Documentation capture

East Kent NHS Trust streamlines clinical documentation workflows

East Kent Hospitals University NHS Foundation Trust cares for nearly 700,000 people in southeast England, with services spread across five hospitals and community clinics. A shortage of admin staff meant clinical teams were outsourcing documentation—but that was costly and added delays to patient care. The trust deployed Dragon Medical Workflow Manager to introduce speech recognition and streamline clinical documentation processes. With 80% of its transcription now handled in-house by Dragon, the Trust is predicting savings of more than £2.3 million over five years, and its patient records are now more accurate and detailed. The project has also brought the trust a “Highly Commended” in this year’s UK IT Industry Awards as “Best Healthcare Sector IT Project of the year”.

East Kent Hospitals University NHS Foundation Trust’s vision of ‘great healthcare from great people’ serves more than 695,000 people across five hospitals and community clinics in southeast England. But the combined pressures of regulation, staff shortages, and increasing demand were putting East Kent’s clinical documentation processes under strain.

“Like many trusts across the country, we’re challenged by the increasing demand for our high-quality specialist care and services in the face of significant financial pressures,” said Andrew Barker, IT Director at East Kent Hospitals University NHS Foundation Trust.

The trust’s IT team needed a technology that would improve service delivery, helping clinical staff provide personalised care and better outcomes, without adding a major new expenditure to an already tight budget. And that drive for efficiency and innovation brought them to speech recognition.

Tackling shortages in admin staff—without relying on outsourcing

The team wanted to focus on streamlining clinical documentation workflows—a set of processes that were significant time and budget drains for the trust. With a shortage of in-house administration staff to help clinical teams transcribe and share patient notes and write follow-up letters to patients and colleagues, East Kent relied on outsourcing. Staff would send audio recordings to a transcription agency, who would send documents back for review, which was expensive and time-consuming, with hardcopy printing and mailing adding further costs and delays.

As doctors and other clinical staff were already used to dictating their notes and documentation, AI-powered speech recognition was the next logical step. The trust’s IT team chose Dragon Medical Workflow Manager (DMWM) to bring transcription back in-house, without needing to hire in extra admin staff. It’s an end-to-end solution that streamlines clinical documentation from dictation to sharing, and integrates with electronic health records to create a complete ecosystem of patient information. Its speech recognition engine is tailored for medical applications, which means it recognises and transcribes even the most complicated medical terminology with ease.

East Kent had three goals ahead of implementation:

  1. Reduce reliance on third-party typists to cut outsourcing costs
  2. Reduce average document turnaround times to meet the NHS England guideline of seven days
  3. Achieve adoption rates of DMWM of 70% or more

Working with Nuance, East Kent deployed Dragon and its advanced speech recognition capabilities in 26 clinical specialities including haematology, trauma, and orthopaedics, within its hospitals and community clinics—and so far, the implementation has been hugely successful.

5 million lines of dictated text, all handled by AI

The team started the deployment with a small group of clinicians who used outsourced transcription frequently. “To deliver immediate impact in reducing outsourcing costs, we strategically targeted the clinicians who were using the outsourced transcription services the most as a priority,” said Andrew. “This meant we could tackle where the issue was most prevalent at the outset, showcasing a faster return on investment in terms of time and cost savings.”

East Kent has exceeded its targets in less than a year, quickly proving the value of speech recognition and connected documentation workflows. Clinicians have produced more than 380,000 documents using Dragon speech recognition since the solution went live, and the average turnaround time is now less than five days, well below NHS England’s guideline. In fact, 60% of those documents have been dictated, finalised, and distributed in less than two days, helping reduce delays in patient care and ensuring clinicians have the most up-to-date information about diagnoses and care plans.

In 2020, East Kent’s clinicians dictated over five million lines of text using Dragon. “That’s a marked increase on the number of lines that our transcription agency could handle,” said Andrew. “We’ve freed up financial resources that can be invested in other areas of the trust, especially for teams that are delivering direct patient care.” By bringing 80% of its transcription back in house, the trust has already saved more than £460,000, with projected five-year savings of over £2.3 million.

More detailed documentation delivers better patient outcomes

On top of its compelling financial results, East Kent is also seeing improvements in the quality of its documentation and communication between hospital staff, GPs, and patients. Patient letters are available instantly in the trust’s web portal when the clinician has finished—and they can be automatically distributed to the relevant people.

Importantly, DMWM helps clinicians capture notes at the point of care, right after they’ve spoken to the patient, when their thoughts are completely fresh. That means they’re able to record more detail to help give patients and other care providers a more complete picture.

“Dragon helps our clinical staff create a more accurate and complete record of patient consultations, and ultimately that will lead to better outcomes and experiences for the people we care for,” said Andrew.

Industry-wide recognition for East Kent

East Kent is now working on a wider deployment of speech recognition within its hospitals and clinics where clinicians can add their notes directly into the patient record by simply using their voice. Its medical records are hosted, shared, and edited using Allscripts’ Sunrise Electronic Patient Record (EPR) system. Allscripts is a Nuance partner, which means our speech recognition solutions are fully compatible with Sunrise; the IT team is now testing a Dragon Medical One deployment with staff in its renal practice.

The trust’s new approach to workflows has been recognised on a broader scale within the IT industry, with its speech recognition deployment securing the team a “Highly Commended” in this year’s UK IT Industry Awards as “Best Healthcare Sector IT Project of the year”.

Learn more about streamlining workflows

East Kent is using clinical speech recognition to deliver superior personalised care—explore the solution and the benefits of speech recognition for clinical documentation.

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Dr. Simon Wallace

About Dr. Simon Wallace

Dr. Simon Wallace is the Chief Clinical Information Officer (CCIO) of Nuance’s Healthcare division in the UK and Ireland. Simon has worked as a GP, hospital and public health doctor in Brighton and London. His interest in health informatics began in the 90s when he spent a year at the King's Fund investigating the impact of the internet on shared decision making between patients and their healthcare professional. For the past 15 years, he has worked for a range of organisations including Bupa, Dr Foster, Cerner Corporation and GSK across a range of technologies which include electronic patient records, telemedicine, mobile health and lifestyle devices. Simon has a keen interest in the voluntary sector, recently completing a 7 year term as a Trustee for Fitzrovia Youth in Action, a children and young people’s charity based in London.