[Impact of a PACS/RIS-integrated speech recognition system on radiology reporting time and report availability].
OBJECTIVE
Quantification of the impact of a PACS/RIS-integrated speech recognition system (SRS) on the time expenditure for radiology reporting and on hospital-wide report availability (RA) in a university institution.


METHODS
In a prospective pilot study, the following parameters were assessed for 669 radiographic examinations (CR): 1. time requirement per report dictation (TED: dictation time (s)/number of images [examination] x number of words [report]) with either a combination of PACS/tape-based dictation (TD: analog dictation device/mini-cassette/transcription) or PACS/RIS/speech recognition system (RR: remote recognition/transcription and OR: online recognition/self-correction by radiologist), respectively, and 2. the Report Turnaround Time (RTT) as the time interval from the entry of the first image into the PACS to the available RIS/HIS report. Two equal time periods were chosen retrospectively from the RIS database: 11/2002 - 2/2003 (only TD) and 11/2003 - 2/2004 (only RR or OR with speech recognition system [SRS]). The mid-term (> or = 24 h, 24 h intervals) and short-term (< 24 h, 1 h intervals) RA after examination completion were calculated for all modalities and for CR, CT, MR and XA/DS separately. The relative increase in the mid-term RA (RIMRA: related to total number of examinations in each time period) and increase in the short-term RA (ISRA: ratio of available reports during the 1st to 24th hour) were calculated.


RESULTS
Prospectively, there was a significant difference between TD/RR/OR (n = 151/257/261) regarding mean TED (0.44/0.54/0.62 s [per word and image]) and mean RTT (10.47/6.65/1.27 h), respectively. Retrospectively, 37 898/39 680 reports were computed from the RIS database for the time periods of 11/2002 - 2/2003 and 11/2003 - 2/2004. For CR/CT there was a shift of the short-term RA to the first 6 hours after examination completion (mean cumulative RA 20 % higher) with a more than three-fold increase in the total number of available reports within 24 hours (all modalities). The RIMRA for CR/CT/MR was 3.1/5.8/4.0 in the first 24 hours, and 2.0 for XA/DS in the second 24-hour interval.


CONCLUSIONS
In comparison to tape-based dictation, an SRS results in a significantly higher primary time expenditure and a modified report dictation workflow. In a university institution, a PACS/RIS-integrated SRS achieves a marked improvement in both short- and mid-term RA which eventually results in an improvement in patient care.
Trumm
C G
CG
Institut für Klinische Radiologie, Klinikum der Universität München Grosshadern. christoph.trumm@med.uni-muenchen.de
Glaser
C
C
Paasche
V
V
Crispin
A
A
Popp
P
P
Küttner
B
B
Francke
M
M
Nissen-Meyer
S
S
Reiser
M
M
D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D005858:Germany; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D011872:Radiology Department, Hospital / Q000706:statistics & numerical data*; D011873:Radiology Information Systems / Q000706:statistics & numerical data*; D049250:Speech Recognition Software / Q000706:statistics & numerical data*; D013637:Tape Recording / Q000706:statistics & numerical data; D013673:Technology Assessment, Biomedical; D013997:Time Factors