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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.

“Non Structured Data Is More Valuable to Practitioners Than Discrete Research Oriented Data”

Posted on June 19, 2012 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.

In my post on the EHR Bubble, Don B offered this strong statement:

“Recognizing the non-structured information is more valuable to the practitioner than discrete researcher oriented data.”

I love people that make strong statements and this is no exception. This is a comment that will no doubt hit people the wrong way when you consider how much focus things like meaningful use have focused on discrete data. I can already hear the chorus of doctors asking why meaningful use wants all this discrete data if the non-structured data is where the value is for practitioners.

There are a lot of nuances at work that are worth discussing. I agree with Don B that at this point in time the non-structured information is more valuable to a physician than the discrete data. I’d also extend that comment to say that non-structured information will likely always have value to a practitioner. There are just certain parts of physician documentation that can’t be discrete or at least cost far too much to make them discrete. I’m sure the EHR narrative crowd out there will love this paragraph.

Although, even proponents of the EHR narrative realize the value of discrete data elements. That’s why companies like Nuance and MModal are investing so much money, time and effort into their various NLP (Natural Language Processing) and CLU (Clinical Language Understanding) offerings. The key question for these companies has never been whether there was value in discrete healthcare data, but in how you capture the discrete healthcare data.

When thinking about discrete healthcare data I hearken back to a post I did in 2009 that asserts the Body of Medical Knowledge Too Complex for the Human Mind. This concept still resonates with me today. The core being how does a physician take in all the patient data, device data, lab data, medical data, research data, etc and provide the patient the best care possible. This will never replace the physician (I don’t think), but I expect the tools will become so powerful that a physician won’t be able to practice medicine without them.

Much of the power required for computers to assist physicians in this way is going to come through discrete data.

Over the next 2-3 years we’re going to start seeing inklings of how healthcare will improve thanks to discrete data (often captured through and collected by an EHR). Then, in the next 5-10 years we’re going to see how healthcare couldn’t survive without all the detailed healthcare data.

Medical Siri on the iPhone and iPad

Posted on November 11, 2011 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.

One of my regular physician readers, Brian, left the following comment on my post about the mythology of the Perfect EMR.

The reality is that we are now comparing EMR to our iPhone 4s’s. Our consumer technology is so far ahead of hospital technology that it is jarring and annoying to use work tech. This is what I want: “Siri, give me a differential for elevated amylase. Thank you. Now order CBC, Chem 14, TSH and free T4. Good. Now I will dictate. The patient is a 41 year old man with abdominal pain…”

Certainly we could have a long discussion about the difference in consumer technology and popular healthcare technology. However, I couldn’t help but wonder how many doctors have tried out Siri on their iPhone in order to get healthcare information. I bet this is pretty common. Although, I wonder how good the answers are that Siri gives.

If you’re a medical provider that’s used Siri for accessing health and medical information, I’d love to hear about your experience. I bet there are probably also a bunch of funny experiences trying to use Siri for medical info. I’d love to hear those as well.

Are there ways that “Siri” like technology could and should be implemented in EMR and EHR software?