By Stephen J. Hage
Management types like to talk about deliverables. It's a business term that allows them to agree, in management-speak, on something they all innately understand. What's a deliverable? It's what you deliver -- the final product of your work. And it's a bonafide practice management concern for radiologists as much as anyone.
When a radiologist talks about deliverables, he's probably referring to the final signed radiology report. I don't think it would be exaggeration to say that most referring physicians want the report the moment they decide what examination they want performed.
An important question then becomes: "What's the most efficient and cost-effective method of producing the report?" Embedded in that question is another: "Efficient and cost-effective for whom?"
The healthcare market demands that everyone involved constantly search for ways to do more with less. There are lots of reasons why, with efficiency and cost-effectiveness topping the list, but they all amount to cutting costs. That goal applies to radiologists working in hospitals and in private practice.
How do you produce your deliverable? If you use transcribers or a transcription service, you need to examine the decision carefully. Voice recognition technology has progressed from a bleeding-edge to a leading-edge application that's robust enough to help reduce your production costs. I know because I've tried it on my computer, and while it isn't perfect, the technology is ready now.
For example, a product like Dragon Naturally Speaking will run on a PC costing about $2,000, or a laptop in the $2,500 range. It will take you about 30 minutes to train the system to recognize your speech patterns. When it encounters a word that’s not in its lexicon, you'll be prompted to enter that word so that next time, the system will know it.
Some companies offer practice-specific lexicons that can simplify first-time use of the VR program. But even without a radiology-specific lexicon, commercially available voice-recognition systems can be taught.
What's the downside to voice recognition? The time and effort required to learn how the software works, and to train it to your voice and speech patterns. If you like technology you may even enjoy the process. If you don't, you'll probably see it as a hassle.
Using voice recognition software does mean more work for you. Once you've mastered the software, you'll have to proofread on-screen each report produced after dictation. But you should be doing that anyway, so proofreading is a wash. The key difference is that you have to do it in real time. It's not as convenient as transcription. Get over it.
The process will slow you down at first, but once you're comfortable with using the software, the decline in productivity will become substantially smaller, much like driving a stick-shift car. Once you know how, shifting becomes automatic.
What's the upside? The modest cost of the hardware and software required is a one- time investment, which will amortize itself quickly. Voice recognition technology eliminates the middleman between you and the production of your deliverable. It eliminates the personnel concerns and costs, both incremental and ongoing, associated with transcription. It's available 24/7, putting you in direct control of the (deliverable) report production process.
Businesses that succeed give their customers what they want, even if it means doing things differently. It's a question of convenience -- not yours, but theirs. If you don't think this is a bonafide practice management concern, you're not paying attention.
If you work in a hospital, think carefully about how you'll respond when management suggests you use voice recognition to produce your deliverable. Their concerns about efficiency and cost-effectiveness are just as valid for their business as they are for yours.
About the author
Stephen Hage is a radiology consultant in Los Angeles. He is past president of the American Healthcare Radiology Administrators Western Region and is a contributing editor to Radiology Management. He may be contacted at [email protected].
October 3, 2000
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