Adoption of EMR systems are lagging with less than two percent of U.S. hospitals fully switched to EMRs, according to the New England Journal of Medicine. Part of the problem is a reluctance by physicians to change their work habits such as switching to speech recognition systems to do dictation. Despite the stumbling blocks, progress is being made, soon to be supported by an infusion of federal money to support EMR installation.

DOTmed attended this week's HIMSS09 conference in Chicago where Nuance Healthcare showcased its latest speech solution, Dragon Medical software. The company also launched the Dragon Medical EHR Certification Program, designed to optimize clinician use of EHRs by introducing a new standard of speech recognition interoperability. Dragon is the health care industry's most widely used real-time speech recognition software.

A survey completed by 1,255 physicians who have adopted Nuance's Dragon Medical software found that 83 percent said that it improved the quality of their electronic patient notes; 81 percent said that it significantly reduced transcription spending; and, 69 percent said it made their EHR faster and easier to use.

"This method of documentation is easy for me, because I can dictate findings on a pathology specimen, which results in a faster turn around time for physician and patient," said Peter Libbey, M.D., Director of Anatomic Pathology, Roger Williams Medical Center, University Pathologist's Group. "Reporting directly to an Electronic Hospital Record (EHR) system eliminates hours of paperwork, allowing me more time to present findings on many more pathology specimens." Dr. Libbey also told DOTmed News that speech-enabled medical records enhances his work because it is easy to dictate reports on pathological specimens that he examines, rather than write or type up reports.

"Our physician clients have embraced Dragon Medical as the primary and best means of speech-enabling their electronic health records, because Dragon Medical helps them to quickly and easily create high-quality, real-time patient documentation," said Glen Tullman, chief executive officer of Allscripts. Nuance is collaborating with leading EHR vendors such as Allscripts to launch the Dragon Medical EHR Certification Program. "With the option to speech enable their EHR system with Dragon Medical, our clients are empowered to create high-quality, real-time patient documentation without solely relying on templates. Speech is raising the bar in healthcare IT, and voice command is an essential component of our comprehensive electronic health record solution."

While Dragon Medical software already works "out-of-the-box" with more than 150 EHR systems, the Certification Program is designed to optimize clinician use of EHRs by introducing a new standard of speech recognition interoperability. As part of the Dragon Medical EHR Certification Program, EHR vendors complete a Nuance-managed evaluation during which they work with Nuance engineers to further optimize the Dragon Medical software's interoperability with their EHR. By adding this additional layer of interoperability, physicians and healthcare organizations can confidently make their EHR migration, knowing speech recognition is not only possible, but has been pre-tested and optimized for utmost clinician efficiency.

The benefits of clinicians using "desktop" speech recognition to directly control an EHR system include sharply reduced costs and increased productivity. Transcription costs are reduced because clinicians can dictate directly into the EHR system with real-time speech recognition. Physicians can create patient documents at the point of care, resulting in faster turn-around times and more accurate patient records. Patient documentation can be more detailed because a medical record that combines point-and-click EHR templates with dictated physician narrative promotes ongoing higher quality care.

Wes Rishel, vice president Healthcare Industry Analyst for Gartner Healthcare said, "EMRs cannot make a dent in improving healthcare without dramatically increased physician adoption. Physicians must not only adopt the products, but begin to use them as more than electronic file-drawers and billing systems. Voice input well-recognized and well integrated with EMR software is critical to closing the gap to meaningful adoption."

Another challenge facing the rollout of electronic medical records contemplated in the American Recovery and Reinvestment Act is achieving "meaningful use" without adding to physicians' documentation burden. According to Rishel, "this can be accomplished by closely coordinating voice entry with structured notes, rather than treating voice and structured entry as an 'either-or' proposition."

As the Health and Human Services Department works to define "meaningful use" of an EHR, Nuance believes that Dragon Medical software can help physicians and organizations move toward complying with what will ultimately be considered meaningful EHR use, by ensuring that clinicians actually utilize the EHR and that the physician narrative is not lost during the documentation process. Senior vice president of marketing anD product strategy at Nuance Healthcare, Peter Durlach said, "Dragon Medical is increasingly recognized as an essential component to EHR rollout as healthcare provider organizations work to implement, and effectively utilize EHR systems to comply with the federal government's five-year adoption goal, as well as earn their fair share of incentive payments from the American Recovery and Reinvestment Act."

Watch DOTmed News for ongoing coverage of health IT topics.