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Hear how hospitals across Europe and beyond are speech-enabling Epic workflows with Dragon

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Explore highlights from our recent webinar, where we sat down with experts from the UK, Denmark, and the USA to discuss how healthcare organisations are speech-enabling their Epic electronic health records with Dragon Medical One.

Across a single healthcare organisation, there’s so much variety in how people work. Different departments and specialisms have their own requirements. New technology has to achieve two potentially conflicting goals: creating a centralised, standardised approach to tasks while allowing each team to adapt new systems to fit their needs. For digital transformation to work in the healthcare sector, flexible solutions are a must.

 In our recent webinar, we brought three experts together to chat about how they’ve approached introducing Dragon Medical One to speech-enable Epic electronic health record (EHR) systems across their organisations.

Dr Brian Zimmerman is a US Nuance CMIO and an emergency department clinician from Premier Health in Dayton, Ohio. A long-time user of Epic and Dragon, Dr Zimmerman joined us to share how his team uses its speech-enabled Epic system alongside PowerMic Mobile, and to demonstrate the combined solution for our audience. Panellist Graham Smith, CCIO and consultant orthopaedic surgeon from Frimley Health NHS Foundation Trust joined us to give an update on his trust’s progress after six months with its fully speech-enabled Epic environment. And, bringing us the mobile side of the discussion, we also welcomed Lene Strandbygaard from the Centre for IT and Medical Technology (CIMT), which supports digital transformation for healthcare providers across the Capital Region of Denmark.

A big-bang deployment at Frimley Health

Frimley Health NHS Foundation Trust runs two large acute hospitals and a new elective site near London, where patient information used to be managed through paper records, manual transcription, and 200 legacy systems. To bring all that into one centralised EHR, Frimley went live with Epic in June 2022, after a year of using Dragon Medical One as a standalone solution to prepare staff for the transition. “We contracted with Nuance soon after we made the decision to go with Epic,” explained Mr Smith. “And this made it possible to start using Dragon voice recognition […] before we went live to get our clinicians more used to using front-end transcription.”

This two-phase approach allowed Frimley’s clinicians and support staff to shift away from handwritten notes and lengthy outsourced transcription processes before introducing a whole new digital system. “We have people who’ve been using their systems for a long time. So the behaviour and habits are quite embedded,” Mr Smith noted.

This strategy is ideal for large teams undergoing a major change, as it allows everyone to build confidence together and start finding ways that Dragon Medical One can support their preferred workflows. Then, once the team is comfortable with speech recognition, those new skills can be applied to the Epic EHR, limiting how much extra learning clinicians need to do on top of their everyday responsibilities.

It’s only been a few months since the full launch, but the team is already feeling the impact. For Mr Smith, clinic letter turnaround-time is near-instant, and across the trust there has been a big reduction in outsourced transcription costs. Frimley now has almost 700 active users in Epic, who used Dragon to dictate nearly 80,000 minutes of notes and follow-up letters in January 2023 alone. “As a trust, we have done quite a big leapfrog in terms of our clinical digital abilities,” said Mr Smith.

Mobile deployments for different specialisms in Denmark

Joining us from Copenhagen, Ms Strandbygaard is a program leader at CIMT. The team works with the region’s clinicians to create an optimised Epic environment for each department by combining Epic’s Haiku, Canto, and Rover mobile apps with Dragon’s speech-to-text capabilities. “We have a big project that customises the user interface on speciality and department level,” she explained . “And that gives […] users a Canto and Haiku user interface that contains speciality features, and also department preference lists and note templates.”

CIMT operates four to eight-week trials that allow departments to experiment with mobile devices that come pre-loaded with Epic and Dragon—free of cost. The region’s clinicians are now using speech recognition for consultations, bedside visits, home care, and more. “The mobile application can become a valuable supplement in everyday clinical life,” Ms Strandbygaard said. “For example; in thrombolysis, we experience time saving with Canto on duty when the patient is in the scanner and needs an order for a supplementary scan. Previously, a nurse had to find a PC, open it and look for the order. Now the doctor has it all right in the pocket of his medical gown and can place an order more quickly,”

Ms Strandbygaard also mentioned her team is looking into the specific challenges of clinical documentation for nurses and providing support with Dragon Medical embedded on the Rover app.

Catch up with the full discussion now

The stories from Premier Health, Frimley, and the Capital region show the versatility of a combined Epic and Dragon Medical One deployment. The solutions deliver the tools and guidance for each hospital, department, and individual clinician to tailor their experience to match their needs. We concluded the webinar with a fireside chat and Q&A that gave our audience the opportunity to dig deeper into our panellists’ stories and ask their own questions about Dragon and Epic.

We had some great prompts from our audience for this discussion. We covered how to ensure clinicians are providing structured data as well as the narrative component of a clinical note, and how to encourage long-term adoption and stop clinicians slipping back into old, inefficient habits.

You can hear the responses from Dr Zimmerman, Mr Smith, and Ms Strandbygaard to these queries and many more in the on-demand recording of Speech-Enabling Epic with Dragon Medical One, available now.

Watch the full discussion

Hear directly from Dr Brian Zimmerman, Dr Graham Smith, and Lene Strandbygaard in the on-demand recording of Speech-Enabling Epic with Dragon Medical One.

Watch the video
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.