Talking HealthTech: 296 – Speech technology & efficient documentation reducing healthcare workforce burnout. Jonathan Larbey, T-Pro

A lot goes into providing healthcare, both before and after the actual care is given to the patient. Consider all the time spent scheduling, organising, and preparing for a consultation, as well as the paperwork, examinations, patient requests, and physician referrals that follow. There is no doubt that clinicians would be swamped with non-value-adding duties without the assistance of the correct technology, which would ultimately draw them away from what they got into healthcare to accomplish, which is looking after patients.

This episode is joined by Jonathan Larbey, CEO of T-Pro, a company focused on increasing productivity in clinical documentation. In this discussion learn about the importance of accurate documentation, the effects of administrative personnel shortages on healthcare delivery, the importance of developing system-specific solutions, and the recent developments in speech recognition technology.

Who is Jonathan Larbey?

Jonathan Larbey is the CEO of T-Pro. They are the global industry leader regarding software designed to improve clinical documentation. They offer cloud-based or on-premise clinical documentation solutions to enable workflows for accurate and efficient speech recognition, medical transcription, messaging, and coding.

T-Pro enables a solution that is centred on the patient by simplifying the process by which doctors record the patient’s narrative and provide information at the point of care, which is the time when it is required the most.

Brief History

T-Pro was initially established as an outsourcing service ten years ago. Initially, venturing into transcribing audio files as an overnight service for a law firm. Due to the economic status at that time, law firms were not hiring legal secretaries for low-value work like typing for an expensive salary. Using cloud software creates a lean business model of having secretaries and staff working from home. Setting the business up, T-pro quickly pivoted into healthcare. The demand in the industry was high. Clients organically started coming on board.

Pivoting to Healthcare

Business analysis was conducted, making it evident that there is a need to automate many aspects of healthcare. They invested in developing their own platform; a fully cloud-based workflow solution. Although the technology was somewhat immature at the time, developing a proprietary speech recognition technology did function well in automating the typing process. 

Editors focus more on cleaning up and formatting the documents rather than typing the whole from scratch. From that point, they built the process around the workflow of the hospitals. Doing everything from the upstream, as soon as an appointment is scheduled within an EPR, the platform can do patient communication, send out surveys, or even provide telehealth. Video consultations are also automated as well. 

Developing Automatic Speech Recognition (ASR), a sort of Natural Language Processing technology, is like mining the data, abstracting useful information from the text, and using the transcribed text to get closer to the final intended output, whether a structured document or codified problems and even diagnosis.

Core Business

T-Pro’s is known for improving documentation workflow. In the workflow application, a clinician can provide a schedule so they can select the patient and eliminate patient identification problems with the associated risks. Taking the audio and producing a first draft of the document before it goes to the encoders saves time.

Clinicians have different needs from voice-to-text technology.  When using the technology in real-time, words can appear on the screen, which is helpful in certain circumstances, other times not necessary. For example, when doing a consultation in an outpatient setting, after 10 minutes, the patient’s documentation can be seen in the EMR. They also can edit, attach files then send them. However, it is not as required when going bed-to-bed, as it would be challenging to log on to the terminal each time a patient is seen.

Worldwide Reach

T-Pro has a global presence.  Starting in Ireland, the company expanded quickly into the United Kingdom. 650 organisations from across the world are already using T-Pro. In Australia, the organisation has grown partly via acquisition, similarly in New Zealand and in Singapore and other parts of Asia as well.

Speech Recognition in Healthcare

Fundamentally, speech recognition needs to recognise what someone is saying to dictate it accurately – this can be difficult in a healthcare setting as typically a doctor dictates in a stream of consciousness without punctuation. The opportunity exists for a solution that predicts the language of words, and punctuations, inserts new sections, recognises headings and applies styles as the clinician speaks. The technology needs to be not just a talk and type model but also a talk, type, and produce a document.

Artificial Intelligence can also help with some of the tasks that medical secretaries typically perform, for example a list of possible medical diagnosis or problem lists. Based on those suggestions, it can also build a potential list of remedies and medications. 

T-Pro is involved in a research project to build structured notes through listening rather than dictating. Instances like a S.O.A.P note with subjective data like present complaint, history and many more, looking for at least  invasive and efficient ways to produce notes that are usable for doctors. 

Language Summarisation Techniques are also being considered, where the technology takes the input of information and by classifying the sentences, the system can know what section goes into those different sections and structure a document based on intent.

Assistive technology is also being explored; including a solution like a sort of Alexa, where a clinician can talk to the device and do real time assistive work like ordering medication with specific medical parameters and dosage. 

In conclusion

Trying to automate all aspects of workloads as much as possible with the paradigm of dictation and producing documents. Changing the technology from active dictation into passive note-taking. A record can now be made where doctors can do a three-minute dictation at the end of each consultation in a quick review, saving 60% of documentation time. 

A lot of people still have not embraced speech recognition in healthcare. Outsourcing speech recognition to improve medical documentation with structured helps clinicians and the people using the technology.

_{Source talkinghealthtech.com}