Danny Roberts, associate director of IT at University Hospitals Coventry and Warwickshire NHS Trust, talks to NHE about increasing visibility throughout the workfl ow.
supporting clinicians and secretaries to work more eff ectively whilst reducing the amount of typing and delays in verifi cation.
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University Hospitals Coventry and Warwickshire Trust piloted the technology in 2011, between May and July, across its haematology, paediatric orthopaedics, breast surgery and respiratory units. Danny Roberts, associate director of IT at the trust, said that diff erent devices were trialled, including smartphones and laptops, to remotely access the system from wherever clinicians are.
The pilot sites have now switched to digital dictation, while the rest of the trust is still using traditional methods, including outsourced
igital dictation is allowing trusts to integrate workfl ows,
transcription and tape recordings. In the future, digital dictation will be rolled out throughout the trust, to enable all to benefi t from the signifi cant time and accuracy savings.
Roberts said: “We’re quite happy with the solution. The issue is the capacity to deploy that alongside a number of other projects that we’re working on.
“The trust has an in-house electronic patient record (EPR) for clinicians to access letters, results, patients’ tests, discharge summaries and basic assessments. A clinician will work from a clinic list of all the patients expected. The beauty of that is opening the dictation system with the entire patient context: demographics, consultant’s specialty, clinic and so on.
“Previously that would have had to be dictated onto the tape or added later by a secretary. All that detail is now transferred in context electronically. That’s the real hub of the integration.”
Dictation fi les are then typed up by secretaries, predominantly in-house,
although Roberts added: “There’s another stream of the digital dictation project which is looking at outsourcing services.”
No resistance
A status fi eld in the clinical correspondence area of the EPR allows users to log in and see if a letter has been typed. Authors also have their own to-do lists within the system, which fl ag up letters ready for online verifi cation, such as checking errors and editing the text.
Roberts said: “That speeds up the end-to-end process; they don’t have to scribble on a piece of paper that a secretary then retypes and they have to check.
“They can re-dictate the letter, or if it’s just minor changes, they’ll go in and tweak it themselves. We expected a bit of resistance to that from clinicians, but it’s been very enthusiastically taken up because of the fl exibility. They’re not waiting to do a batch of letters for next Thursday, or in the offi ce with letters stuck in the post to get to their outworking in the community. They can log on from wherever they are
and verify the letters straight away.
“Letters can be typed during clinic, directly into the system. Eff ectively a clinician could dictate, with his secretary in another part of hospital typing up all the letters. Then he can verify all the letters and by the end of the morning, potentially have all the clinic letters done for that day. Full end-to-end is achieved because we have an electronic document interface to transmit those letters directly out to connected GPs.”
Roberts explained that some of the trusts’ consultants do remote clinics, and operating on two principle sites means that secretaries can often be in a diff erent location to the clinician. The ability to dictate and verify from anywhere therefore simplifi es the whole process of record keeping.
Topping and tailing
Voice recognition has already been used for several years in radiology, but while Roberts said the technology had been considered, he added: “At the moment we don’t have any immediate plans to move to voice recognition.
54 national health executive Jan/Feb 12
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