· Speech Recognition Takes a Giant Step Forward
· Tech Zoom: Seven Suites for Specialized Needs
· Improving Throughput and Workflow: GE Healthcare and PACSHealth Sign Distribution Deal

Speech Recognition Takes a Giant Step Forward

Although digital speech recognition has been around for many years, computers have long had difficulty understanding the meaning of the spoken word in an integrated way. Users also had to supply proper grammar and punctuation. But all of that is changing.

M*Modal (Multimodal Technologies, Inc, Pittsburgh) has now introduced AnyModal CDS Live, a conversational documentation service that overcomes these problems. It is the first real-time, hosted speech-understanding system designed to extend the benefits of the company’s widely adopted CDS service. The new technology captures and comprehends clinical information from dictation and transforms it directly into accessible, retrievable, and shareable electronic files.

The physician does not need to become a skilled typist or be proficient at data entry. No change to physician behavior or speaking style is required. Nor is there a change required to dictation workflow, recording method, or location.

AnyModal CDS moves beyond simple speech recognition to speech understanding with a proprietary technology that captures and structures words and meaning amid the endless variations of human speech. Rather than recognizing a few words at a time, it looks for meaning from the entire conversation, and then uses that understanding to create accurate, complete, and meaningful health care documentation.

Lynn Kosegi, director of professional services at M*Modal, notes that the system helps ensure compliance with the Physician Quality Reporting Initiative. “The system works with deep integration, which allows it to check a report and alert the physician for missing data and relevant information. It also integrates all data, and can combine data, such as including a PACS image with the text documentation.”

Kosegi adds that “the technology utilizes spoken words and organizes them into meaningful categories. It focuses on context rather than individual words and then structures the information for use in health record systems and medical reports. It encodes clinical facts, such as medications, dosages, allergies, and measurements. We support a clinical vocabulary for various disciplines,” she said. “The Radlex coding system, for example, supports the radiology workflow.”

What M*Modal calls Meaningful Clinical Documents handle structured data and natural language narratives with equal ease. Data is structured to support rich links between clinical documents and electronic health records. That makes it easy to share information across provider and computer system boundaries.

M*Modal technology learns from experience by monitoring its own performance, and by adapting to edits made by reviewers. This continuous learning improves the accuracy of word selection, data structuring, and meaning capture.

AnyModal CDS Live works with existing hardware in place, on any computer. Its ease of deployment enables small institutions, as well as large hospitals, to take advantage of increased productivity through physician self-editing of more accurate, complete documents. Physicians can choose multiple options: immediate “edit in place” and sign-off; batch processing for multiple report review and sign-off; or transfer for medical Language Specialist (MLS) editing and completion with return to the physician for sign-off.

“Now physicians can enjoy full control of their own clinical documentation with no capital expense or change in workflow,” said Joel Fontaine, M*Modal business development director. Physicians can also select their own templates to begin the transcription process, cutting down on actual dictation time.

—James Markland

Tech Zoom: Seven Suites for Specialized Needs

During this year’s RSNA meeting, diagnostic imaging solutions provider Agfa Healthcare demonstrated seven IMPAX Suites geared toward meeting the needs of a variety of institutions, from enterprise solutions for large-scale institutions, to specialized mammography, cardiovascular, radiology, and orthopedic systems.

Possessing self-descriptive monikers, the latest series of solutions consist of the IMPAX Enterprise, IMPAX Hospital, IMPAX Imaging Center, IMPAX Radiology, IMPAX Cardiovascular, IMPAX Orthopaedics, and IMPAX Mammography suites. An integration of several modules into one, each Suite is powered by the company’s IMPAX 6 solution and is designed to meet specific clinical needs.

The IMPAX Enterprise Suite was developed for large-scale, multisite health care operations and Integrated Healthcare Delivery Networks that operate in multipatient ID domains. The solution combines the clinical depth of IMPAX with a specially designed set of corporate modules, helping to manage an enterprise environment with many departments and specialties. Specifically, one of the suite’s major components is the IMPAX Multi Site architecture, which enables health care delivery in sites across the country with a singular view to patient records, regardless of the patient ID domains.

Created for hospitals with multiple specialties, departments, and disciplines, the IMPAX Hospital Suite is a fully integrated offering that incorporates three key modules. In particular, the flexible solution can include any combination of RIS, PACS, and reporting tools, in addition to connectivity services that can integrate the solution within the health care IT infrastructure. Results may be distributed to clinicians through EPR integration, Web portals, or wireless devices, and around-the-clock remote monitoring and management is included. With easy-to-add modules, the Suite can take on functional extensions while employing a shared infrastructure for operational efficiency.

The IMPAX Imaging Center Suite, tailored for imaging centers and radiology practices, facilitates workflow and business processes through a single desktop access to integrated image and information. Also focusing on streamlining clinical workflow, the IMPAX Radiology Suite was made for self-sufficient radiology departments, while the IMPAX Cardiovascular Suite was designed to meet the needs of a multimodality cardiology department. Orthopedic requirements, like planning, measuring, and simulating, are handled by the IMPAX Orthopaedics Suite, while the IMPAX Mammography Suite tackles imaging, workflow, and reporting needs of diagnostic and screening mammography.

According to Erkan Akyuz, Agfa’s chief technology officer, the delivery of increased productivity and reliability, resulting from the dedicated and focused nature of the company’s new solutions, will in turn help to improve the delivery of patient care.

“The introduction of our seven IMPAX Suites is a clear next step in the evolution toward driving more efficient and effective solutions toward our customers,” Akyuz said. “The clear focus of our IMPAX Suites, and their modular approach, is to provide our customers with the solutions that meet their specific demands, however complex these may be.”

—Elaine Sanchez

Improving Throughput and Workflow: GE Healthcare and PACSHealth Sign Distribution Deal

PACSHealth LLC, Scottsdale, Ariz, has signed a deal with GE Healthcare, Waukesha, Wis, under which GE will resell PACSHealth’s software to GE’s Centricity Imaging Solutions customers worldwide. PACSHealth’s software is designed to improve workflow and throughput in complex medical systems.

“We provide proactive information into the PACS, fixing problems before they interrupt the radiologists’ workflow,” said Mike Battin, COO of PACSHealth. “Let’s say the retrieve queue gets stuck. No one would know that until the radiologist sat down to read in the morning and had to call the PACS administrator. We’re very big on proactive monitoring and finding problems before they’re presented to the radiologist.”

PACSHealth recently launched version 2.0 of its software; new features include e-mail alerts on critical values and custom configuration settings. “The application now has some custom configurables,” Battin said. “Administrators will be able to configure the alert parameters, set high and low alert values, on things that make a difference like queue management, making sure that the system is performing normally.”

Battin explains that PACSHealth combines three applications: a dashboard monitoring tool, deep dive database analysis, and a HIPAA and audit log transaction analyzer.

“The dashboard monitoring tool monitors the PACS and the health of the application—inbound and outbound traffic and the database itself,” Battin said. “It also does workflow management, where it monitors the studies coming in and out, how fast they’re turning around, and where they are in the process.”

PACSHealth’s deep dive database analysis does a series of 39 proprietary checks for problems like duplicate patient numbers, duplicate accession numbers, invalid birth dates, and more. “We look for things that are really bad for the system, that can cause a patient data error or result in the wrong images in the wrong folder,” Battin said. “It’s a solution that’s been needed for a long time, but hasn’t been available.”

The third component, the HIPAA and audit log transaction analyzer, builds a database out of every transaction in the system and applies a searching application. “It has a lot of interesting connotations when you can track who did what, when and where, which is not something you’d normally see,” said Battin. “The scenarios we solve for are what happens when a patient or their attorney walks in the door and says, I need to know everybody who’s touched my records since I’ve been here. We offer that information down to a very detailed level, and we enable the user to print that off and send it to the chief compliance officer or anyone else.”

PACSHealth currently integrates with GE and McKesson PACS, but will be compatible with other vendors’ systems soon, according to Battin. The application requires its own server and needs to be on-site with the PACS system. With the new distribution deal, PACSHealth will be folded in with a synergistic GE application, the Centricity Business Intelligence Portal.

“Our initial step is to tie it into the Centricity PACS database, and we’ll release it on two family versions,” explained Rob Mayer, global segment manager for Centricity Radiology Solutions at GE. “One is Centricity 2.1 and the other is 3.0, and it will be part of higher releases as well. Centricity will continue to accrue log data, because some customers do their own monitoring, but PACSHealth offers a user-friendly means to provide trending information and reports.”

Mayer notes that PACSHealth’s capabilities are particularly valuable in the current climate, wherein insurance companies are increasingly differentiating based on appropriateness of exams. “It will help manage utilization,” he said. “I think there’s a lot of data in our install base to work with.”

—Cat Vasko