removed those delays, as letters are now automatically transferred to the secretary once the clinician has completed a dictation.
“It’s a more efficient way of working,” Ekins said. “It makes it a lot more straightforward. Every page is linked to the correct clinic appointment.”
Not all GP practices in the area are yet on the new system, but when it is fully rolled out to them all, the trust will rely purely on the electronic process and the secretaries would then follow the same process for all letters.
Ekins explained: “Eventually we
oncaster and Bassetlaw hospitals have benefited from the integration of digital
hope to move towards a completely paperless process, but at the moment we’re rolling out the electronic system to GP practices so that they can receive the letters electronically as well. We’re still in the rollout process; we are sending paper copies as well to avoid clinical risk.
“The secretaries still have to type the main content but the transcription system automatically picks up information from our patient administration system and self-populates a letter with the hospital’s address, the consultant and the date of the appointment, so it reduces the amount of typing.”
Analogue vs digital
The quality is also better for the secretaries, Ekins suggested, as digital is easer to hear and understand. Other benefits of dictation compared to old- fashioned tapes include easier manoeuvring around the recording.
“Tapes can be a bit fuzzy and just not very clear; this is a lot clearer for them to understand the clinician,” she said.
recognition at the moment, this is a consideration for the future. Additionally, there are some clinicians within the trust who have already decided to purchase it themselves.
Julie Ekins
Ekins believes the clinicians’ language doesn’t need too much modification, as the secretaries are often working with the same consultant for a long time and so are used to their form of speech.
She explained: “The secretaries and clinicians work so closely together that it’s not really that much of a problem. That’s irrespective of the system you use, that would always be an issue I think. This system just helps clearly pick up whatever they do say.”
Pockets of the trust Although the trust isn’t using voice
Ekins commented: “Voice recognition does take a lot longer for training. This system requires quite a minimal amount of training from clinicians. They’re very busy so even that short time is difficult to get with a clinician when they’re so back-to-back with clinics.”
Training also depends on how computer literate the clinicians are, and it can take varying amounts of time.
She added: “Digital dictation we can confidently roll out across the trust, but voice recognition would probably be more used just in pockets of the trust if we chose to go down that route. We have to look at where it would benefit most.”
Digital devices
In terms of hardware, the devices the trust chose to use are speech mics, installed where required. Ekins suggested that in the future departments or individuals may wish to buy their own equipment, but at the moment she said: “We’ve just rolled out the same speech mic everywhere; we’re happy with that and it’s working well.”
The speech mics are not portable, but this is something the trust is considering, perhaps for other types of dictation, such as ward rounds.
However, Ekins said: “It does actually change the workflow with the system. With the speech mic, the information goes straight to a secretary as soon as it’s dictated, but with the portable ones you need to dock it. There’s a bit of a delay there if the clinician is not at a computer, which would be the point of having a portable device.”
www.dbh.nhs.uk For more information
national health executive Jan/Feb 12 49
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