30% faster case turnaround: how Mt. Nittany's pathology lab achieved lean efficiency with VoiceOver PRO®

“No doubt about it, we can sign out more cases more quickly.” A few years ago, the medical director of the pathology department at Mt. Nittany Medical Center in State College, Pennsylvania could see the writing on the wall. Hospital leadership had made it clear that they intended to move away from transcription eventually, and Dr. Paul Murray decided to take action. “I could see what direction it was going, and I didn’t want to get stuck with a system I didn’t like,” says Dr. Murray, who has worked at Mt. Nittany for more than 18 years. “I wanted to pick the system that I preferred, as the medical director of the pathology department. So I was proactive about switching over to VoiceOver PRO^® before the hospital possibly saddled us with something I didn’t want.” Dr. Murray had heard about VoiceOver PRO online and watched a few demo videos, then set up an online demonstration of PRO with the lab team. “I knew we’d either go with PRO or just the Dragon medical speech recognition. But I didn’t want to go with Dragon if at all possible. With Dragon, I think we’d have had to open each part of the report to use it, and it would have made things a lot more cumbersome and hard to use, particularly for some of our staff members who are maybe not as computer savvy.”

Mt. Nittany at a glance

• AP/LIS: Meditech
• 5 pathologists
• 1 Pathologists’ Assistant
• 1 lab tech
• Up to 13,000 cases per year

Replacing a batch process with a flow process

Mt. Nittany’s pathology department went live with PRO in the fall of 2020, and Dr. Murray quickly realized that using PRO was making them much more efficient.

“It’s a huge improvement,” he says. “The main thing is that it’s made our turnaround time so much better. Obviously the turnaround time per report is faster because you don’t have to wait for someone to type it. But in terms of lean processing, you are replacing a batch process with a flow process, or random-accesstype process. Rather than waiting for transcriptionists to type up 10, 20, or however many cases for the day, you just go case-by-case-by-case. And there’s no doubt about it: we can definitely sign out more cases more quickly.”

“In the situations where I can start looking at a case and finish it right at that point, which in general is a situation with short cases where I don’t have to do a follow-up immunohistochemistry stain, I would say it’s easily 25 percent or 30 percent quicker,” Dr. Murray says. “I really like being able to look at a case, dictate really quickly, sign it out, and just know it’s done. I definitely like that workflow much better.”

Mt. Nittany’s lab handles a number of orthopedic knee and hip joint cases, which often use the same process repeatedly. Dr. Murray used PRO to build templates for those cases and found that he signs off much faster with the power of templates.

Tailored to every pathologist

Dr. Murray’s fellow pathologists agree, though each has uniquely tailored PRO to their own preferred workflow. “I do a lot of the autopsies here, and autopsies are very long reports,” says Dr. Harry Kamerow, a pathologist at Mt. Nittany. “You can dictate quite a lot with PRO and you don’t have to stop. At first I didn’t realize that VoiceOver PRO’s speech recognition can handle a very long paragraph. You can just continually talk and you don’t have to worry that it’s going to miss anything. And when I go back and edit, if there’s a piece I really don’t like, I’ll just delete it and dictate over it. That’s very helpful.”

Dr. Kamerow good-naturedly notes that he’s one of the older pathologists on the team, and jokes about everyone worrying he wouldn’t transition easily. “It’s an amazing system. I am 63 years old, and I really am amazed at my age that I can actually use technology like this and be efficient. I was the one person in our group that we were really worried would be put off by this program, but it’s worked out great.”

PRO is just incredible. I never thought I’d see this type of technology. It’s like the iPhone… it’s just incredible.

— Dr. Harry Kamerow, Pathologist, Mt. Nittany Medical Center

“Even in surgical pathology, I’m the most long-winded person here. When I first used the system, I thought I had to stop after one or two sentences and go back to make sure it was doing its thing. But you don’t have to do that. I’ve had surgical cases where my comment will be ten sentences long, and I just dictate all ten sentences and it doesn’t miss anything.”

CAP checklists that catch what you miss

Mt. Nittany isn’t a huge hospital and doesn’t handle a lot of resections, generally one or two a day. When the lab does need PRO’s CAP eCC (electronic Cancer Checklists), they work very well. “It’s easy for us to miss something or forget it. And then PRO just tells you that you didn’t fill in an area. I had it set up with a hard stop, so I can’t finish it without filling in all the blanks. That keeps me from forgetting something.”

Dr. Murray likens PRO’s CAP eCC functionality to doing his taxes. “It’s easy, in a sort of question-and-answer format, like doing your taxes on TurboTax. The checklist guides you through the whole process and then fills it in for you. I really like the checklists for accuracy and ease.”

We would never go back to human transcription. PRO is just way faster, no comparison. Every year we are expected to do more and more work, so it’s way better for us to use PRO.

— Dr. Paul Murray, Medical Director of Pathology, Mt. Nittany Medical Center