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What’s in a Chart? – Fun Friday

Posted on November 30, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

I’ve heard people say “What’s the difference between stats and lies? Nothing!” While that’s a bit of an exaggeration, there is something to say about stats that don’t share the real story. A good person with the right data can tell whatever story they want to tell.

I guess this fact is why this cartoon resonated so much to me and many others who shared it on social media.

The tweet is said from a marketer’s standpoint, but the same is true in healthcare as well. A nurse or doctor looking at a dashboard might miss something if the dashboards aren’t measuring the right thing. The same is true for any healthcare leader that spends time looking at dashboards. Dashboards are great…if you’re measuring and presenting the right things.

Don’t be WOWed by the fancy charts and graphs until you understand what the data really means.

Three Ways AI Can Improve Physicians’ Workflow

Posted on November 26, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

For far too many physicians, EHRs and other important health IT seem to get in the way of getting the job done. But according to one pair of physician-authors, emerging AI technology has the potential to improve physician workflow instead.

“We see opportunities for AI to be a solution for—rather than a contributor to—burnout among physicians and achieving the Quadruple Aim of improving health, enhancing the experience of care, reducing cost and attaining joy in work for health professionals,” wrote AMA chief medical information officer Michael Hodgkins, MD, MPH and Shantanu Nundy, MD, director of the Human Diagnosis Project.

In an article for the journal Health Affairs, Drs. Hodgkins and Nundy outlined three ways in which AI could be used to make physicians’ work easier and more satisfying. They include:

  • Delivering educational information to the point of care: At present, most educational efforts targeting physicians don’t do a good job of keeping physicians up to date, as they aren’t targeted enough, the article asserts. However, by using AI, healthcare organizations can offer personalized content to physicians by reviewing their existing research habits. By analyzing practice data, online search queries and assessments, AI can provide a streamlined infostream offering only what they need.
  • Producing clinical documentation: The authors argue that AI will someday be able to complete clinical documentation tasks on the physicians’ behalf. In their view, these AI applications will analyze a given physician’s free-text narrative, extract relevant information and insert the information into the right data fields in their EHR. (Researchers are testing out some concrete approaches for doing this.)
  • Collecting information needed for quality-measurement reporting: Hodgkins and Nundy envision a scenario in which AI tools spare doctors the need to perform hours of redundant quality reporting duties. As in the documentation example, such tools would review clinical documents and extract needed information, though this time in search of meeting external requirements. They would then populate data fields in need of completion on submission forms.

These are comparatively straightforward applications of AI. In addition to the trio of possibilities suggested above, AI could eventually deliver clinical decision support on the fly, speed and improve the accuracy of medical image interpretation and more.

In the meantime, however, it’s hard to disagree with these authors that physicians could benefit a great deal from AI tools that make basic clinical workflow faster and less draining.

Can AI Inspire Medical Creativity?

Posted on November 16, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

As the capabilities of healthcare AI tools grow, vendors continue to insist that as with previous generations of technology, AI will simply do the grunt work and free doctors’ minds up for higher uses.

For what it’s worth, the research strongly suggests that this is true.  By all accounts, we are incalculably far from creating technology that can think like a trained human or apply empathy and insight to complex problems.

In the meantime, we may see some unexpected benefits from watching AI tackle healthcare problems. According to Nick Peters, a professor of cardiology and head of cardiac electrophysiology at Imperial College London, observing AI at work may jog physicians’ creativity and push them in directions they never would’ve gone otherwise.

Peters, whose article appears on the World Economic Forum website, believes that because AIs, well, think different(ly), they can sometimes inspire their human partners to try new things. “Machines are beginning to challenge human imagination in a way that may not have been anticipated, and which could…unleash a revolution in creativity,” he asserts.

Among the first changes this revolution may bring in a shift in how we track health. Peters argues that while we currently assess a patient’s status by measuring phenomena like blood pressure, respiration, and pulse, AI will replace these measures with subtler approaches.

Over time, we will use machine learning to identify other signals derived from the use of consumer devices which serve the care process better, Peters argues. “It will enable entirely new fields of cheaper, better and more cost-effective clinical science to emerge that may supersede blunt measurements such as the likes of blood pressure,” he writes.

He predicts that the data which will identify these pathways will spring in part from devices like the Apple Watch 4, which incorporates an ECG. These smart consumer devices, in turn, will eventually be able to alert and recruit a nearby citizen who has registered their competence to deliver CPR, he notes. This could have a major impact on survival rates for time-sensitive problems like cardiac arrest, Peters writes.

As interesting as his observations are, the article is too short. I do wish Peters had extended his argument further and attempted to answer more questions about the impact of AI and analytics on medical practice.

For example, if we are poised to discover health measures which take the place of basic metrics like blood pressure checks, how will we determine whether these new measures deliver the kind of results the old-fashioned ones do? What other medical processes will be transformed, and how?  Also, should we focus AI development on finding alternative approaches to traditional care processes or are they just side benefits that might evolve out of other useful analysis?

Still, merely by envisioning AI as a spur to healthcare creativity, Peters has done us a service. Perhaps physicians will benefit from inevitable differences in which humans and AI software process information rather than working at cross-purposes.

Stanford Offers 10-Year Vision For EHRs

Posted on October 12, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Despite many efforts to improve EHRs, few physicians see them as adding value to the practice. Sadly, it’s little surprise given that many vendors don’t worry much about what physicians want, focusing instead on selling features to CIOs.

As a result, they still don’t like their EHRs that much. In fact, a recent survey conducted by Stanford Medicine and the Harris Poll found that 44% of physicians said that the top value of the EHR was to serve as digital storage, which isn’t a ringing endorsement. Just eight percent saw the EHR as having clinical value, with three percent citing disease prevention, 2% clinical decision support and 3% patient engagement as top benefits.

Is it possible to create a new EHR model that physicians love? According to Stanford, we could build out an ideal EHR by the year 2028.

In Stanford’s vision, clinicians and other healthcare professionals simply take care of the patients without having to think about health records. Once examinations are complete, information would flow seamlessly to all parties involved, including payers, hospitals, physicians and the patient.

Meanwhile, it would be possible to populate the EHR with little or no effort. For example, an automated physician’s assistant would “listen” to interactions between the doctor and the patient and analyze what was said. Depending on what is said in the room, along with verbal cues of the clinicians, it would record all relevant information in the physical exam.

What’s more, the automated physician’s assistant would have AI capabilities, allowing it to synthesize medical literature, the patient’s history and relevant histories of other patients available in anonymized, aggregated form.

Having reviewed these factors, the system would then populate different possible diagnoses for the clinician to address. The analysis would take patient characteristics into account, including lifestyle, medication history, and genetic makeup.

In addition to its vision, the survey report offered some short-term recommendations on how medical practices can support physician EHR use. They included:

  • Training physicians well on how to use the EHR when they’re coming on board, as well as when there are incremental changes to the system
  • Involving physicians in the development of clinical workflows that take advantage of EHR capabilities
  • Delivering EHR development projects as quickly as possible once physicians request them
  • Making data analytics abilities available to physicians in a manner that can be used intuitively at the point of care
  • Considering automated solutions to eliminate manual EHR documentation

Technologists, for their part, can take also take immediate steps to support physician EHR use, including:

  • Developing systems and product updates in partnership with physicians
  • Limiting the use of manual EHR documentation by using AI, natural language processing and other emerging technologies
  • Using AI to perform several other functions, including synthesizing and summarizing relevant information in the EHR for each patient encounter and offering current and contextualized information to each member of the patient care team

In addition, to boost the value of EHRs over the long-term, 67% of physicians said making interoperability work was important, followed by improving predictive analytics capabilities (43%), and integrating financial information into the EHR to help patients understand care costs (32%).

A Next Step For Personalized Medicine? Vendor Brings Genomics To Ambulatory EHR

Posted on October 8, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Most physicians have some sense of the value personalized medicine can bring to their practice, but I doubt that many have ready access to the tools they’d need to harness its power.

In an effort to close that gap – and of course, to make its platform irreplaceable – a vendor serving medical practices has struck a deal giving physicians the ability to order genetic tests and leverage them to improve care.

The vendor, DrChrono, offers a suite of electronic systems for physicians, including an EHR which can be customized by bundling in affiliated apps. Its new partner is Genomind, a personalized medicine platform offering genetic testing for psychiatry practices.

Physicians using DrChrono will have access to two Genomind test kits, along with some analytics tools they can use to make use of the testing data.

One of the tests is Mindful DNA Professional, a genetic test used by clinicians to help them guide wellness decisions. The test targets aspects of a patient’s genetic details which could have an impact on overall health, such as variants suggesting that they could have sleep issues or a predisposition to anxiety, depression or impaired cognition.

DrChrono users will also have access to the Genecept Assay, the results of which can guide the treatment of psychiatric conditions. Once test results become available on the Genomind system, doctors can use its gene-drug-environmental interaction tool, the Genomind Drug Interaction Guide, to inform their treatment decisions. With the help of the Guide, clinicians can analyze the patient’s current medication regimen and flag gene-drug interactions.

An interesting side note to all of this is that the final test results from Genomind will be stored in the DrChrono information library for the patient and become part of the patient’s medical record.

Looked at one way, sharing the Genomind test results seems almost like a no-brainer in a world where casual genetic testing (think 23andMe) is becoming the norm. On the other, though, I don’t want to gloss over the fact that using genetic data to search for relatives is one thing and putting it into your personal medical record is quite another. It suggests that of consumer-driven demand for precision treatment is maturing, and that Genomind is on the right side of this trend.

This takes me back to DrChrono, which while not itself reinventing the wheel has struck a smart deal here. Not only has it brought a tool on board which could offer some benefit to physicians, its supporting the collection of information (genetic data) that patients are beginning to want. If DrChrono can give patients their genetic info via a decent portal, the company may find itself to be in demand with patients. Way to stay abreast of the times.

Let Vendors Lead The Way? Are You Nuts?

Posted on August 13, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Every now and then, a vendor pops up and explains how the next-gen EHR should work. It’s easy to ask yourself why anyone should listen, given that you’re the one dishing out the care. But bear with me. I’ve got a theory working here.

First of all, let’s start with a basic assumption, that EHRs aren’t going to stay in their current form much longer. We’re seeing them grow to encompass virtually every form of medical data and just about every transaction, and nobody’s sure where this crazy process is going to end.

Who’s going to be our guide to this world? Vendors. Yup, the people who want to sell you stuff. I will go out on a limb and suggest that at this point in the health data revolution, they’re in a better position to predict the future.

Sure, that probably sounds obnoxious. While vendors may employ reputable, well-intended physicians, the vast majority of those physicians don’t provide care themselves anymore. They’re rusty. And unless they’re in charge of the company they serve, their recommendations may be overruled by people who have never touched a patient.

On the flip side, though, vendor teams have the time and money to explore emerging technologies, not just the hip stuff but the ones that will almost certainly be part of medical practice in the future. The reality is that few practicing physicians have time to keep up with their progress. Heck, I spend all day researching these things, and I’m going nuts trying to figure out which tech has gone from a nifty idea to a practical one.

Given that vendors have the research in hand, it may actually make sense to let them drive the car for a while. Honestly, they’re doing a decent job of riding the waves.

In fact, it seems to me that the current generation of health data management systems are coming closer to where they should be.  For example, far more of what I’d call “enhanced EHR” systems include care management tools, integrating support for virtual visits and modules that help practices pull together MIPS data. As always, they aren’t perfect – for example, few ambulatory EHRs are flexible enough to add new functions easily — but they’re getting better.

I guess what I’m saying is that even if you have no intention of investing in a given product, you might want to see where developers’ ideas are headed. Health data platforms are at an especially fluid stage right now, tossing blockchain, big data analytics, AI and genomic data together and creating new things. Let’s give developers a bit of slack and see what they can do to tame these beasts.

How Are Ambulatory Practices Going to Compete with Health Systems?

Posted on July 9, 2018 I Written By

John Lynn is the Founder of the HealthcareScene.com blog network which currently consists of 10 blogs containing over 8000 articles with John having written over 4000 of the articles himself. These EMR and Healthcare IT related articles have been viewed over 16 million times. John also manages Healthcare IT Central and Healthcare IT Today, the leading career Health IT job board and blog. John is co-founder of InfluentialNetworks.com and Physia.com. John is highly involved in social media, and in addition to his blogs can also be found on Twitter: @techguy and @ehrandhit and LinkedIn.

We’ve all seen the stories about the explosion of data and the way healthcare is getting more personalized. However, David Chou recently pointed out how the data is one thing, but figuring out the role everyone plays in your healthcare organization is just as important as the data itself. It gets complex quickly as this graphic David shared shows:

This is a great graphic of the healthcare analytics roles and responsibilities that will be needed to make the personalized medicine future a reality. Plus, it will be key to getting a lot of the value out of our past EHR investments. Many hospitals and health systems already have these roles filled or are working to have them filled. We’ve seen this first hand when we see data jobs being posted to our healthcare IT job board.

While this work is extremely exciting and shows a lot of promise, I imagine a graphic like the one above is just completely overwhelming to consider for a small ambulatory practice. Even a large group practice would likely find the above graphic challenging to consider in their relatively small healthcare organization. How can they compete with a large health system with that kind of complexity? Do graphics like the one above just provide one other illustration of why small practices are going to soon be extinct?

I don’t think so and I hope not. However, graphics like the one above do illustrate the tremendous challenges that ambulatory practices face when they don’t have a massive health system behind them. What’s the path forward for smaller practices then?

The first thing to remember is that even though a health system is large, it doesn’t mean it’s going to do things well. In fact, it’s easy to argue how large organizations are much less efficient. It’s not hard to see how a large health system will focus all of their analytics work on the acute care environment and leaves out ambulatory practices. Smaller healthcare organizations are going to have to use this to their advantage.

While it’s unlikely that ambulatory practices will do all of the healthcare analytics work on their own, it is possible for ambulatory practices to tap into third party vendors that do the work for them and hundreds of other ambulatory practices. Smaller healthcare organizations partnering with corporate and entrepreneurial vendors is going to be the best way for these healthcare organizations to compete with the large health system. In fact, it’s a huge opportunity for them to show why patients should visit their practice instead of the large health system.

One thing that’s holding these efforts back is EHR vendors’ decision to close the doors to outside vendors. There are a few EHR vendor exceptions and areas where every EHR vendor is more open (ie. labs, pharmacy, etc), but it won’t be enough going forward. My friend Jeremy Coleman recently described why in this series of tweets:

I don’t see any healthcare future where centralization will survive. Sure, it will put up a good fight for a while, but the number and variety of applications that are coming out in healthcare are going to be so varied and dramatically important for doctors to incorporate into the care they provide that EHR vendors won’t have a choice but to create APIs that facilitate all of these applications.

An EHR vendor that embraces this approach is going to be essential for every ambulatory practice. Eventually, ambulatory practices will be stuck with the need to switch EHR systems or sell to the health system (which generally means switching EHR systems too). However, an ambulatory EHR that provides an open ecosystem for the latest and greatest in health IT will allow ambulatory practices to thrive even against the much larger health systems.

Payers Say Value-Based Care Is Lowering Medical Costs, But Tech Isn’t Contributing Much

Posted on June 22, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

A new survey of health insurers has concluded that while value-based care seems to be lowering healthcare costs significantly, they aren’t satisfied with the tools they have to analyze value-based performance.

The report, which draws on a survey sponsored by Change Healthcare, including answers from 120 payers across several types of insurance, including managed Medicare, managed Medicaid and commercial plans.

The topline finding from the report was that value-based care (VBC) has lowered healthcare costs by 5.6% on average, with one-quarter of respondents reporting savings of more than 7.5%.

Meanwhile, the volume of fee-for-service payments has dropped dramatically as a percent of overall payments, now accounting for just 37.2% of all reimbursement among respondents. That number is expected to fall below 26% by 2021.

Not only that, 64% of payers said that provider relationships improved, and 73% said patient engagement improved. This suggests that providers have made some strides in delivering value-based care, as many had a hard time restructuring their business in the past.

That said, some payers haven’t met their own VBC goals. In particular, 66% of payers are investing administrative staffers to support episode-of-care programs given what the study terms “exceptional” medical cost savings. Also, one third to one-half said that episode-of-care models were either very or extremely effective at improving care quality.

However, payers haven’t made much progress as they’d like in rolling out episode-of-care programs. While 21% of payers said they were capable of rolling out a new episode-of-care program in 3 to 6 months, more than a third said the needed a year to launch such a program, 21% said it would take 18 months, and 13% said it would take up to 24 months or more. In other words, many payers are so far behind the curve that the programs they’re designing might be obsolete by the time they roll them out.

What’s more, they’ve had a tough time getting providers interested in episode-of-care programs. Forty-three to 58% reported that it is either very or extremely difficult to get providers to participate in these efforts. Not only that, even when they find interested providers, payers are having a hard time finding common ground with them on episode definitions, budgets, the details of risk and reward sharing and performance metrics. These disagreements could prove a major hurdle to overcome.

In addition, more than half of payers said they were not very satisfied with the current value-based analytics, automation and reporting tools, even though most of the tools were developed in-house by the payers themselves. It could be that given provider resistance, the payers aren’t quite sure about what to look for. Regardless, it seems that payers have a longer-than-expected road to travel here.

Geisinger, Penn State Researchers Predict Risk Of Rehospitalization Within Three Days Of Discharge

Posted on June 15, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

In recent times, healthcare organizations have focused deeply on the causes of patient readmissions to the hospital. It’s a problem that affects both physicians and health systems, particularly if the two are not in synch.

To date, providers have focused on readmissions happening within 30 days, largely in an effort to avoid financial penalties imposed by Medicare and Medicaid. However, if the following research is solid, it could push the focus of care much closer to hospital discharge dates.

In an effort which could change the process of avoiding readmissions, a group of researchers has found a way to predict a patient’s risk for needing additional medical care within three days of discharge. The new approach developed jointly by Penn State and Geisinger Health Plan, relies on clinical, administrative and socio-economic data drawn from patients admitted to Geisinger over two years.

The model they created is known as REDD, an acronym which stands for readmission, emergency department or death. Using this model can help physicians target interventions effective and reduce the number of adverse events, according to Deepak Agrawal, one of the Penn State researchers.

You won’t be surprised to hear that readmissions after 30 days are often related to social determinants of health, such as a poor home environment, limited access to services and scant social support. Providers are certainly working to close these gaps, but to date, this has remained a major challenge.

However, the dynamics are different when finding patients who may be readmitted quickly. “Readmissions closer to discharge are more likely to related to factors that are actually present but are not identified at the time the patient is discharged,” said research team leader Sundar Kumara, Allen E. Pearce and Allen M. Pierce Professor of Industrial Engineering with Penn State, who was quoted in a prepared statement.

Another Penn State researcher, Cheng-Bang Chen, added another interesting observation. He noted that the more time that passes after a patient gets discharged, the less likely it is that problems will be caught in time. After all, it may be a while before treating physicians have time to review lengthy hospital records, and the patient could experience a time-sensitive event before the physician completes the review.

To test the REDD program, Geisinger ran a six-month pilot tracking high-risk patients and adding additional services designed to avoid readmissions, ED visits or death.

To treat this population effectively, physicians took a number of steps, such as scheduling appointments with patients’ primary care doctors, educating patients about their medications and post-discharge care plans,  having the inpatient clinical pharmacist review the provider’s recommendations, filling patient prescriptions before discharge and having the hospital check on patients discharged to a skilled nursing facility one day after discharge.

It’s worth noting that there was one major issue which undermined the research results. Penn State reported that because of a shortage of nurses at the hospital during the pilot, they couldn’t tell whether the REDD program met its goals.

Still, researchers are convinced they’re heading in the right direction. “If the REDD model was fully implemented and aligned with clinical workflows, it has the potential to dramatically reduce hospital readmissions,” said Eric Reich, manager of health care re-engineering at Geisinger.

Let’s hope he’s right.

Recording Doctor-Patient Visits Shows Great Potential

Posted on June 1, 2018 I Written By

Anne Zieger is veteran healthcare consultant and analyst with 20 years of industry experience. Zieger formerly served as editor-in-chief of FierceHealthcare.com and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also contributed content to hundreds of healthcare and health IT organizations, including several Fortune 500 companies. Contact her at @ziegerhealth on Twitter or visit her site at Zieger Healthcare.

Doctors, do you know how you would feel if a patient recorded their visit with you? Would you choose to record them if you could? You may soon find out.

A new story appearing in STAT suggests that both patients and physicians are increasingly recording visits, with some doctors sharing the audio recording and encouraging patients to check it out at home.

The idea behind this practice is to help patients recall their physician’s instructions and adhere to treatment plans. According to one source, patients forget between 40% to 80% of physician instructions immediately after leaving the doctor’s office. Sharing such recordings could increase patient recall substantially.

What’s more, STAT notes, emerging AI technologies are pushing this trend further. Using speech recognition and machine learning tools, physicians can automatically transcribe recordings, then upload the transcription to their EMR.

Then, health IT professionals can analyze the texts using natural language processing to gain more knowledge about specific diseases. Such analytics are likely to be even more helpful than processes focused on physician notes, as voice recordings offer more nuance and context.

The growth of such recordings is being driven not only by patients and their doctors, but also by researchers interested in how to best leverage the content found in these recordings.

For example, a professor at Dartmouth is leading a project focused on creating an artificial intelligence-enabled system allowing for routine audio recording of conversations between doctors and patients. Paul Barr is a researcher and professor at the Dartmouth Institute for Health Policy and Clinical Practice.

The project, known as ORALS (Open Recording Automated Logging System), will develop and test an interoperable system to support routine recording of patient medical visits. The fundamental assumption behind this effort is that recording such content on smart phones is inappropriate, as if the patient loses their phone, their private healthcare information could be exposed.

To avoid this potential privacy breach, researchers are storing voice information on a secure central server allowing both patients and caregivers to control the information. The ORALS software offers both a recording and playback application designed for recording patient-physician visits.

Using the system, patients record visits on their phone, have them uploaded to a secure server and after that, have the recordings automatically removed from the phone. In addition, ORALS also offers a web application allowing patients to view, annotate and organize their recordings.

As I see it, this is a natural outgrowth of the trailblazing Open Notes project, which was perhaps the first organization encouraging doctors to share patient information. What makes this different is that we now have the technology to make better use of what we learn. I think this is exciting.