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How Front-End Speech Recognition Adoption Impacts EHR Usability

While front-end speech recognition tool adoption ideally would have aided EHR usability, research shows that a lack of widespread adoption hinders a full impact.

ehr usability speech recognition tools

Source: Thinkstock

By Elizabeth Snell

- It was previously thought that widespread adoption of cloud-based front-end speech recognition systems would have helped solve certain EHR usability issues, according to KLAS research. However, more recent data shows that if an adopted tool does not bring improved efficiency, cost reductions, or physician satisfaction, there will be little motivation for clinicians to adopt it and integrate it into their workflows.

Physician fulfillment is nearly equal between organizations with high adoption and those who do not use front-end speech tools, KLAS found in its Front-End Speech 2018 report. Additionally, a significant increase in physician job fulfillment does not appear to be a primary benefit of speech recognition tools.

“Many of the high-adoption organizations interviewed for this study share in the common industry belief that front-end speech recognition tools increase physician fulfillment,” report authors explained. “Nearly all of these organizations say that speech tools have had an impact on overall physician satisfaction, yet when pressed for details, most point to satisfaction with the speech tools themselves and not specifically to impact on physician job fulfillment or burnout.”

“Respondents report that those who use the solutions nearly universally have a favorable experience and are quick to share that the tools have positively impacted other areas, such as costs and productivity, and respondents can readily cite specifics as to why this is.”

KLAS reviewed insights from customers of three main front-end speech recognition providers: Dolbey, MModal, and Nuance.

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Six of eight organizations utilizing Dolbey reported very high adoption among clinicians, with training practices being cited as a key reason for the adoption level.

The majority of respondents also said extensive training and follow-up were the top key to their success with high organizational adoption.

“Among all those interviewed and regardless of vendor, one piece of advice was shared: continual training (beyond initial training) to optimize efficiency among those who are already using front-end speech tools is extremely important to maintaining high adoption and user satisfaction,” the report stated. “Clients of Dolbey, MModal, and Nuance emphasize the value that vendor-provided representatives/trainers bring to the provider organizations and feel that these employees are able to bring clinician users to the next level with the software.”

Overall, physician productivity increased because of higher speech recognition adoption, research showed. Providers were found to be spending less time on completing reports.

Additionally, cost reductions were a top benefit of higher speech recognition adoption.

READ MORE: Can Natural Language Processing Boost Clinical Documentation?

“Many hospitals have been able to reduce the number of transcriptionists on staff, the amount of overtime, and the need to outsource physician dictation to outside firms,” the research team said.

Sixty percent of respondents with high adoption of MModal said there was a significant impact on physician satisfaction.

“Physicians can finish their documentation and not have to worry about going back to sign or review it,” one manager said in the report. “The providers just have to learn that spending a little extra time on the front end is going to save them a lot of time on the back end. They can do things to reduce the time needed to clean up their documentation.”

Regardless of the solution being utilized, providers often cited internal obstacles as the top driver of adoption issues. Comprehension, configuration issues, hardware, personalization, and the product being time consuming were all roadblocks providers listed.

Respondents did show that they plan to keep their current speech-recognition option as part of their long-term plans. All of Nuance Dragon Medical One users said they plan to keep the vendor, while 97 percent of those utilizing MModal Fluency Direct stated the same. Ninety-five percent of Nuance Dragon Medical NE plan to stick with the vendor, while 81 percent of Dolbey Fusion SpeechEMR said they will keep it.

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“At present, Dolbey is the only front-end speech vendor who does not offer a cloud-based solution, though some providers are eagerly awaiting the release of this functionality, which they hope will help increase adoption within their facilities,” report authors noted.

Other studies have shown that providers want speech recognition solutions as part of their overall EHR system. Having speech recognition solutions for hands-free data was one of the top reasons practices said they are considering an EHR replacement, according to an April 2018 Black Book survey

Eighty-two percent of EHR users said they wanted speech recognition solutions, while 87 percent said telehealth/virtual visit support was their top priority.

Additionally, 93 percent reported that cloud-based mobile solutions for on-demand data was essential and approximately one-third of practices with more than 11 clinicians said they would likely replace their EHR system by 2021.

"Traditionally, it’s been the smaller and solo practices with the highest dissatisfaction ratings for electronic health record applications but we confirmed also that the smaller the practice, the less likely they are to use advanced IT tools and that is where EHR frustration among small practices is generally focused," Black Book Managing Partner Doug Brown said in a statement.

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