Blackpool Teaching Hospitals NHS Foundation Trust

Blackpool Teaching Hospitals NHS Foundation Trust is situated on the west coast of Lancashire, and operates within a regional health economy catchment area that spans Lancashire and South Cumbria, supporting a population of 1.6 million.

The Trust provides a range of acute and community services to the 440,000 residents of Blackpool, Fylde & Wyre and North Lancashire, as well as specialist tertiary care for Cardiac and Haematology services across the wider region.

The Trust employs more than 6,500 staff and have around 912 beds across all sites and see more than 94,000 day-case and inpatients, 305,185 outpatients and over 82,900 A & E patients every year.

In November 2013, the Trust decided to look at new technologies as the current analogue methods were not creating the desired efficiency levels. The old analogue system caused correspondence delays between clinics and administration teams. The dictation on the tapes was often inaudible or of poor quality and fast track correspondence could not be easily identified. Due to financial constraints on the NHS, the Trust needed to work more efficiently than ever to keep up with demand and so searched for innovative methods to aid the process.

Karen Edwards, Health Informatics Project Manager at the Trust led the project and described how the organisation was looking to move into the 21st century with the latest digital technology available. Karen said, “We didn’t know what was available when we set out with the project but we knew things needed to change. We were looking for technology that revolutionised our working methods and a platform that standardised documentation management across the Trust. We researched at the NHS North West Forum to see what other Trusts were doing and to understand what challenges we may face. Top suppliers were then invited to the Trust to demonstrate their products and we shortlisted from 8 down to 4. We invited the 4 to provide an interactive demonstration day and invited all staff to see for themselves and have a go. After rigorous testing, engagement days with staff and feedback sessions, it was decided that G2 Speech would be the supplier of choice. Staff preferred the solution and we had the confidence in G2 Speech due to their experience of providing trust-wide speech recognition at other large Trusts.”

The Trust opted for SpeechReport provided by G2 Speech which utilises the speech recognition technology provided by Recognosco. The Recognosco platform is built on the core Microsoft speech recognition technology.

Karen went on to explain the process of the initial implementation, “When the technology was first introduced it wasn’t without a few teething problems which was only to be expected, as the technology was brand new. These were very quickly resolved as G2 had an onsite presence and built good working relationships with our staff, seeking feedback and working swiftly to resolve issues.

There were originally some sceptics amongst consultant staff which I think was probably down to previous experience of speech recognition technology from years ago. This didn’t put us off going forward as voice recognition technology has advanced significantly in recent years. Once the staff received training and got used to the technology, they were surprised at how accurate it was and how easy the system was to use. This encouraged their belief in the long term benefits we were seeking from using the system.”

One consultant, Dr STM Jones, Consultant Rheumatologist at the Trust spoke about his experiences: “I did have some early concerns…Before its introduction we were outsourcing and at that point were about 3-4 weeks behind in producing letters. In order to smooth the transition process, additional support was put in place to clear our backlog. I was concerned that the introduction of the G2 solution would create a new backlog due to the change. In contrast with my prior concerns, I have to say that my personal experience with using the G2 system has been very positive. The interface is very intuitive and easy to use and the peripheral computers cope very well.

We have been pleasantly surprised by the introduction of the G2 system and its overall performance.”

So far the Trust has 137 authors using speech recognition of which 48% are using real time front-end recognition. There are already 11 departments installed and using the software and things are going really well. We also have 74 admin staff (some part-time and some full-time) supporting the authors, editing and sending documents through the workflow. This is a combination of Medical Secretaries and Typists.

Karen said: “We do have lots of other departments to roll the solution out to and are looking forward to the challenge! News about the system success is spreading and I’m receiving requests from departments asking when the technology will be installed with them. I check the statistics from the system weekly as we can easily monitor how much work is in the system per department, how people are performing and where people may need some additional training.”

When the Trust set out with the solution there goals were as follows:

• Ability to manage documents in real time without waiting for clinics to end
• Ability to identify fast / tracks and cancers immediately aiding referrals and phone queries
• Ability to manage the workload and identify pressures within a department
• Ability to identify peaks in activity / which can aid business cases
• Standardisation of working across the Trust, removing the variants of templates/formatting.

She explained: “With the help of the G2 system, the Trust is now working towards these goals, trust-wide. Turnaround times have reduced from 19 days in some department’s right down to 5 days and our Breast Department regularly has turnaround times of 24hrs. Where documents are extremely urgent, we’re now able to prioritise them in the system which ensures they are identified easily and managed swiftly.”

One of the most startling, physical differences for me was to actually see the difference in the Breast Department. The team had a bookcase with shelves of paperwork where there was a backlog. Each week I’d be sent a photograph of the bookcase steadily decreasing and then one week the shelf was empty! This has all been made possible with the help of SpeechReport and the engagement of the staff in that department to ensure we achieved full benefits.”

Since using the software the Trust has created 126,500 documents. Staff involved are very positive about the system and can see the real benefits it has to bring to patient care, their workflow and aiding telephone queries.

Speaking about the system Karen summarises: “I would definitely recommend G2 Speech Report.

My advice would be to ensure users understand it is a joint effort to teach the voice profile and achieve high accuracy levels for long-term benefits. The Author has to punctuate and speak with clarity, accents are not an issue or medical terminology due to the medical dictionary built in. The admin staff need to ensure they give feedback to the Author at the start and finalise documents quickly from the first clinic to teach their profile before next clinics to get benefits in accuracy early on.

I would also advise that the specification of the PC is high to achieve optimum benefits.”

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