Pipeline session speech and medical intelligence – revolutionizing the doctor and patient experience

CONFIDENTIAL | © 2002-2013 Nuance Communications, Inc. All rights reserved. HEALTHCARE SOLUTIONS

Speech and Medical IntelligenceRevolutionizing the Doctor and Patient Experience

Pipeline SessionDr. Nick van Terheyden, MD

@drnic1


Objectives

• Speech is delivering efficiencies and improves EHR adoption

• Adding Clinical Language Understanding is set to revolutionize healthcare delivery allowing the clinician to focus on the patient not the technology delivering real time medical intelligence at the point of care.

• Medical Intelligence helps healthcare providers transform patient stories into high-value clinically actionable medical information

• Improving the quality, efficiency and value of documentation and help drive better care without burdening the clinicians with data entry tasks


Paper is no longer fit for purpose

Slide Courtesy of Dr Michael Bainbridge


The Art of Medicine

JAMA. 2012;307(23):2497-2498. doi:10.1001/jama.2012.4946.http://jama.jamanetwork.com/article.aspx?articleid=1187932


Improving Healthcare

“If you can not measure it, you can not improve it.”

Lord Kelvin (1824-1907)


• At the forefront of the next chapter of human-computer interaction

• Deeply invested in creating effortless and natural user experiences

• Rapid advances in voice-recognition technology

Reinventing the relationship between people and technology

CONFIDENTIAL | © 2002-2013 Nuance Communications, Inc. All rights reserved. HEALTHCARE SOLUTIONS7 CONFIDENTIAL | © 2002-2011 Nuance Communications, Inc. All rights reserved. HEALTHCARE SOLUTIONS


Unstructured Data

Structured DataDictation and Transcription

System generated or interfaced data

Direct data entry, not physician

Direct data entry, physician

Handwritten

Current Methods for Data Capture


Years ago Today

This gap injures patients

Knowledge processing capacity

Knowledge processing requirement

“Current medical practice relies heavily on the unaided mind to recall a great amount of detailed knowledge – a process which, to the detriment of all stakeholders, has repeatedly been shown unreliable”

Crane and RaymondThe Permanente Journal Winter 2003 Volume 7 No.1Kaiser Permanente Institute for Health Policy

Challenge – Clinical Knowledge-Processing Burden

Slide Courtesy of Dr Michael Bainbridge


Automating the Extract of Clinically Actionable DataNatural Language Processing




CHIEF COMPLAINT

PAST MEDICAL HISTORY


PAST MEDICAL HISTORY

CHIEF COMPLAINT


In EHR MT-editing

In EHR Self-editing

On the Go

At a Dictation Station

With a RIS/PACS

On a PC On an MFP

EHR

CLU

• Meaningful Use• Quality Reporting• Decision Support

• Value-Based Purchasing• Coding/CMI• POA/HAC

• Medical Necessity• Coding• Documentation Integrity

FinancialIntegrity

Compliance

In EHR MT-editing

In EHR Self-editing

On the Go

At a Dictation Station

With a RIS/PACS

On a PC On an MFP

EHR

CLU

Patient Care

CaptureAnywhere

UnderstandEverything

Use it forGood


From Clinical Narrative to FactsCLINICAL LANGUAGE UNDERSTANDING

63 %

93%

Oct ‘10 Feb ‘12

86 %

Rules: explicit linguistic models

Machine learning: discovery of new patterns

Syntactic parsing & Statistical semantic processing

LinKBase® ontology


Computer Assisted Physician Documentation

17© 2011 Nuance Communications

Extending the value of clinical documentation into efficiency, quality and report turn around metrics


QualityAnalyticsSUPPORTING YOUR ANALYTIC NEEDS

Patient Safety IndicatorsAutomated Clinical Data Extraction

Clinical Documentation ImprovementConcurrent Monitoring

PatientAction Lists

On-Demand Search

DASHBOARDS

Quality Measures

Automated Reporting

Clinical Documentation

Clinical Sourcesof Input


Possibly the first step in this journey could be instant access on mobile platform


Electronic Medical RecordsData Capture and Presentation Complexity


Intelligent Voice Interactions

• Minimize need to remember “gate commands” & “command order”

• Allow multiple forms of expression and handle ambiguous input

• Allow for more conversational spoken utterances, less utilitarian

• Reduce distance between complex spoken commands and desired outcome or action – finding becomes doing

• Customizable to provide levels of seamless access to any content on device

dcollins

Is Intelligent Voice a product name? If so, then it needs to be removed, and a generic reference needs to be made


Example of Intelligent Voice Interaction

Intelligent Voice transforms how you complete tasks by understanding and classifying your spoken request

• Ability to categorizeTell me the risks associated with this disease, treatment or specific set of clinical facts

• Complies with directed interactionShow me the laboratory results for this patient

• Understands intentPrescribe a specific treatment for my patientUnderstanding the context of the patient, the drug including dosage, side effects and patient specific contraindications


Live Demo


P A R T N E R S H I P S


Q&A


Nick van Terheyden, MD CMIO, Nuance CommunicationsAboutMe http://about.me/obiwanTwitter http://twitter.com/drnic1LinkedIn http://www.linkedin.com/in/nickvtVoice of the Doctor http://drvoice.blogspot.com/Plaxo http://nvt.myplaxo.comFaceBook http://profile.to/drnickE-Mail [email protected], [email protected] (301) 355-0877

Where You Can Find Me


Health & Medicine

Pipeline session speech and medical intelligence – revolutionizing the doctor and patient experience