Continuous speech recognition in MR imaging reporting: advantages, disadvantages, and impact

Authors: 
Ramaswamy MR, Chaljub G, Esch O, Fanning DD, vanSonnenberg E
Journal: 
AJR Am J Roentgenol
Publication Date: 
2000 Mar
Volume: 
174
Issue: 
3
Pages: 
617-22
  • HIT Description: Continuous speech recognition hardware and software. More info...
  • Purpose of Study: To compare the continuous speech recognition system to conventional transcription in terms of advantages, disadvantages, and costs.
  • Years of study: 1996-1997
  • Study Design: Before and after.
  • Outcomes: Accuracy of transcription, utilization, and costs.
Summary:
  • Settings: The radiology dept of a 970 academic center, which contained four MR scanners. The MR imaging section was staffed by a combination of residents, fellows, and faculty.
  • Intervention: Med Speak Radiology Version 1.2 IBM
  • Evaluation Method: Before and after measures of utilization and costs
  • Description: Med Speak Radiology Version 1.2 produced by IBM which interfaced over a local area network to the department's radiology information system which was an IDXRAD Version 9.0
  • Strategy: There was a mandatory change from conventional dictations to the use of Med Speak.
  • Cost of HIT systems: Approximately $10,000 with $3500 being hardware $4500 being software, $2000 being optional telephone support with upgrades, no maintenance costs are reported.
  • Cost of Implementation: This included having each radiologist undergo an individualized training session of approx 1 hour in duration.
  • Changes in healthcare costs: The authors estimate the annual cost of human transcription to be $12,000 while the equipment cost is $10,000 and maintenance costs were not reported.
  • Changes in efficiency and productivity: After implementation of continuous speech recognition the mean report length declined by 37% from 95 words to 60 words, while irregular spacing increased from 0.3 to 8.0 per 1000 words, and word omissions and duplications increased from 0.3 to 1.0 per 1000 words. However, spelling errors decreased 3.0 to .8 per 1000 words. Mean turnaround time declined from 87.8 hours in 1996 to 43.6 hours in 1997 with a further improvement to 32.3 hours by the end of the study period, with 71.1% reports being available within 24 hours.