Just speak in!

Kleeblatt Pflegeheime gGmbH from Ludwigsburg has been using the digital voice assistant from the start-up company voize in practice for over a year. In the beginning, some convincing had to be done, but now care documentation via voice app is part of everyday care.

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Relieving the workload of the nursing staff was the decisive factor for Kleeblatt Pflegeheime gGmbH to push ahead with the digitalisation of nursing documentation. In its search for a suitable concept, the provider of 26 micro nursing homes in the Ludwigsburg district came across the start-up company voize. In the meantime, the hybrid voice assistant has been in use at Kleeblatt for over a year and makes the work in the homes easier for the nursing staff.

"Weight Mrs Klingler 63.5." That's it. Documentation by voice command directly to the resident is amazingly simple. No notes, no going to the ward room and no waiting for a free PC. The voice assistant on the smartphone is in the pocket during the entire shift and is available for documentation. Voize analyses the voice input, recognises keywords and thus generates a structured documentation entry. The interest of Kleeblatt's Managing Director Stefan Ebert was aroused when the start-up founders Erik Ziegler, Fabio and Marcel Schmidberger presented their voize app to Kleeblatt in July 2020. "Both the founders and the product convinced us. By using voize, we expected that our nursing staff would be relieved, the documentation quality would be increased and at the same time there would be more time for the nursing staff with the resident." Stefan Ebert decided to introduce voize, and the project was launched in July 2020. "We see great potential in the digitalisation of care. We have created a staff unit for innovation and project management to provide professional support for such projects."

The introduction should first take place in a pilot house in order to derive the further strategic orientation in nursing documentation from the experience gained there. Before the implementation, however, the project team had to clarify a few fundamental issues. Questions about data protection, an interface between voize and Vivendi, the revision of the authorisation concept in Vivendi, the purchase of hardware and other points had to be planned and prepared for the introduction in the pilot house. The technical prerequisites were created, whereby the configuration effort on the part of the system administration for the introduction was pleasingly low and amounted to a total of only one and a half working days. At this point, a comprehensive WLAN network was already available in the pilot house. 

In mid-September, the nursing staff were trained by voize in the use of the app during a one-hour event. The intuitive menu navigation enabled them to document directly with the voice app. Two weeks of close on-site support followed the training, so that questions could be clarified directly and any problems that arose could be solved quickly. At this point, it was possible to create nursing reports, record vital signs and sign off on measures on the smartphone. Thus, already two months after the start of the project, the first documentation entries were created via voize. 

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How does the voize voice assistant work?
The voice assistant uses artificial intelligence to generate structured documentation entries from spoken sentences, which are transferred via a standard interface to the care documentation software Vivendi PD by Connext, which is already established at Kleeblatt. The nurse enters a documentation entry directly into the resident's smartphone via a separate user account. Voize recognises the type of documentation and displays the generated documentation entry. This is checked and confirmed by the caregiver and thus automatically synchronised in Vivendi PD via WLAN. If there is no WLAN available in a resident's room, the whole process also works offline; synchronisation then takes place as soon as the smartphone is within WLAN range again. The mobile recording in the resident's room has changed the care process to continuous documentation instead of the previous block documentation at the end of the shift. This reduces the documentation pressure and waiting for a free PC is a thing of the past.

Acceptance among the nursing staff varied. Many staff members were immediately enthusiastic about the app. The voice input was nothing new to them, as they already knew this function from their private everyday life. They quickly found their way around the intuitive menu and used voize daily. They had hardly any problems with the voice recognition and found the type of documentation to be a relief in their daily care routine.

Other staff members still had difficulties with speech recognition in the beginning, as too many words had to be corrected manually. They had problems getting involved with the recording and preferred to document on the PC as before. Corina Burkhardt-Herdtle, the project manager in charge at Kleeblatt, compares overcoming the resistance of some staff members to the introduction of Vivendi nursing documentation software, which replaced paper documentation 15 years ago. "At that time, the nursing staff had to get used to working on the PC and quite a few found it difficult. In the meantime, no one wants to go back to the Cardx. With the voize introduction, we are encountering similar reservations." 

While the nursing assistants were able to document only via the app after some time due to the range of functions, the nursing professionals still had to enter some things on the PC, as the app did not support further functions at the beginning. So the desire to include additional functions in the app quickly arose. A productive collaboration developed between Kleeblatt and voize, from which both sides benefit. The Kleeblatt employees' wishes are met with open ears and voize is able to integrate many of the suggestions into the app very quickly and develop them further. Voize is regularly on site at the nursing home and is in close contact with the nursing staff.

"Voize is an extremely agile company and the company founders impress us time and again with their uncomplicated and dedicated commitment," reports project manager Corina Burkhardt-Herdtle. "In addition, voize is regularly present on site. This personal contact and the collegial cooperation with the nursing staff enables a very good exchange, so that wishes, suggestions and experiences of our employees constantly flow into the further development of the app and its added value for us is constantly improving." 

A milestone was the integration of wound documentation in voize, as this provided a function that was previously much more complicated to use. Wounds can now be photographed and documented directly from the app and are immediately available in Vivendi for further documentation. 

A big wish on the part of the nursing staff is the integration of shift handover into the voize app, which is now in progress. However, the complete nursing documentation will not be integrated into the app. Voize is a supplement to Vivendi PD and does not aim to completely replace the software. For example, care planning will continue to be done on the PC with Vivendi.

From the very beginning, the main goal of the project was to reduce the workload of the nursing staff. To evaluate the achievement of this goal, an anonymous staff survey was conducted after three quarters of a year: More than 80 per cent of the users stated that the use of voize made their daily care routine considerably easier and just as many said that they could handle the app very well. The self-learning speech recognition system has also improved greatly over the course of the project and learns with every documentation text that is spoken, recognises new technical terms and accents and understands dialects better and better. 80 percent of the nursing staff now state that voize understands them very well or well, and the trend is rising. The question of whether they would recommend the app to others was answered in the affirmative by 100 per cent of respondents. At the same time, the employees still see potential for improvement in voize. The nursing staff in particular would like to see more functions added. "Voize really makes work easier and definitely saves time. We see incredible potential in how the app can further support care in the future," reports residential area manager Sandra Saad. "Voize also takes a lot of stress out of emergencies. You have everything at your fingertips and can pass on information directly to the emergency doctor. We don't want to do without voize any more."

In January 2021, Kleeblatt decided to introduce voize in a second house. Here, it was possible to draw on the experience from the pilot house and the app had already been expanded with helpful functions. The speech recognition had also already improved considerably. 

And what's next for Kleeblatt? "We are very pleased with the positive feedback from our pilot homes and several of our facilities have already expressed great interest in using voize as well. For this reason, we are planning to equip more Kleeblatt nursing homes with voize in the coming year. Should the acceptance and success also become apparent here, we will use voize company-wide," says Managing Director Stefan Ebert.

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