Q&A column, 10/15

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2. Johnson L, Kissoon N, Fiallos M, Abdelmoneim T, Murphy S. Use of intraosseous blood to assess blood chemistries and hemoglobin during cardiopulmonary resuscitation with drug infusions. Crit Care Med. 1999;27(6):1147–1152.
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David N. Alter, MD, DABCC, Clinical/Chemical Pathologist, Blood Bank Medical Director, Clinical Professor of Pathology, College of Human Medicine, Michigan State University, Spectrum Health Regional Laboratory, Grand Rapids, Mich., Vice Chair, CAP Chemistry Resource Committee

Mark A. Cervinski, PhD, DABCC, Assistant Professor of Pathology, Director of Clinical Chemistry, Dartmouth-Hitchcock Medical Center, Lebanon, NH

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Q. I’ve talked to other pathologists about their experience with speech recognition, and it tends to vary greatly from group to group. Some have an easy time and others find it difficult and just tolerate it. How can this varied experience with the same product be explained?

A. As I have mentioned in past articles in CAP TODAY, speech recognition is not a product/solution. It is a technology that can be used as part of an effective pathology reporting solution like our VoiceOver product. I can’t speak entirely for other implementations of speech recognition technology, but among our VoiceOver client base we do see variances in initial adoption satisfaction. I would not objectively describe those variances as great, and they tend to narrow with time and experience. As I like to say, “The devil is in the details.”

I recently wrote a three-part blog series intended to help pathology sites determine what solutions are best for them and how they can better predict success at their site. In the third part of the series, “Ways to make sure your speech recognition selection isn’t a failure,” I discuss the many variances in pathology laboratories that make it difficult to look at any one user, at any one site, and at any one AP system and predict your success based on their experience (https://j.mp/speechsolution). All users, sites, AP systems, and workflows are not created equal, and each combination brings its own unique implementation success challenge.

Since speech recognition technologies and solutions are not self-contained reporting solutions, they rely on the underlying AP system and its workflow, which are major variables in the user experience. Specifically, there are variances in:

• User role (pathologist, resident, PA, others)
• AP system (Cerner, Epic, Meditech, Soft, Sunquest, others)
• AP system infrastructure (client/server, virtual, or cloud)
• Workflow (gross dictation, microscopic dictation, autopsy, other)
• Organization type (academic hospital, private lab, hospital group, other)
• Site locations (multisite versus standalone lab)

In each case, different combinations of these factors create many permutations of variance with challenges to address to create similarly successful user experiences.

Finally, I asked my director of client services, Lindsey Pitsch, what she believed caused the biggest variations in initial user satisfaction and acceptance, and she said that in most cases there is a direct correlation between satisfaction and user involvement in the planning stages of the implementation process. She believes that sometimes administrators take over with the thought that it is better for the pathologists to not “waste” their time on a change that the administrators perceive to be an administrative task. The problem is that they aren’t just replacing a dictation system. The change alters the user’s daily workflow. We always request the presence of PAs and pathologists on project teams. We have historically seen that those clients with users who participate fully in the implementation process tend to have a much higher initial satisfaction rate. Their voices are heard and they know what to expect when they go live. When users are not involved, sometimes they receive the wrong message. They think speech recognition will never make a mistake or that on day one they will be exponentially faster than with transcription. By keeping users involved you can properly set and manage expectations, which will lead to a more successful user experience and perception.

Ross Weinstein, Voicebrook, Lake Success, NY
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Dr. Kiechle is medical director of clini­cal pathology, Memorial Healthcare, Hollywood, Fla. Use the reader service card to submit your inquiries, or address them to Sherrie Rice, CAP TODAY, 325 Wau­ke­gan Road, Northfield, IL 60093; srice@cap.org. Those questions that are of general interest will be answered.

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