Most Electronic Medical Records (EMRs) were not designed to support nursing clinical workflow. They were designed to capture discrete data in fields that are set up in a linear fashion, mainly to support billing and charge capture. Clinical workflow comes in many varieties, but it is rarely linear. Nurses are daunted by the often laborious process of using the EMR, even those that happen to be strong typists struggle with the poorly designed user interfaces that require completion of multiple required fields. The valuable time of the nurse is being eaten away in front of a computer.
The need to capture data, in order to justify the out of control rise in healthcare costs, as well as patient safety concerns, has led us to adopting a form of technology that has been described as “disruptive”. Now, as we take a deep breath, pause, and assess our current situation, we realize that the efficiencies gained in the field of data collection have created inefficiencies in clinical workflow. The question that begs to be asked: “Is the technology working for us or are we working for it?”
One solution is the use of Speech Recognition to automate workflow. Voice enabled macros and scripts can navigate the many tabs, drop-down menus and pick-lists. These voice commands can accomplish many of the tasks associated with clinical workflow and free up the nurse to spend more time with their patients. A nurse can simply speak a voice command, such as; “Update problem list,” and the voice-enabled shortcut will automatically enter a series of keyboard strokes or shortcuts, take the nurse to the appropriate place in the EMR and allow the nurse to either type in or say the patient’s most recent problem.
While clinician’s have historically used speech recognition for traditional narrative dictation, the use of Speech to navigate the complex EMR could be the “silver bullet” in terms of easing things up and restoring lost productivity. Automation of the EMR will assist in EMR adoption, improve adherence to meaningful use guidelines and, ultimately, improve patient care. I believe, there is little debate over the fact that EMRs are in desperate need of workflow automation, the challenge that remains; how is this accomplished? Speech recognition may be the answer.