Documentation capture

Speech-enabling InterSystems TrakCare: Streamlining clinical documentation in shared care

Up-to-date and accessible patient records help provide joined-up care. But what steps can Integrated Care Systems (ICSs) take to improve clinical documentation across diverse healthcare settings? And how can Integrated Care Boards (ICBs) support this? Our recent webinar brought together NHS experts to discuss how speech recognition supports clinical documentation across the care continuum. Run in collaboration with InterSystems, our Nuance webinar also featured a live demo of InterSystems TrakCare speech-enabled with Dragon Medical One.

Comprehensive, up-to-date, and easily accessible patient records are fundamental to the efficacy of Integrated Care Systems (ICSs) and other shared care models.1

However, many healthcare professionals already spend a significant proportion of their time creating clinical documentation. And, in a Nuance survey of almost 1,000 NHS healthcare professionals across primary and secondary care, 85% thought the burden of clinical documentation is a significant contributor to burnout.

So what can be done to help ICSs streamline record-keeping and reduce the burden on clinicians? Integrated Care Boards (ICBs) can play a key role in transforming documentation processes by identifying the right technology and finding the resources to deliver it at scale.

In our recent webinar, I spoke with two NHS clinicians who are also involved with strategic work within their Trusts, to explore the challenge of effective documentation in shared care.

  • Dr James Reed is a Consultant Forensic Psychiatrist and CCIO at Birmingham and Solihull Mental Health NHS Foundation Trust, Clinical Lead for West Midlands Shared Care Records, and Physician Executive at InterSystems.
  • Mr Leon Lindsey is a Consultant ENT Surgeon at South Tyneside and Sunderland NHS Foundation Trust and speech recognition project lead for the North East and North Cumbria ICS.

We began by discussing some of the drivers behind shared care.

What are the benefits of greater coordination between healthcare providers?

When care is siloed, communication can break down. This means that healthcare providers across the NHS, social care, and other settings such as prisons often struggle to get the information they need to give patients optimum treatment.

Dr Reed gave an update on the West Midlands Shared Care Records project “We’ve been able to construct a ICS-wide program. It was birthed originally during the pandemic where we went from a very small mental health system.  But it’s grown at great pace, and we now have all the NHS and social care organisations across 3 areas contributing and consuming data. Our big challenge now, is to get the value out of it, increase usage and get the clinical benefits.”

Dr Reed believes that to make shared care work you need a common platform that’s widely available. “Include everybody,” he said. “Think big, think broadly, go out and engage with all the interested parties and you’ll be surprised with the results.”

For Dr Reed, the benefits of shared care extend to include charities such as hospices and voluntary groups. “The visibility they had before of what was going on with patients was almost nothing,” he said. “They greatly benefit from seeing simple information like their patient’s medication from GP records or for example, if the person they are due to visit has been admitted to hospital – this was invisible before.”

As care settings become more connected, data is increasingly visible, but Dr Reed believes that greater visibility can drive better patient care. “If you’ve got poor data quality—and you know everyone is going to see it—you’re incentivised to improve it,” he said. “If we all do better at this, everyone benefits, and the patient most of all.”

Why does timely access to shared records matter?

Making simple information, such as current medication, quickly and easily visible can help provide joined-up care for patients when they need it most urgently, in acute care.

In fast-moving healthcare settings, more pressing responsibilities can cause clinicians to delay updating patient records until later in the day. But the longer the gap, the more likely it is that small details will be missed. This could mean the records are less useful when quick decisions are essential for good outcomes.

“That time could be very important for the patient,” said Dr Reed. “At every stage, you have to get the information you need into your system—and it’s got to be rapid and accurate.”

Mr Lindsey also believes that the speed of taking patient notes has a direct link to quality of care. He said, “If I admit someone urgently and the letter is there immediately, with the management plan, the nurses and junior doctors on the ward can see exactly what to do.”

How can speech recognition help provide that timely access?

Clinicians throughout primary and secondary care are already using speech recognition solutions like Dragon Medical One to create notes in electronic patient records instead of typing.

But to get good adoption, it’s essential that speech recognition is accurate and can easily understand strong accents and complex medical terminology—all key for Mr Lindsey and his team. “The big difference is that people can use Dragon Medical One straight away, without any prior training,” he said.

And could speech recognition also provide the immediacy that Dr Reed advocates for? “The time when you’ve just done something is when it’s freshest in your mind,” he said. “That’s why contemporaneous notes are always held in the highest regard, and using things like speech recognition allows us to get as close to that as we can.”

Mr Lindsey highlighted another benefit of accelerating documentation turnaround times with speech recognition “it just improves safety at all levels, because the timeliness of correspondence goes up. There is less clinical risk and clinical governance issues associated with delayed communication.”

What are the organisational benefits of using speech recognition?

New technology can catalyse opportunities to build different, more efficient, systems of work. “It’s essential to get clinical processes and pathways mapped out and well-understood,” explained Dr Reed. To see the most benefit in reducing the burden on clinicians, having optimised workflows in place—such as agreed-upon templates and distribution lists—is critical.

Built-in templates provide a standardised structure that superusers can easily tailor to clinical specialties. When these templates are updated over time, new versions can be shared instantly across users, departments, and organisations.

As well as helping to keep accurate, timely patient records, speech recognition is also proving to be a valuable tool for drafting clinically relevant correspondence such as emails. To help him lead a rollout of Dragon Medical One in his ICS, Mr Lindsey is exploring what more his team can do with speech recognition.

“There are lots of extra things you can do, from ordering scans to writing papers or educational supervision,” offered Mr Lindsey. “But the fact you can document immediately is the most important thing. You don’t have the effort to type; it’s like a relief to use speech recognition.”

It’s exciting to see speech recognition making clinicians’ lives easier but to ensure the success of a large-scale rollout, the right strategy is essential. “The mistake often made is to think that the technology on its own will solve everything,” cautioned Dr Reed. “The tools are just the beginning of the journey.”

Fostering digital maturity can take time. But as our panellists have shown ICBs can play a leading role in building a business case and strategy for deploying transformational solutions at scale, across regions and across different healthcare settings.  

See Dragon Medical One at work with InterSystems TrakCare

At the end of our session, we invited Mark Leonard, Technical Specialist for AI-based healthcare solutions at Microsoft, to give a live demo of speech recognition. Mark put Dragon Medical One to work with InterSystems TrakCare.

Watch the webinar to see Dragon Medical One and TrakCare in action.

Further reading:


Watch the recording

Missed the webinar? Catch up on our discussion about the benefits of using speech recognition for clinical documentation in InterSystems TrakCare. Watch on-demand now.

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.