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Voice Recognition Technology

Barbara Dixon Module 7

Wolf, D. M., Kapadia, A., Kintzel, J., Anton, B. B. (2009). Nurses using futuristic technology in today’s healthcare setting

Why was this article, blog, post, or multimedia chosen?

I chose this article because with this technology documenting can be easily and accurately completed in real time while multi-tasking.  Technologies such as this one, can improve workflow and productivity for healthcare providers, especially nurses.  One case study revealed that “for every 60 minutes of patient care, nurses spend 30-60 minutes on corresponding paperwork” (p. 61).  Workflow and patient safety have been improved with the voice commands that conveniently provide patient information such as allergies, orders, and care plans. 

What makes it interesting, appropriate, or reputable?

Communication is made easier with this device, including handoff communication and shift reports.  At the end of each shit, report can be recorded and sent off to the next nurse.  Additionally, the technology provides infection control by eliminating the need share computer keyboards, computer mouses, patient charts, and pens.  Each nurse will keep their own headset while the hard case of the small pocket computer can be wiped down with disinfectant wipes before handing it off to the next nurse (Wolf, Kapadia, Kintzel, and Anton, 2009).

Is it an opinion? Case study? Research study? Product review?

This is a product review

What was the need, problem, issue or trend addressed in the article, blog, post, or multimedia?

Time management and accurate documentation in real time for nurses that are already spread to thin was the problem of the article. The immediate concerns would be HIPAA violations from overhead information, errors in voice recognition that result in errors, and wasted time trying to use the new technology.  The privacy concerns are overcome with that use of headphones to provide privacy and confidentiality of patient information that is transmitted through the system, allowing only the nurse on the receiving end to hear what is being said.  The device uses a verification process to confirm what the nurse wants before it carries out anything, ensuring accuracy.  Training for the device entails a few hours of classroom time to learn the new system, the database of voice commands, and program the system to recognize the nurse’s voice (Wolf, Kapadia, Kintzel, and Anton, 2009). 

What was the solution for which technology had an answer?

Workflow and patient safety can be improved with the voice commands that conveniently provide patient information such as allergies, orders, and care plans.  The computer contains a database of select spoken words that allow the nurse to document information as well as retrieve information while simultaneously completing patient care, never needing to leave the patient’s side. An integrated communication system also allows nurses to communicate between each other, illuminating the need to walk around looking for help (Wolf, Kapadia, Kintzel, & Anton, 2009).

What implications might this have in healthcare delivery?

The documented success of this technology is remarkable.  A top U.S company documented that it has over 80% reduction in errors in less than twelve months.  Other companies revealed that had seen a return on investment in less than three months.  There is was also a reported reduction in generated reports, decrease in wasted time searching for staff, decrease in staff turnover, and increase in reimbursement from Medicare and Medicaid (Wolf, Kapadia, Kintzel, & Anton, 2009). 

What did you learn from it that might have application for your practice?

I agree with their approach to develop and test this technology in a LTC setting.  In a healthcare setting where a nurse might care for 30 patients during a shift can provide great insight into the requirements of the technology.  Having nurses in the forefront of technology innovation is vital to the development of technology and devices that can successfully support their work (Wolf, Kapadia, Kintzel, & Anton, 2009).

References

Wolf, D. M., Kapadia, A., Kintzel, J., Anton, B. B. (2009). Nurses using futuristic technology in today’s healthcare setting. Doi: 10.3233/978-1-60750-024-7-59

Update - A few semesters back, I had injured both of my hands very badly and bought Dragon Dictate, voice recognition software for my computer so I could continue with my classes. It worked great.   It is my understanding that Wolf, Kapadia, Kintzel, and Anton (2009) describe the concept of human computer interaction (HCI) consisting of voice assisted technology, that allows nurses to "document patient care in real time, retrieve patient information from care plans, and complete routine tasks" (p.59.). This is similar to what physicians use to dictate. However, the voice assisted technology in this article is also integrated with "leading edge and award-winning technology" that was built with an interactive design (I imagine it to be similar to the iphone's Siri or Amazon's Alexa) and also allows the staff to send and receive information as needed as well as interact with each other.   A voice technology that is built into a patient's EHR that allows us to document as well as retrieve information without a computer is something I think we can all jump on board with.  Interactive technology is becoming a bigger part of our culture. I see people more and more people including myself pull up out their phone and ask it questions. It would be very convenient to be at the patient's bedside and have the ability to ask a device what medication are due for that patient or what the patient's allergies are.  Documenting while I'm working would be amazing.  We already multi-task as much as possible, and to be able to multitask and document at the same time would be perfect. Not to mention patients would recognize that we are spending more time looking and interacting with them instead of a computer screen (Wolf, Kapadia, Kintzel, & Anton, 2009, p. 59). 

The technology described in this article is from 2009 and sounds amazing.  I could not understand why it is not in main stream use for nurses by now.  With some further research, I found that Fratzke, et al. (2014) references the technology Wolf, Kapadia, Kintzel, and Anton (2009), concluding that while it offered great benefits in the long-term care (LTC) setting, there is not enough evidence that it offers the same benefits in an acute care setting (Fratzke et al., 2014). 

McDonald (2014), is an author for an Australian PulseIT magazine, and describes a voice recognition technology, available by the U.S. company Honeywell. This technology allows for nurses to document, record handover report, ask questions, and provides two-way communication. McDonald (2014) calls the technology a "clinician in the ear" (para. 4) because of its ability to provide responses to questions and interact with a user. The technology also has the ability to block-out background noises and learn the user's voice. The device can be put into sleep mode, and when it gets woken up again it will run through some test words and phrases to relearn the sound and vibrations of the user's voice. The technology is currently only used in the long-term care setting, although there are plans of developing a similar system to fit the needs of the acute care setting (McDonald, 2014).

 

Johnson et al. (2014) provide a systematic review of the literature relate to speech recognition (SR) technology in Healthcare. Their review included all literature dating as far back as the year 2000 that referred to speech recognition in healthcare settings, used by Healthcare professionals, both experimental and non-experimental. Their review offered evidence that SR technology does provide return on investment with better-quality, quicker change-of-shift and handover report.  This report documents that language technologies potentially have the capability of making information easier to understand and access. Some SR systems applied generic templates and dictation macros and others applied systems with supplementary accessories for managing text information. For example, in addition to generic templates, medical terminology dictionary, or pathology terminology dictionary. The systems that used additional applications proved to have better handoff report time, and more accurate, complete documentation that was able to be completed in a shorter period of time. Users that were slow typers rated the SR technology as being more beneficial than users that were quick typers.  Noise cancelling capabilities, profiles for voice accents, medical and pathology vocabulary dictionaries have improved the accuracy some SR systems. This review showed that some SR software provided better benefits then other software, and some clinical areas benefited more from SR than others. The cost, training needs, amount of documentation to be transcribed, accent profiles, specific software design with the use of macros and templates, are need to be considered when committing to a SR system (Johnson et al., 2014).

 

References

Fratzke, J., Tucker, S., Shedenhelm, H., Arnold, J., Belda, T., & Petera, M. (2014). Enhancing nursing practice by utilizing voice recognition for direct documentation. The Journal Of Nursing Administration, 44(2), 79-86. doi:10.1097/NNA.0000000000000030

Johnson, M., Lapkin, S., Long, V., Sanchez, P., Suominen, H., Basilakis, J., & Dawson, L. (2014). A systematic review of speech recognition technology in health care. BMC Medical Informatics and Decision Making, 14, 94. http://doi.org/10.1186/1472-6947-14-94

McDonald, K. (2014). ITAC: Hands-free nursing through voice-activated documentation. Retrieved from: https://www.pulseitmagazine.com.au/index.php?option=com_content&view=article&id=1981:itac-hands-free-nursing-through-voice-activated-documentation&Itemid=332

Wolf, D. M., Kapadia, A., Kintzel, J., Anton, B. B. (2009). Nurses using futuristic technology in today’s healthcare setting. Doi: 10.3233/978-1-60750-024-7-59