Transcription Solution Receives a Radiant Review

After more than a decade of considering a speech recognition solution, 10 hospitals in the Baptist Memorial Health Care (BMHC) Network decided to do away with their fragmented and often repetitive clinical documentation services and roll out the very latest in speech transcription technology. 

BMHC, which operates 15 hospitals and a number of urgent care and outpatient facilities in Tennessee, Arkansas, and Mississippi, weighed its options, assessed its needs, and evaluated four different products before selecting the PowerScribe for Radiology solution from Nuance Communications.

According to Nina Armstrong, radiology information system manager and PowerScribe administrator for BMHC, the hospitals involved radiologists and administrators in the decision-making process and sent staff on numerous site visits before selecting PowerScribe.

“[PowerScribe] was the product that they all agreed would be best for our facilities,” Armstrong says. “We’ve been looking at it for a long time, and we just felt it was a good situation to improve turnaround time, to better serve our patients, and to get those results out to them and to the doctors so that patient care can go forward.”

The results have been nothing short of spectacular for BMHC. Since rolling out PowerScribe last February, BMHC has seen an 81 percent reduction in radiology report turnaround time, from 11.4 hours to 2.2 hours—a figure that surpasses BMHC’s original stated goal of five hours. Additionally, transcription costs had been lowered by nearly $400,000 as of November.

“Our key benefit is that patient results are on the chart within minutes after the study is performed,” Armstrong says. “So patient care is always right on time instead of a delay waiting for something to be typed out and waiting for it to be signed out. The impact to patient care is phenomenal. The [emergency department] does not discharge a patient without that radiology report in hand.”

Armstrong also says that PowerScribe—which enables radiologists to sign off on completed reports while viewing original images, thus eliminating the need to double check reports returning from transcriptionists—has helped boost both doctor and patient satisfaction. Reports are also expedited immediately upon doctor sign-off and faxed to referring physicians’ offices.

“Our satisfaction rate has gone up immensely,” Armstrong says. “The issue now is that they’re so used to getting [reports] immediately that if there is a two-minute delay, they’re calling, ‘Where is my report?’…They’ve come to depend on that report being in their hands that quickly.”

In fact, BMHC’s deployment of PowerScribe has been so successful that Bob Fleming, senior product manager at Nuance, describes the rollout as “poster-child, case-study-type material.”

“They’ve had a very successful deployment of PowerScribe, reducing costs and reducing turnaround time,” Fleming says. “When I look at those achievements, it’s pretty clear that they had a very successful rollout.”  

But despite all of BMHC’s success, Armstrong says that rolling out PowerScribe presented several challenges. Many of the radiologists, she notes, weren’t initially excited about switching to PowerScribe.

“There was resistance to start out with,” she says, adding that once the doctors saw the benefits of PowerScribe they became “very attached” to the new system and have indicated a disinclination to revert back to transcriptionists.

A Group Effort

Additionally, the PowerScribe deployment presented some logistical and technical challenges for BMHC. “We have 10 facilities on this product,” Armstrong says. “There are five different radiologist groups and two different radiology clinical systems that had to be integrated with it and interfaced.”

According to Armstrong, a lot of travel was involved—given that some of the sites are located hundreds of miles from each other—and the BMHC implementation strategy started with two smaller sites within the largest radiology group in the Memphis, Tenn., area.  

“[We] built from there and had all of them trained and functioning for six weeks, and then we went to another site and we would stay with them for a week and get them up and going,” she says, noting that it took about six months to completely roll out PowerScribe at all 10 sites.

But BMHC had help with the rollout from Nuance. As part of the implementation process, the speech solutions company sent PowerScribe trainers to each of the 10 BMHC sites. According to Armstrong—who notes that each doctor required three hours of training time—the Nuance trainers visited each site, trained and worked with doctors, ran additional training sessions out of the Memphis site, and returned three weeks after the rollout to answer questions and monitor progress.

“All of the trainers [Nuance] sent in were excellent,” Armstrong says. “The radiologists were very complimentary of the way they worked with them.  They basically just sat with the radiologists and went through the training. And then they would just sit with them for an hour and watch how they functioned in the system.”

Armstrong says significant follow-up and communication with Nuance took place, which, in part, led to the success of the BMHC deployment.

“We’ve also been implementing, installing, training, and supporting the PowerScribe product for 10 years,” Fleming says. “We’ve learned a lot over the last 10 years, so the level of expertise that we can bring to the table to help our customers be successful in implementing a product like PowerScribe is also unrivaled in the industry.”

But Fleming says that much of the credit for the successful rollout belongs to BMHC for following best practices, setting measurable goals, and getting doctors involved in the process early.

“When you know all those things are in place, then you pretty much guarantee success,” he says. “Part of being successful is that they set some goals for themselves.”

A Banner-Bearer

Fleming says that other hospitals and healthcare providers can learn valuable lessons from the BMHC story: First and foremost is the importance of getting end users—in this case, the radiologists—involved as soon as possible. In fact, Fleming says an implementation that doesn’t involve end users in the purchasing process raises a “red flag.”

“When we see that, and we’re starting our implementation and training process, we raise a flag,” he says. “But in Baptist’s case, it’s pretty clear that [the radiologists] were involved early on. It makes them a stakeholder. It makes them a part of the process. They want the project to be successful....So that’s usually rule number one: Make sure the radiology staff is involved in the product selection decision.”

Armstrong says BMHC is planning to upgrade to the latest version of PowerScribe this year.  

“One of the things that I’m very proud of is that, even with all the resistance and everything we had, within the first eight weeks that we went live with the [first] five sites…we were at ninety-nine percent self-edit, and we remain there today,” she says. “That has been a huge victory.”