Digital Data and the Spoken Word: Bridging the Communication Gap

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As radiology equipment becomes ever more advanced, so-called “structured data” only increases. Advanced 3D and reconstruction visualization generates measurements from multiple angles, and the digital information builds and builds.

Seamlessly combining structured data with the spoken word can be tricky. Mistakes can cost time, money, and worst of all can lead to poor patient care. Juergen Fritsch, PhD, chief scientist and co-founder of Franklin, Tenn-based M*Modal, devotes most of his waking moments figuring out the best ways to integrate voice and data.

These days, it’s relatively easy to capture structured data, import it, and store it. The art is using technology, combined with human workflows, to avoid mistakes and boost efficiency. “We link structured data with the spoken documentation,” explains Fritsch, who operates from an office in Pittsburgh. “A radiologist may say, ‘This measurement has grown since the last time I saw this patient.’ With our technology, specifically with natural language understanding technology, we parse the verbiage that they dictated—and either identify new structured data measurements—or link them up with existing ones.”

If the spoken word conflicts with existing digital measurements, the M*Modal system tells the radiologist. “If they are talking about a lesion in the left lung, for example, we pair up that dictation with the actual measurements,” Fritsch adds. “There may be a contradiction. The radiologist might say, ‘This lesion has diminished,’ and we notice from actual measurements that it did not diminish. In fact, it actually grew. Or the radiologist accidentally refers to the right instead of the left lung. We can bring it up as an alert and inform the radiologist that the data contradicts the dictation. That is the real challenging aspect that makes the biggest difference. We put the data in proper context.”

Minimizing Errors

Dictating measurements into a microphone always carries the potential for error. The M*Modal solution is to automatically integrate the electronically measured data into the radiologist’s report.

These days, measurements go beyond lesions to encompass various clinical aspects that must be properly documented. “In CT imaging, patients sometimes get a contrast agent injected into the body,” says Fritsch. “The equipment measures the flow rate, and the amount that goes into patients is captured, but it’s not typically integrated with other systems. Again, there is the risk that the data gets lost or is not properly relayed, interpreted, or dictated. That discrepancy is a risk for patients, but we are able to eliminate that risk.”

In most parts of the country, the radiology report is still dictated. This process of creating a narrative is still a vital side of the profession, and preserving that human element—while avoiding mistakes—is the goal at M*Modal.

Government entities, on the other hand, are increasingly enamored with data collected from devices, or directly from physicians. This push toward structured data is largely driven by meaningful use rules, which essentially award money to practices that successfully adopt electronic systems.

Unfortunately, hastily adopted systems can be tedious to use, leading to slowdowns and a lack of integration. “We help by making it easier and more efficient for physicians to capture the necessary documentation for meaningful use,” enthuses Fritsch. “Rather than making users point and click or use drop down reporting systems, which typically take two to three times longer, we allow them to dictate—just narrate. Our system identifies the data in the narrative, supporting practices in fulfilling government requirements and complying with meaningful use.”

Maintaining patient care while increasing speed and profitability is not easy, but Fritsch believes it’s possible, even necessary, in today’s environment. “It’s all about efficiency in the radiology space,” he says. “If you can do it in a minute, rather than a minute and 10 seconds, it adds up to a huge savings, possibly allowing you to see more patients in a day.”

Other clinical documentation systems, he contends, may not document all the required elements. When that happens, radiologists may incorrectly believe they are in compliance. “So we also provide feedback to radiologists and users that either something is missing in the report, or meaningful use guidelines require them to be more specific about something,” says Fritsch. “We analyze the dictation