VA Pathologists Using VoiceOver PRO Save As Much as One Hour Per Day

Disclaimer: To maintain confidentiality and compliance with VA policies, specific laboratory locations and individual names have been omitted from this case study.

The Challenge

A VA anatomic pathology department faced significant workflow inefficiencies. The existing processes lacked consistency, leading to operational bottlenecks. 

Dictation and Transcription Issues

In the gross room, laboratory technicians relied on an outdated Dictaphone system for dictations, requiring manual transcription. This process was time-consuming, error-prone, and created additional workload for staff.

“The dictaphone system was so old that if the unit we had broke down, we couldn't even find a replacement,” the department chief told Voicebrook. “We were at the last point for our gross room to try to find some solution that would work.” 

Not only that, the department was struggling to find office support staff to meet transcription needs.

“We thought about using just Dragon voice dictation, but with our VistA AP system, especially for big reports like gross dictations, the formatting and the amount of errors that we would get with Dragon would basically not allow us to use that system,” said the department head. “We'd have to reread everything, basically go through it line-by-line, to make sure there wasn't an error and format everything. So Dragon by itself wasn't a really good solution to replace transcription.”

Lack of Standardization and Consistency

The laboratory lacked a standardized approach to synoptic reporting. Staff relied on the "copy and paste" method, leading to outdated reports and compliance concerns. These inconsistencies posed patient safety risks and created inefficiencies in pathology sign-out workflows.

One pathologist was in charge of updating synoptic protocols, but invariably, there would be reports in the system that were outdated. That meant compliance issues, since they were not using the most up-to-date protocols in their cancer cases.

Additionally, pathologists used varied methods for generating reports, including Dictaphone dictation, manual typing, and copying templates from Word documents into VistA. Others were using Dragon medical dictation in VistA for pathology sign out. That, too, was fraught with issues.

According to one pathologist: “It wasn't the best. There was a lot of manual moving around with arrows. You couldn't just click with your mouse and highlight a word and delete it; you’d have to manually use your keyboard arrows or shortcuts, which I don't know all the shortcuts for the VistA system that we have. So it took a little bit more effort. You could create templates in Dragon and use them, which was helpful to some extent, but for most of it, it was cumbersome.”

The Solution

Recognizing the need for a streamlined and error-free workflow, the department explored alternative solutions. After learning about VoiceOver PRO and its compatibility with VistA, they decided to implement Voicebrook's reporting solution to improve workflow consistency, reduce errors, and enhance efficiency.

“We heard about VoiceOver PRO and wanted to see how it worked with VistA,” the department head explained. “We knew that other VAs were using it and that sparked our interest. We were all over the board and needed a solution and that's why we sought out VoiceOver PRO. When Voicebrook did the demonstration showing how it works with VistA and how it can work in the gross room, and the sign out, and how you can incorporate the synoptic reports seamlessly... it seemed like a win-win for us.”

The Results

Immediate Workflow Improvements

The department went live with VoiceOver PRO and the impact was immediate. Pathologists and laboratory technicians quickly reported positive results, citing a seamless transition and strong support from the Voicebrook implementation team. The new system significantly improved workflow efficiency and integrated well with VistA, despite the legacy platform’s known challenges.

“The VistA system is so old, it’s probably from the 1970s or something," a VA pathologist said. "So to make a modern system like VoiceOver PRO work as well as it does with a system like VistA? That is pretty great!”

All pathologists and laboratory technicians transitioned to VoiceOver PRO, ensuring consistent operations in the gross room and pathology sign-out processes. The majority of pathologists adopted the solution for 100% of their cases, streamlining workflows from routine biopsies to complex pathology reports.

Efficiency Gains: "PRO Pays for Itself"

Before implementing VoiceOver PRO, some pathologists at the VA site used Dragon Medical Dictation. However, they found PRO to be significantly more efficient. One pathologist reported saving at least 45 minutes per day, while a colleague noted a time savings of over an hour daily.

Financially, the department saw substantial savings. With the transition to VoiceOver PRO, they eliminated the need for full-time transcription staff. Previously, three full-time employees handled transcription duties. After one retirement and two role transitions, the department no longer required transcription support, saving approximately $60,000 per year. The cost savings justified the investment in VoiceOver PRO, demonstrating a strong return on investment.

According to lab leadership: “When it comes to the cost of VoiceOver PRO, up front it might seem like, oh, that's a big number. But when you factor in the savings from eliminating an FTE, and we're not paying that $60,000 yearly, then quickly it's going to be a wash and VoiceOver PRO is going to pay for itself.” 

Standardization and Error Reduction

Synoptic reporting saw immediate improvements. The laboratory was able to standardize reporting practices, ensuring compliance with up-to-date CAP checklists. VoiceOver PRO’s built-in prompts and validation features reduced errors and improved reporting accuracy. The department found this especially beneficial for meeting compliance requirements during cancer committee inspections, which had previously identified issues with outdated reports.

“Before PRO, we had issues with synoptic reports being out-of-date and not containing the required material,” said one pathologist. “Using VoiceOver PRO was a way to really ensure that everyone would have the most up-to-date CAP checklists and that all the required material would be there. In PRO, you cannot send the report back without having that filled out. PRO gives you a nice red circle, stating what's required. Now our synoptic reports are really more uniform.”

“PRO gives peace of mind, with not having to worry about errors when we're consistently using PRO for the synoptic reports.”

Preparing for Future Enhancements

Looking to the future, the lab is planning its transition from VistA to Cerner Millennium PathNet. While the timeline of this nationwide rollout remains uncertain, the VA department was pleased to learn that VoiceOver PRO integrates seamlessly with both systems, ensuring a smooth transition whenever the switch occurs.

Additionally, the laboratory has leveraged PRO’s efficiencies to reallocate resources. With reduced transcription needs, staff have been reassigned to support histology and molecular lab expansion, improving overall workflow flexibility.

The VA system nationwide is also exploring telepathology and digital pathology. As laboratories prepare to incorporate high-throughput digital scanners to support research and inter-facility consultations, they can collaborate with Voicebrook to develop workflows that integrate digital pathology into daily operations, aligning with the evolving landscape of anatomic pathology.

Conclusion

The implementation of VoiceOver PRO has transformed this VA pathology department’s workflow by eliminating inefficiencies, reducing errors, and standardizing reporting. The solution has saved significant time and resources, allowing the department to focus on high-value tasks and future innovation. By partnering with Voicebrook, the laboratory is well-positioned to adapt to technological advancements and continue delivering high-quality pathology services within the VA system.