Health Service Focus

Rolling out digital dictation and voice recognition

Keith Richardson, of the Informatics Directorate at NHS North of England, speaks to NHE about progress so far in the NHS North West region.

The benefits of digital dictation are clear, and the majority of trusts now use some form of it for their clinical notes and correspondence.

Keith Richardson, who leads on electronic clinical correspondence, PACS, digital dictation and voice recognition in the NHS North West area, works with trusts across the region to promote the adoption of digital dictation and speech recognition, also providing small pots of funding to pump-prime extra investment.

Asked about progress so far in the North West, he said: “I do track this very closely on an organisational basis: over two-thirds of the organisations have now adopted digital dictation.

“There’s a minority of trusts that haven’t got digital dictation: but it’s now the case, from my perspective, in terms of technology adoption, that it is basically a ‘done deal’.

“There are still one or two that are yet to get there; for example Blackpool are out to procurement at the moment, they’re using the shared business services framework contract for digital dictation. They’re expecting to announce a winner either just before or just after Christmas. It’s a minority of trusts who haven’t got digital dictation.

“Voice recognition though, in the wider organisation [i.e. outside of radiology departments, for example], is still at the early adopter stage. For example, the SHA is funding a five-consultant pilot of Winscribe voice recognition in East Cheshire.

“But the North West is quite advanced in terms of its adoption of these technologies.”

In radiology departments specifically, voice recognition adoption stands at just over 72%, Richardson said. Hundreds of software licences funded by the SHA are in use in radiology, he said.

Richardson has also been promoting electronic document management systems, which can be integrated with digital dictation technology.

He said: “Traditionally, the main repository of clinical information in an organisation like a hospital is the paper medical record. That stays in a medical record library with lots of staff running it. The problem with the paper-based medical record is that it can only be in one place at one time. So, if there’s a patient being dealt with by different clinical professionals, that makes it more difficult for people to get the full picture of that patient at any one point in time because it’s not as easily accessible.

“One of the key benefits of electronic document management systems is that they digitise the paper casenotes. It means they’re available anywhere, any time – subject to the usual information governance and access rights and security concerns and so on.

“To make sure it’s as current as possible, the best organisations are taking the paperbased medical records, generated at a clinic or on a ward or in A&E, and digitising them as soon after the event as possible.

“With the best systems I’ve seen, if the patient is going into an outpatient clinic, when the computer system has got details of all the appointments for that clinic, it prints out a clinic sheet for each patient appointment. The best ones are structured so that there are boxes that can be ticked and all of the patient’s identifiable information, who their GP is, what the appointment is for and so on, is printed out onto the sheet together with a barcode. That means that when the clinic is finished, that paperwork is then scanned straight into an electronic document management system. Because it’s got the metadata on it, it automatically gets indexed against the electronic patient record. The paper record is then part of an electronic patient record, in a scanned format. That means you don’t need to have people with trolleys carting casenotes from the library, bringing them to the clinic, taking them back and refilling them: all that goes away.

“One of the ways to avoid having to scan the paper is to do it digitally in the first place,” he added. In the next edition of NHE, Keith Richardson tells us more about moves to implement clinical correspondence hubs across the region.