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Like virtually every other hospital, the Miami Children’s Hospital relied on the “clipboard” patient tracking system that has been popular for over a century. The hospital recognized that capturing real-time patient data at the point of care is critical in saving lives, and sought to improve on the paper-and-clipboard approach. In addition, they wanted a secure system to ensure compliance with federal rules that govern the privacy of medical records.

Miami Children’s Hospital chose Teges Corporation’s i-Rounds (short for “Internet rounds”) software, which is powered by IBM WebSphere Multimodal Environment. IBM’s software integrates different modes of data entry: speech, keyboard strokes and handwriting-recognition technology. This “multimodal” approach provides physicians and nurses with the option of using spoken commands to access patient records and enter repetitive information.

The specification underlying IBM’s multimodal capabilities is called the XHTML+Voice (X+V for short) markup language, which is a combination of two other technologies, XHTML and VoiceXML. Based on Web standards, X+V sped the addition of speech to i-Rounds and used Web application development skills already possessed by Teges programmers. The use of X+V for multimodal applications demonstrates the powerful flexibility and extensibility of the VoiceXML markup language, an industry standard and W3C recommendation used by thousands of companies worldwide.

The speech features of i-Rounds have been enabled in the Cardiac Intensive Care Unit (CICU) and in the OR for use during pediatric cardiac surgery. They provide a hands-free mechanism for physicians to enter information, retrieve information and record their voice directly into the patient’s medical record, making the doctor’s assessment/diagnosis available immediately without waiting for transcription services. In the OR, the computer speaks to the surgeon through four speakers that are embedded in the ceiling. The surgeon interacts with the computer using a cardioid wireless microphone, which activates the speech system when the surgeon utters the keyword “computer.” In the CICU, clinicians access the system by using a wireless tablet PC. Watch video.