Instant Text Provides Proven Technology for Fast Data Entry

Clinical documentation in healthcare may be changing, with the migration from paper charts to digital, but text and data still need to be entered into whatever electronic system is used. Only then can health professionals use the data for statistical purposes, to exchange information and to look up health records.

Input challenges
When computers were first invented, our expectations of them were limitless. We even believed that one day they would be intelligent enough to understand our natural speech. Forty years have gone by, and while computers have increased productivity in all aspects of our economy, our early dreams have not all been realized. Computers are not good, for example, at recognizing a doctor's speech. Even though speech recognition technology (SRT) is slowly making progress, the computer is more reliable when it 'listens' to the keyboard.

Fast typists can still type in data, but this is time-consuming and costly, particularly in the healthcare environment, where clinical documentation is voluminous. To accelerate the text entry process and reduce turnaround-time, many electronic health managers and individual transcriptionists have turned to new technology.

Instant Text
The founder of Textware Solutions and chief architect for the design of the computer language Ada, Jean Ichbiah, was among the first software engineers to insist on innovative, reliable and easily maintainable software designed to achieve realistic goals.

The system he designed, Instant Text, greatly accelerates the text entry process, taking into account the increased speed and inexpensive memory of modern PCs, the fact that every profession uses language largely limited to a certain terminology, the usefulness of the visual feedback empowered by Windows and the conviction that keyboarding is here to stay.

Instant Text is designed to compile enormous amounts of text and select the most frequently used words and phrases in a particular domain. It creates customized glossaries for any person's language or any specialty language in a few seconds.

These customized glossaries make the language available whenever the user keys in text. This offers an easy way to produce words and phrases with just a few keystrokes. As soon as the user types a few letters, Instant Text matches them with the vocabulary in the customized glossary. A million invisible tasks are executed between keystrokes to bring up the words needed in a particular context. Type in bso, and a medical glossary will bring up bilateral salpingo-oophorectomy, while a general glossary may bring up Boston Symphony Orchestra and a German glossary will show besonders.

Instant Text is more efficient than word completion, because it allows the user to employ the most relevant letters of a word. Any word can be pulled up with three or four letters: cdpu will immediately present cardiopulmonary. A phrase can be pulled up by typing only the initials of the words: tpor brings up all the phrases that contain The patient . . . and . . . the operating room.

Windows displayed on the screen give visual feedback. A shortcut like copd can trigger COPD as well as chronic obstructive pulmonary disease. Instant Text suggests these phrases, and the user selects the one needed. No predefined abbreviations are necessary, and no memorization is required.

Doctors prefer to use narrative language when assessing a patient's health, rather than predefined structured language. When Instant Text compiles a glossary from existing reports, it examines the frequency of the words and phrases used and discovers the structure of each doctor's language. The glossary is based on their own speech patterns.

Instant Text can also suggest what will follow after a sentence is started. It can expand tpt to The patient tolerated and immediately triggers the continuation choices the procedure, the procedure quite well, the procedure very well, etc., depending on what situation each doctor has encountered and described in previous reports.

Instant Text glossaries allow a much wider use of shortcuts - up to tens of thousands. The user types a few letters, and the word or phrase will be shown. Visual feedback and expansions happen instantaneously.

Old and new
Speeding up text entry has been a concern in medical transcription for a long time. The traditional way was to build a list of abbreviations and try to remember them. Many transcription platforms still offer this kind of expansion utility, but it can take medical transcriptionists years to build such a list, and there is a limit to what one can memorize. For the most part, these lists are not reusable when the system changes.

Jean Ichbiah showed in a study that keystroke savings is limited to about 30 percent when abbreviating words, up to 80 percent when abbreviating phrases. Instant Text makes it easy to abbreviate phrases and use continuations since they can be obtained in a few seconds in the form of the customized glossaries

With a library of glossaries it is possible to use tens of thousands of shortcuts instead of the 2000 generally used when memorization is involved, and because there are no abbreviations to memorize, anyone can use and share Instant Text glossaries.

With Instant Text, transcriptionists can develop their own personal glossaries, at the same time combining glossaries as they see fit. Glossaries are not tied to a word processor, a transcription platform or a system. They can be used wherever needed. Instant Text is an independent Windows application that links to whatever system is used for clinical documentation.

Text entry and SR editing
In order to keep the time they spend on clinical documentation to a minimum, doctors choose the fastest method: dictation. Many transcription platforms have integrated back-end speech recognition technology that translates the doctor's dictation into text. Depending on the accuracy rate achieved in the SRT draft, the report is either retyped or edited.

When SRT editing is used, Instant Text glossaries can again be very useful. The draft may show a phrase like The patient was noted to have undergone a direct a lumbar spine fusion and needs to be corrected to thoracolumbar spine fusion. The erroneous section can easily be replaced with tclb or thcl, expanding to thoracolumbar.

However, despite some recent successes, SRT is still far from reliable. In an environment where accuracy and turn-around time are key factors, healthcare management needs cost-effective technology that works 100 percent of the time.

Instant Text has a role to play every time a keyboard is used. Cost savings in healthcare management depend very much on the right productivity tools. These tools need to be innovative, reliable, flexible and cost-effective. 

Textware Solutions specializes in fast text entry software that fulfills these requirements. More than 20,000 medical transcriptionists and editors use Instant Text on a large variety of transcription platforms. They have seen their productivity increase, and turn-around-time decrease. And their fingers don't hurt anymore.

Contact details:
Marianne Kleen
Sales & Marketing
T: 781-272-3200
E: marianne@textware.com