Documentation capture

Transforming outpatient services at Oxford University Hospitals NHS FT with speech recognition


Dr Paul Altman, Consultant Nephrologist and Chief Clinical Information Officer at Oxford University Hospitals NHS FT recently led a Digital Health webinar for Nuance demonstrating the value of speech-enabling the hospital electronic patient record (EPR). He describes the significant benefits the trust has seen since the rollout of clinical speech recognition software. This includes an increase in clinician satisfaction, an enriched patient record, faster outpatient letter turnaround time, reduced administrative and transcription costs, and accelerated digital transformation plans.

In a recent webinar hosted by Digital Health, Dr Paul Altman, consultant nephrologist and chief clinical information officer at Oxford University Hospitals NHS Foundation Trust, explained how speech-enabling their Cerner Millennium electronic patient record (EPR) has helped the trust accelerate its digital transformation plans.

Prior to rolling out Nuance’s Dragon Medical One speech recognition software, the trust was using off-site transcription services that were not integrated into the EPR, suffering with administrative staff shortages, and incurring considerable costs associated with delays and complex workflows. It was also having difficulty meeting the 10-day target (now seven days) for outpatient letter turnaround.

Following a three-month pilot period in the renal outpatient department, Dr Altman says the differences the trust experienced were “quite spectacular”. The workflow was much faster, with the option to send letters instantly without secretarial input, if none is required or laboratory results are pending. Letter turnaround time has been reduced from an average of 12 days to just three. Also, Dr Altman explained, the letters cannot be sent to the wrong patient by accident, and the Dragon template has standardised what goes out, which is useful for time-poor GPs. Costs were also significantly reduced, with far fewer transcription services needed, as well as an administrative vacancy no longer needing to be filled and printing costs eliminated entirely.

Other benefits the trust has seen include being able to capture patient information at the point of care and enter it directly into the EPR – this means no reliance on memory and, consequently, letters are more accurate. This has facilitated improved quality and speed of communication and improved patient safety.

Additionally, the Nuance cloud infrastructure offers many advantages around speed of deployment, costs, return on investment, and also means staff can access the software wherever needed, including from home.

The adoption of the technology within the renal department is now complete, and as a result the department is now paper-free, as are a number of other outpatient services across the trust. This aligns with the views of the trust’s senior leadership on digitalisation and is helping the trust work towards its strategic goals.

The rollout of Dragon Medical One is continuing across the trust, with one off-site transcription supplier now eliminated. By using the Dragon Medical One auto-text functionality, in 2020 trust staff collaboratively saved 48 full-time equivalent days.

By the end of 2021, the trust is aiming to completely eliminate all off-site transcription services and continue driving the benefits the software offers around time and financial savings.

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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.