The benefits of the hands-off approach to reporting results-voice recognition technology-are being heard across the country. The conversational computing software enables laboratorians-typically cytotechnologists and pathologists-to interact with the computer through a series of voice commands and expedite the input and verification process of results reporting.

Rapid Input, Verification
At the Pathology Services Department of High Point (NC) Regional Health System, Steven K. Olsen, MS, HLT(ASCP), director, said that since the December 2003 installation of the Vox PapuliT from Psyche Systems (Milford, MA), the lab has seen a reduction in data entry errors. Vox Pap works with Psyche Systems' WindoPathT anatomic pathology information system.

The system allows for rapid input and verification of data, Olsen said. Cytotechnologists can make a voice record of their observations with a cordless headset or microphone. The computer verbally prompts the cytotechnologist for patient identification and other demographic information associated with a particular specimen, and then prompts the cytotechnologist for the adequacy and the diagnosis. The computer records the diagnosis and reads the data back for verification, prior to prompting the cytotechnologist to "sign out" the completed case using the e-signature.

"If a cytotech inputs data by traditional methods, they have to spend valuable time entering data rather than screening or rescreening slides," Olsen said. "If someone else enters their findings, then a cytotech has to record their findings and verify that the data is correctly entered. Doing either, direct input by hand or input by another person, is an inefficient mechanism as it waste valuable resources-cytotech's time and dollars. We desired a method of entry of data that would not only be efficient use of manpower but also meet the technical intent of an electronic signature."

Using the system, a cytotechnologist can input, review, sign, refer, recall and verify all information while simultaneously reviewing slides, Olsen said.

"We looked at other methods for input or verification but found none to be as efficient as the voice entry system," Olsen added. "Each of these other methods required tech time to record, enter, and verify information that could not be used to do other work."

With voice recognition software, Olsen reported that slides per day screened have increased and reduced inputting time-and errors.

Web-Based Module
Another voice recognition software available is PowerScribe Workstation from Dictaphone Corp., Newton, PA. Product Manager Robert Fleming explained that the workstation is a Web-based digital dictation and real time speech recognition system for medical report creation. Users access the system through a standard Web browser, dictate reports and uploaded reports to their clinical information system.

The system's Pathology Language Model is a discipline-specific speech recognition language model. Its Pathology Workflow system is designed to support the workflow requirements of a pathology environment, including multi-sectioned reports, supporting multiple users dictating into a single report and final sign-off by the pathologist. Other features include transcription workflow for those users uninterested in speech recognition.

Further, text-based templates speed up dictation and allow users to quickly click through fill-in-the-blank style templates. Hands-free dictation using headset and foot pedal are available for gross room environments. The system provides faster turn-around time of reports, financial savings by decreasing or eliminating transcription costs, Fleming said.

"With all documentation tasks being done in PowerScribe Workstation, the pathologist has access to the complete case while performing their final diagnosis and sign-off," he said. "The use of templates across the department will help to standardize the formatting and content of the reports for your referring physicians."

Additionally, several quality assurance and controls are in place. The barcode scanning support eliminates manual entry of data. The work list is available for Web sites that have not deployed barcode scanning; users can select cases from a work list within the system so manual entry is not required. The spell check uses a medical dictionary that automatically scans reports prior to final sign-off.

The goal of the technology, Fleming said, is "to provide a solution to the pathology market that increases documentation quality and efficiency while decreasing costs within the department. It allows the customer to streamline their documentation process and move towards a paperless environment. Our technology continues to evolve based on user feedback and the trends we see in the marketplace."

Technology Trends
"I'm sure it won't be long until this technology is employed in a wider sense in pathology," Olsen added. "We are exploring other ways to use voice technology to do routine tasks in the pathology laboratory. There are mechanisms to manipulate tasks on a PC via voice commands, just as you can now dial your phone by voice or turn on lights in your car or house by voice."

Erin James is an assistant editor of ADVANCE. She can be reached at ejames@merion.com.