It has taken many years to mature from developers to the market place. NLP is now in the consumer marketplace, offered by Google and Amazon. Their speech engine an AI and machine learning algorithm support many other devices licensed by the patent holders to add functionality to their own products. The demand for this application has stimulated demand for smart speakers, and distributed voice commands for security systems, control devices, and also the (IoT), Internet of all Things. It is a self-sustaining and economic return on investment.
It may be the saving grace for the shortcoming of data entry into electronic health records. If properly designed it could alter the physician's perception of electronic health records. EHR is listed as a major cause of physician burnout and early retirement. It eliminates many keystrokes, and point and click operations that slow down data entry.
It has taken a long time to gain entry into the medical system. Vendors have been distracted by federal regulations regarding meaningful use and data collection. They were required to obtain certification regarding meaningful use to be able to bill Medicare for services. While it may have improved the 'back end", invisible to users it distracted from the User Interface (UX).
In our opinion, HHS, and CMS should require this in EHR to become a certified vendor. What is my reasoning?
Vanderbilt University Medical Center is exploring the potential for Epic EHR-integrated virtual assistants to boost EHR usability.
Problems with EHR usability continue to counter the potential benefits of EHR systems and leave physicians, nurses, administrators, and patients by and large feeling dissatisfied and frustrated with the technology.
While patient EHRs contain a wealth of potentially actionable clinical information providers and researchers can use to improve clinical decision-making, care delivery, and patient health outcomes, the administrative burden associated with documenting and retrieving health data still weighs heavily on providers.
It has taken a long time to gain entry into the medical system. Vendors have been distracted by federal regulations regarding meaningful use and data collection. They were required to obtain certification regarding meaningful use to be able to bill Medicare for services. While it may have improved the 'back end", invisible to users it distracted from the User Interface (UX).
In our opinion, HHS, and CMS should require this in EHR to become a certified vendor. What is my reasoning?
Vanderbilt University Medical Center is exploring the potential for Epic EHR-integrated virtual assistants to boost EHR usability.
Problems with EHR usability continue to counter the potential benefits of EHR systems and leave physicians, nurses, administrators, and patients by and large feeling dissatisfied and frustrated with the technology.
While patient EHRs contain a wealth of potentially actionable clinical information providers and researchers can use to improve clinical decision-making, care delivery, and patient health outcomes, the administrative burden associated with documenting and retrieving health data still weighs heavily on providers.
EHR-integrated, voice-activated virtual assistants powered by artificial intelligence (AI) may help to resolve some of the industry’s longstanding problems with EHR usability. Virtual assistants enable providers to dictate physician notes, request specific data, order prescriptions and view lab results without touching their keyboards.
But is the technology effective, or will it only cause more frustration for providers? That’s the question providers at Vanderbilt University Medical Center (VUMC) hope to answer.
VUMC Assistant Professor of Biomedical Informatics Yaa Kumah-Crystal, MD, is currently working with Nuance to develop an EHR-integrated virtual assistant capable of summarizing patient health information and dictating that information to providers in response to verbal queries. Kumah-Crystal uses a prototype of the Nuance virtual assistant integrated into VUMC’s Epic EHR system.
“I've been testing it, and I actually use it on a regular basis to review some of the content in the patient's chart before I walk into the room to see them,” Kumah-Crystal told EHRIntelligence.com. “We have another provider who's testing it as well, and in the next month, we're going to be doing some studies with the rest of our clinicians.”
While new and emerging virtual assistants will be used to complete a variety of tasks within provider EHR systems, VUMC is testing a product primarily designed to ease patient management and health data access for providers.
“The main purpose of the voice assistant is to help summarize the information that's hard to get out of the EHR,” Kumah-Crystal explained. “We’re going to have providers there with the scheduled patients that they're going to see within the next week. We’re going to review the patient's information in the chart.”
VUMC providers who participate in upcoming studies exploring the efficiency of voice recognition software and virtual assistants will use Nuance technology to find information about patient’s vital signs, medication lists, problem lists, and general health status. Kumah-Crystal and her team will then compare the individual provider’s experience using virtual assistants with each provider’s experience retrieving information manually. The VUMC team will do a timed task analysis to determine whether providers are able to access and review health data more quickly using either method.
A new report from AMA, Pew Charitable Trusts, and MedStar Health outline recommendations on how stakeholders can improve EHR usability and safety throughout the entire EHR life cycle, as well as criteria for rigorous safety tests.
Preparing AI-Powered Virtual Voice recognition software and virtual assistants may help to boost EHR usability.
Nothing is foolproof. Adding another interface can increase errors. A 2018 JAMA study found clinical documentation generated through voice recognition software is often error-prone, with physician notes generated through Dragon Medical and Nuance’s eScription showing a 7.4 percent error rate. Clinician review can help to reduce dictation errors and boost the accuracy of voice recognition-generated notes.
VUMC is currently in the process of building a use case for utilizing virtual assistants to prep providers for patient visits.
“You're gathering information to build a picture in your mind about who the patient is and what the next steps and their care will be,” said Kumah-Crystal.
The tool could be especially effective for prepping providers during their morning commutes. Kumah-Crystal hopes to further develop commute summaries through virtual assistants after getting more active participation with the existing workflow.
“The concept of a commute summary where you know that you have a schedule of 10 patients for the day, you have a 30-minute commute to work, and you can say, ‘Tell me about my patients,’ or, ‘What's today look like?’” said Kumah-Crystal. “And then it summarized for you just patients on your list while you're on your commute.”
“It saves me time as a physician, and I'm oriented by the time I walk in,” she added.
While concepts like the commute summary hold potential, Kumah-Crystal recognizes that some providers will be hesitant to integrate virtual assistants and voice recognition software into their workflows.
“They're right to be reluctant to completely adopt something that's not tried and true and tested,” she said. “And that's exactly what we're doing.”
Physicians, like engineers, solve challenges 'one step at a time' Each step depends upon the accuracy and reliability of the preceding steps
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