Dictation done right: access from anywhere with ASP

The healthcare sector in Canada continues to catch up, technology-wise, as exemplified by the Region of Waterloo and Wellington County’s use of AnyWare Group’s access management software and Web portals to improve remote working and improve access to medical transcription services.

Cambridge Memorial Hospital’s IT department bears the burden of many an IT department in the health sector in that it has only a small team to support a large, complex infrastructure (and one that is supporting critical care itself).

Plus, the team had to take care of the many healthcare workers required remote access to the hospital’s records and Health Information System (HIS), including other facilities, physicians with privileges at that hospital, specialists from the major cities, and medical personnel out in the field. This was done primarily through a jerry-rigged combination of dial-up and VPN access that worked mainly for the in-house staff, but left something to be desired when it came to jacking in remotely.

“There was demand from external physicians to access us from their clinics—they needed more efficient service ,” said Pilar Turcotte, the hospital’s network administrator. “Their numbers were getting bigger and bigger, and it was just getting crazy. A great deal of the medical community are also Mac users, and Mac support is very different, so to support the VPN and a Mac client was difficult.”

Cambridge knew it was time to make a change, and were intrigued when the Saint John, New Brunswick-based AnyWare Group came calling. The role-oriented access management (ROAM) vendor was indeed a good fit. Said Turcotte: “They used a Web interface that could have a look and feel very similar to ours, and the security was there, too.”

Chris Cummins, vice-president of sales with AnyWare Group, said, “Web interfaces work well because of the sheer number of applications and legacy systems in hospitals—it’s much easier to tie everything into one platform.”

Ease-of-use was a must-have for the hospital, as medical staffers are notoriously averse to change. The interface was easily customizable—a simple Web page would house links that would take users to the application or action or health record they needed. “They might not be familiar with some applications,” said Turcotte, “But, of course, over 99 per cent of them have used a browser before!”

The other big selling point was AnyWare’s model as a managed service provider. “This way, we don’t own or support the hardware, and the hospital doesn’t have to develop or maintain anything. They give ongoing support, and it remains with them,” Turcotte said.

“Sharing that responsibility then also allows for much more consistency and scalability,” said Cummins.

The ease-of-use did indeed come through. Norwich said, “As with any culture—physicians especially so, it can be difficult to change. But with the portability and flexibility of this solution, they were the ones begging us to do it, instead of their usual hanging back.”

The service model of AnyWare’s ROAM platform meant implementation was quite easy, and the Web portal ensured that the physicians and clinicians could access the necessary hospital information such as the HIS or picture archiving system (PAS) on any platform or hardware they liked.

This May, transcriptionists at the Grand River Hospital and St. Mary’s Hospital also got on board with the AnyWare ROAM platform to access the regional dictation system. Cummins said, “There is a trend around regionalizing applications, and more and more hospitals are doing it. It’s easier to deploy to multiple hospitals rather than have to do deployments one by one, with all the set-up, maintenance, and service that that would require.” (Other industries where regionalized offerings might work, said Cummins, include insurance, engineering, consulting, and contact centres.)

London, Ontario's Lanier Healthcare Canada integrated the regional dictation and transcription system and used the ROAM platform as the single secure access point.

Now, the physicians can dictate their reports, and the transcriptions be entered into the ROAM portal, where they will be easily accessible to transcribers, other medical personnel, and for the original physician to sign off on the transcription.

The next step will streamline the process even further, with the doctors being able to dictate the information and have voice-to-text software translate it into a text file for storage and use. This next phase is slated for completion early next year.

When it comes to Cambridge Memorial Hospital’s ROAM portal, there seems to be no end to its utility. It will even help with compiling information for the province’s wait times improvement goals. Said Norwich: “It’s not just a simple application—it has multiple roles over one day.”