1. College of Radiologists Voice Recognition What it should And can do For radiology

2. Introducing Myself Malcolm Grant GHG Software Developments Ltd Working with VR in radiology > 5 years Installed a number of NHS VR Systems

3. What it Should Do Save time and money? Shorten turnaround times? Improve reporting quality? If possible deliver all 3 together!!!

4. What it Can Do Save time and money Shorten turnaround times Improve reporting quality So why is it not in more universal use? ….

5. Unwelcome Technology?

6. Stethoscope

7. Unwelcome Technology? Stethoscope PC

8. Unwelcome Technology? Stethoscope PC PACS

9. Unwelcome Technology? Stethoscope PC PACS Voice Recognition

10. Cultural Change? Authors need RIS and VR knowledge –not just PACS – therefore learning curve Authors take full responsibility for Report –Second language speakers, mumblers –Full proof reading burden Appropriate workflows –Scanned request cards, barcodes, worklists

11. Reputation? “I tied voice recognition bee 4 and it did not walk” This is not a demo day, but … The technology is proven to deliver What is needed to succeed?

12. What is Needed High accuracy and fast editing Tight integration with RIS and PACS Network solution Good ergonomics 1:1 training

13. What is Needed High accuracy and fast editing UK Radiology Vocabulary essential Speech Engine dependency is high –Near monopoly Voice friendly report box –Not evident in most RIS systems Can all be checked in a short demo

14. What is Needed Tight integration with RIS and PACS Authoring must be time-neutral –Benefits are not directly for the Author –RIS designed for typists, not authors –Measurement is for report + verification RIS overheads must be minimised –E.g. “No bony injury seen”, “Heart and lungs are clear, no abnormalities of note” Drive must be easy to use –Simple accurate commands, fast drive

15. What is Needed Network solution Speech engines designed for single users Radiologists need to move around Shortcuts need to be shared and individual Voice files need to be network managed Back-end recognition also required –E.g. Breast clinic

16. What is Needed Good ergonomics Choice of Microphone –Accuracy, portability, durability, comfort Foot-pedal controls (mike control) –Needed to remove mike control issues Focus controls –Dictation, PACS RIS (mouse free) True hands-free use –Keyboard to be an option only

17. What is Needed 1:1 Training Trainer - Expert in VR –Every speaker is different –Broad experience needed Trainer – Conversant with RIS and PACS –Able to advise on best practice –Good experience in radiology

18. Successful implementation Choose an experienced specialist vendor Check recognition accuracy, speed, editing and shortcut capabilities at the demo stage Sign-off an integration specification –Detail RIS and PACS issues –Test in a pilot (e.g. 4 users) Roll-out in stages with full training –2 1:1 sessions with each author (approx 6 hrs/author) –Review management issues at each stage

19. What VR Users Say Consultant Radiologists & Registrars Reporting Radiographers SonographersReluctant users Typist Reductions Norwich40201250% Truro176123Yes MK470250%

20. What VR Users Say Preferred Reporting method Accuracy v Expectation TrainingTight Integration Turn back Clock Overall OK Norwich NoneVariableEssential NoYes Truro VRBetterEssentialKeyNoYes MK VRBetterMost Important Very Important NoYes

21. Users - Stated Benefits Faster turnaround Immediate verification Workflow improvements 24-7 working Encouragement to standardisation Improved user satisfaction

22. My stated benefits Verification time saved (10%) Large savings in typing costs

23. Users - Stated downsides Up to 50% slower reporting initially Users take up to 3 months to get up to speed Proof reading of long reports can be weak Minority of users do not succeed

24. Conclusion Voice Recognition can and does do, what it should do with considered implementation

25. System Comparison