Health IT, Hospitals

Speech recognition helps Indiana ED go paperless

The emergency department, perhaps the most chaotic place in any hospital, has been completely paperless at Community Hospital Anderson, in Anderson, Indiana, since 2011. What’s more, the ED achieved this without putting computers between clinicians and patients.

 

 

 

 

 

 

 

 

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The emergency department, perhaps the most chaotic place in any hospital, has been completely paperless at Community Hospital Anderson, in Anderson,Indiana, since 2011. What’s more, the ED achieved this without putting computers between clinicians and patients.

Speech-recognition technology made the difference, according to Dr. Thomas Short, who runs the ED at Community Hospital Anderson. Emergency physicians there interact with patients at the bedside instead of typing, then dictate their notes into computers stationed just outside patient rooms. Popular speech-to-text software Dragon Medical, a Nuance Communications brand, captures the notes.

These notes get saved immediately to the electronic health record, leading to a clearer summary for other physicians, regardless if a patient is admitted, discharged or referred to outpatient care. “It’s legible, and you can tell what happened,” said Short, who has been with the hospital since 2003.

“It reads like prose,” Short said. “It reads like a history and physical has always.”

That’s helpful for others within the ED as well. “Emergency medicine is a challenging specialty in that we are not seeing patients that we have relationships with,” Short said.

The notes do come out as unstructured text, which sometimes makes analysis and clinical decision support difficult. Short said the ED might try to convert some documentation to discrete data, but he does not think the staff is ready for that yet. “We worry about speed and efficiency,” he said.

But Short can report that that door-to-disposition time for patients in the ED has improved over the last five years since the department first started replacing paper charts.

Photo: Tony Frederick (hospital exterior)