Dragon Medical One (DMO) Voice to Text in the Emergency Department

Aim

To create efficiencies in the Emergency Department by reducing documentation time.

Outcomes

When the documentation for time per patient - seen in ieMR - was compared with other Queensland Health physicians, the Mackay physician using Dragon One spent about two minutes for documentation per patient, compared to the average of 12 minutes per patient for other physicians in Queensland Health. Dragon Medical One contains different medical vocabularies which make an enormous difference to the accuracy and speed of dictation.

Background

Speeding up documentation allows clinicians to discharge Emergency Department (ED) patients more quickly. This may only be by five to 10 minutes (often more) but applied to more than 100 patients per day, the increased efficiency is enormous.

Mackay Base Hospital ED treats about 62,000 patients per year. For an ED, it is essential that any possible improvement in efficiency is made. The capacity of ED specialists to see new incoming patients is often markedly reduced by admitted patients waiting for beds, however, the majority of patients each day are discharged from the ED.

The bulk of patient complaints are generally around long wait times in the waiting room, so increasing patient turnover times will improve patient satisfaction and reduce patient complaints.

Discussions

A staff satisfaction survey was done as well as DMO analytics to record difference in typing speed to dictation speed and to show any decrease in time spent documenting.

Documentation Speed Results: The average typing speed in ED prior to the DMO pilot was measured at 28 words per minute. Using DMO, the average dictation speed has become 107 words / minute. This is 3.78 times faster than typing. One participant is now dictating 178 words / minute (5.9 times faster than typing). At the end of the day it amounts to a considerable amount of time.

Clinicians responded that the reduction in time spent on documentation allowed them to use the time for the benefit of staff, where they connect to nursing staff to better understand their challenges. It also benefits patients because they get discharged from ED earlier. It also improves patient care because the possibility of wrong documentation is less. That obviously help with patient flow and patient safety.

Other use beyond Voice-to-Text, such as ordering (pathology, imaging, medications, etc) is the next application of the technology that the hospital's emergency physicians believe can improve efficiency going forwards, and they plan to trial and measure that soon.