Q&A: How technology can help put patients front and centre

Diana Nole, executive vice president and general manager, healthcare, Nuance Communications, spoke to Med-Tech Innovation News following her appointment to the role.

What role can medtech play to patients front and centre?

The impact of COVID-19 has placed our healthcare system under more strain than ever before. Already oversubscribed and under-resourced, the NHS is now facing unprecedented pressure to maintain and improve the quality of patient care. 

Ensuring quality care means putting the patient front and centre. Prioritising the patient experience requires a dedication to finding new ways to engage patients in their own healthcare journeys and empowering physicians so they can practice the art of medicine.

The current crisis has accelerated and expanded efforts to overcome the technology and administrative burdens that have created a physical and emotional barrier between patients and physicians. For many years, medical professionals have found themselves struggling under the burden of increasing paperwork. The results have been less time spent on patient care and physician burnout.

The deployment of innovative speech recognition solutions powered by artificial intelligence has begun to alleviate this burden. Physicians previously made sceptical by the failed promises of past technologies are discovering that these new solutions re-humanise the healthcare experience and support the patient-provider relationship even in these times of heightened anxiety. These new solutions alleviate administrative burdens, reduce physician burnout, boost productivity, and improve clinical documentation and care access. Patients can once again be front and centre in their healthcare journeys.

Is this helped by having technology that aids clinicians, too – for example, the voice recognition technology that Nuance has? 

A recent survey by the General Medical Council (GMC) suggested that a quarter of medics feel ‘burned out,’ with around half feeling routinely exhausted. Another survey by the NHS discovered that at least a fifth of its staff wants to quit. Much of this stress is caused by the staggering level of administrative and documentation processes that physicians face daily. A recent study discovered that physicians were spending, on average, 11 hours a week creating clinical documentation. And, if you factor in lost and repeated documentation, staff could be spending up to 50% of their time on paper-based tasks and clinical documentation processes. In other words, physicians spend only half of their week doing what they trained for and what matters most: caring for patients.

Nuance Dragon Medical One solution helps physicians to tackle the never-ending stream of paperwork. It produces clinical documentation for up to 45% faster and captures up to 20% more relevant data using personalised tools across a wide range of workstations and mobile devices. Physicians can document information efficiently from any location and gain more time to spend on patient care. This technology is trusted by more than 550,000 clinicians worldwide.

Homerton University Hospital in East London is one example of a UK NHS Trust that has already benefited from the implementation of Nuance Dragon Medical One. Not so long ago, the outpatient department was relying on handwritten notes to capture patient information. Backlogs built up as workloads increased, and clinicians were forced to work late to catch up on administrative tasks. Despite considerable outsourced transcription costs, outpatients were experiencing an average turnaround of 17 working days for clinic letters. 

Since deploying Nuance’s solution, patients benefit from faster, personalised communications, as well as fewer missed appointments, and medical secretaries now have more time to focus on patient contact. In fact, since implementing the technology, the hospital has reduced the turnaround time for clinical letters to just two days and saved more than £150,000 per year on the cost of transcription services.  

In terms of the healthcare space, what do you think is different now compared to pre-pandemic?

In recent months, the most significant change in the healthcare space has been the speed at which technology has been embraced. The pandemic has forced a cultural shift within the NHS that has been envisioned for a long time, but many organisational structures and barriers prevented it from becoming a reality.

One of the immediate changes we’ve seen is patients and physicians increasingly turning to telehealth for routine and non-urgent care. Until recently, just 10% of patients took advantage of telehealth in lieu of an in-person visit - but that is changing rapidly before our eyes, with many GPs and practitioners shifting to video consultations and virtual clinics to continue treating patients.

Accelerated adoption of telehealth technologies means new healthcare experiences for patients and physicians alike. From an efficiency perspective, there are time savings to be had. Patients no longer need to drive back and forth to appointments and follow-ups, allowing for time back in their day. For physicians with the right technologies and resources in place, patient care can still be delivered quickly and efficiently, allowing physicians to complete their work faster while maintaining the level of care given. The adoption of these technologies, and the easing of many time pressures, has ultimately enabled clinicians to reconnect with their vocation and concentrate on why they went to medical school, to care for patients.

And what aspects of change have you seen that you think will be lasting?

Although the future is challenging to predict, there is much talk about the new normal. The new normal for the NHS will likely incorporate a continued spike in virtual visits. To comply with social distancing regulations and advice, the millions of GP appointments that take place each month are now by video – and this doesn’t appear as though it will change.

UK health secretary Matt Hancock has even predicted a long-term mass shift to remote appointments, stating recently, “From now on, all consultations should be teleconsultations unless there’s a compelling clinical reason not to.” This new normal does, however, require some learning on the part of patients, and physicians, about the various challenges, for example, the need to understand security and privacy etiquette, and perhaps more importantly, the documentation of the interaction.

For physicians, that positive change comes with the challenge of capturing the patient’s story. In essence, a 10-to-15-minute conversation via a telehealth platform could encompass some 1,500 words or three pages of single-spaced text. Some physicians have found that standard EHR tools to document visits can take added time and may miss pertinent details. This is where technology such as speech recognition incorporated into a physician’s routine can play a critical role in significantly cutting that administrative burden for teleconsultations as it does for traditional in-person visits.

What do you see is the most important kind of innovation in the months and years ahead?

We’re going to see an increase in the consumerisation of healthcare as a result of the pandemic. The expectations we have all developed as digital consumers are now clearly mapping onto how we think about our own healthcare, the services we receive, and how we engage with the NHS or private healthcare providers. 

Therefore, in the years to come, it’s likely that patients will look for more transparency when it comes to treatments, wait times, and clinical outcomes. The faster that technology innovators can increase transparency and engagement and make healthcare IT more user-friendly for physicians and patients alike, the quicker we can alleviate the strains and frustrations, elevate trust, and improve the quality of care for patients. All of that will be essential for keeping patients front and centre in their healthcare journeys.