Overcoming 3 Obstacles to Speech Recognition in Healthcare


Dustin LakeThe growing requirements being heaped on healthcare professionals are well known: higher quality care, reduced costs, and increased regulatory compliance. These demands have ramped up the pressure on clinicians to use technology to make them all happen – complicating already hectic 12-hour shifts filled with upwards of 50 patient interactions.

Managing that workload means clinicians need to be as efficient as possible. Unfortunately, in too many cases, the technology that is supposed to deliver increased productivity has proven to do the opposite. So instead of spending time treating patients, physicians end up wasting time tending to their computers.

A prime example involves the drive to improve patient documentation. Everyone recognizes the need to ensure patient information is accurately updated in a timely manner. This allows every physician involved in a patient’s health care plan to have a unified view of all clinical data. Many providers now use speech recognition software to allow clinicians to verbally input patient data, rather than relying on laborious key clacking or expensive transcription services.

Sounds like a good idea right? Physicians can speak faster than they can write, so in theory, applications like Dragon Enterprise Edition, M*Modal Fluency Voice Manager, and 3M ChartScript should enhance productivity and efficiency. The sad reality is that often when the physician goes to use the application, three obstacles stand in the way.

Delayed log in times
Clinicians immediately run into problems caused by long log in times. The system can take several minutes to load the physician profile and relevant applications – including the speech recognition software needed for verbal data entry.

Microphone connection issues
A microphone must be available at each workstation for the clinician to begin dictating. If the microphone is missing, placed in a noisy area, or is experiencing connection problems, the application becomes unusable.

Extended log out process
Logging out can cause more than just delay problems. The system often takes a while to save any profile updates made during the session. Worse than enduring the long wait is when an impatient clinician does a force close on the program. This can cause the loss of all the profile learning that’s been entered.

The frustration caused by these issues sometimes leads the physician to make an unfortunate decision – he or she simply stops using the application. That causes a number of negative ramifications including:

  • Reduced productivity and efficiency for both the physician and the organization.
  • Lack of timely and accurate documentation. Manual entry means other physicians treating the patient may not have access to the most up to date information. Poor handwriting or errors during manual recording can result in incorrect patient records
  • Waste of resources. The organization likely made a significant investment in purchasing and supporting software and hardware that now sits idle on the shelf.

Implementing a situational awareness platform like the one offered by Aventura can help overcome these issues. This solution provides a customized clinical computing experience providing quick authentication that reduces the launch process from minutes to seconds. It also controls the start up sequencing to ensure proper operation of microphones. Finally it automates and accelerates the log out process, reducing wait times and the urge to shut down prematurely – eliminating the risk of losing data.

Speech recognition technology is meant to streamline the data entry process and maximize the physician’s time treating patients. Using a situational awareness solution can help make sure that happens.

- Dustin Lake, Senior Sales Engineer

Join us Thursday, September 10 for a webinar on MemorialCare: A Case Study on Roaming the EHR in the ER with Scott Raymond, Executive Director of MemorialCare.

Using Aventura to Support IT Security Innovation at MemorialCare Health System

Nurse-PasswordFrom 2010 to 2013 more than 29 million patient healthcare records were compromised in nearly 1,000 reported security breaches. A recent study from Stanford University and Kaiser Permanente says that more than half of those instances involved deliberate unauthorized access to data or attempted theft of hardware where the data resided. The report says intentional hacking to steal data has risen from 12 percent to 27 percent as a portion of all data breaches during that period.

To combat this growing threat, healthcare organizations are constantly looking for ways to enhance IT security. MemorialCare Health System, a six-hospital, integrated delivery system in southern California with more than 200 locations in Los Angeles and Orange counties, is finding that using Aventura’s Roaming Aware Desktop (RAD) platform supports its comprehensive approach to security risks.

“It’s all about containing patient data within the four walls of the enterprise,” says Scott Raymond, Executive Director of Information Services. “We’ve been very proactive about data security at MemorialCare.” 

Engaging VDI
The organization has employed a traditional IT environment: installing their Epic EHR and other applications locally on computer workstations with security safeguards like hard drive encryption, port blocking, log in credentialing, and locked workstations.

MemorialCare decided to further enhance their security strategy by moving to a Virtual Desktop Infrastructure (VDI) with thin clients and VMware View to further reduce risks that conventional desktop installations may present.

Enabling Roaming with Aventura’s RAD
A key component of the strategy is the use of the Aventura RAD platform. RAD allows clinicians to tap in, authenticate their username and password with their badge, verify their credentials, access Epic and other required apps, and allows that desktop to ‘follow’ them wherever they go so they can continue their work on any computing device in the system.

“Aventura simplifies password management by minimizing the number of times users have to use it to access the systems,” says Raymond. “It allows us to have those credentials hidden and use Single Sign-On (SSO) through a dual authentication process. Once signed in, users can take that Epic session with them wherever they go and not have to keep signing in.”

“We chose Aventura in part because we felt it was a system that would grow with us as we continue to develop our virtual environment.

For a more in depth look at security in particular and roaming Epic, click here to sign up for Scott Raymond’s webinar MemorialCare: A Case Study on Roaming the EHR in the ER on September 10.

MemorialCare Innovation Fund, LP is an investor in Aventura.

A Nurse’s Perspective: Shifting the Focus from the Computer to the Patient

Nurse-BlogNursing today involves far more than just “nursing.” While the patient is always the top priority, sometimes technology gets in the way of hands-on therapeutic care because updating medical records, documenting the administration of medications, and noting any nurse interventions adds up to many hours clicking on the keyboards of a computer per week.

Most nurses are fairly skilled users of technology. We regularly access EHRs, bar-coded medication administration systems, scheduling programs, patient tracking systems, automated communication programs, and more. Typically each of these programs require a separate log-on and password to ensure patient data remains secure. Unfortunately all these log-ons and passwords are not only hard to remember, they also create inefficient workflows.

With all the time nurses spend in front of the computer, it’s a wonder they have enough time in the day to provide direct patient care!

Consider this hypothetical nursing workflow:

  • From a device in a clinical area, a nurse logs into the hospital’s network. This requires a user name that might be 5-10 characters long, plus a password that might be eight or more characters and includes a combination of at least one number and one upper case and one lower case letter.
  • The nurse then accesses the EMR, entering another user name and another (complex) password.
  • After completing documentation in the EMR, the nurse decides to enter an update in the scheduling system. Another user name and password must be entered.
  • The nurse then gets called to a patient room. Before walking away from the computer, the nurse must log out of the system and each of the open programs.
  • Once in the patient room, the nurse needs to verify some details in the patient’s record. Using the computer in the patient room, the nurse logs into the system, then the EMR, then pulls up the specific patient record.
  • Before leaving the patient room, the nurse logs out of the system and all open programs.

Keep in mind that depending on the speed of the system, which may vary throughout the day – the nurse may have to wait a few seconds … or perhaps a minute or more – to log into each program. In a typical 12-hour nursing shift, a nurse may log into the system 60 times and thus spend one or morehours a day simply waiting on this non-value added work.

As a nurse, I know first-hand how common these inefficient and frustrating workflows are in healthcare. Usability issues are common because too few vendors seek the voice of clinicians when designing their products.

Aventura, however, is different. When creating our products, we rely on input from multiple clinicians and are committed to delivering solutions that adapt to how clinicians prefer to work.

For example, the Aventura Roaming Aware Desktop (RAD) provides users with authenticated access with the single tap of a secure card – eliminating the need to enter all those user names and passwords. RAD then immediately launches all the correct clinical applications based on the user’s location (operating room versus patient room, for example). RAD also delivers an extra layer of enterprise security through privacy screen functionality, idle disconnect, and intelligent printer reassignment.

If you are a nurse, this means you are spending less time on the computer and more time at the bedside and actually “nursing.” That’s a boost to both patient and nurse satisfaction, and contributes to improved safety and better outcomes.

Technology is essential in healthcare. At Aventura we believe that by listening to the clinician voice, we are better able to create solutions that allow nurses to maintain the right balance of technology and touch when delivering care.


Dr. Cole is an informatics leader with over 20 years of practice, strategic, operational and academic experience in healthcare information technology and nursing. Her clinical background is in adult critical care; she was licensed as a Nurse Practitioner and held CCRN certification for over 20 years. She is the acting Chief Nursing Information Officer (CNIO) for Aventura.