1. Business Value of IT HSCI 740Mike Grambo May 24, 2004 Utility and Cost Effectiveness of Voice Recognition Technology in Surgical Pathology, Hendricks, et al

2. Technology evaluated In this study conducted at the Cleveland Clinic, Cleveland, Ohio, the authors compared an automatic voice recognition (VR) system that automates the entry descriptions of laboratory samples with a conventional transcription service. This study investigated how effective a limited use of VR for generating gross description of biopsies for low to moderate complexity specimens that pathologist assistants (PA) handle.

3. Measuring cost and outcomes Outcomes The authors say that the CR technology saves money and provides an improved turnaround time for getting dictated observations into a pathology laboratory information system. The VR system allowed the same day processing of 35 specimens per day that were received after the previous day’s processing cutoff time. In other words, 35 specimens that would have been processed a day later. How significant is this increase? Savings of $2625 per month over outside transcription agency cost, with payback in1.9 years ($59,750)

4. Measuring cost and outcomes Capital Acquisition Costs Hardware and equipment $22,900 VRT software licenses $13,000 Interfaces between CRT and lab info system $11,000 Implementation and training $9,600 Maintenance (annual) $3,250 Total $59,750

5. Measuring cost and outcomes Other costs While the costs above to mention training costs, for the each user’s 2-3 hour training session, it is not clear whether the $9,600 noted in the costs table includes the 160 hours of computer system analyst and pathologist assistant (PA) time that were required to develop and enter templates into the VR system. 40-hours spent testing the templates 4 weeks on average for users to become proficient

6. Measuring cost and outcomes Other costs-cont’d Proofreading and editing now becomes the responsibility of the person making the VR entry Recognition accuracy was described as between 70-90 percent. This is presumably after VR and the proofing done by users. No comparative figures for the manual transcription system were provided. Wireless headset microphone—No estimates for these costs.

7. Viability of proposed approach In most work environments, the authors analysis would not stand. It simply confirms the relative effectiveness of VR technology. It does not address cost effectiveness adequately. And this is the central issue that I suspect many of the articles featured in this assignment address: effectiveness vs. cost effectiveness. In this VR paper, the new technology is effective, but cost effectiveness is not adequately addressed. Similarly, in the economic valuation of pharmaceuticals, Maynard 1998, confusion addresses confusion between clinical efficacy and cost effectiveness.

8. Testing Class Understanding Should the authors have compared VR to manual entry of data? Could speeding up processing of samples might be important? Remember the early attempts at digital watches and online banking?