Market Spotlight: Healthcare

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Despite increased government pressure for the healthcare industry to convert patient records into electronic files, industry analysts estimate only 30 percent of physicians currently use electronic medical record (EMR) applications. Speech industry insiders expect speech technologies to catalyze broader EMR adoption.

"Everyone wants EMRs, but doctors don’t want to be the ones to enter all the data," says John Vaughan, senior product line manager for Enterprise Express Speech Systems at Nuance Communications’ Dictaphone Healthcare Solutions. And with speech technologies, they don’t have to.

Speech significantly reduces the mouse clicks and typing required by clinicians to document patient care. Doctors can use speech recognition and natural language processing technologies to narrate their patient encounters through free-form dictation/transcription. Once the audio is converted into text, doctors can either directly edit and sign off on the document or deliver the draft and original audio file to a medical transcriptionist for report finalization and storage onto an EMR system.

"In the medical community, speech recognition is one of the most effective tools," Vaughan says. "It’s about turbo-charging an existing workflow process."
To that end, vendors of the technology are making clinical documentation solutions more physician-friendly and feature-rich. Most solutions today—many of which are available as software exclusively for healthcare professionals—contain industry-specific templates, macros, dictionaries, and shortcuts. Because many products are also adaptive, they automatically store new medical terminology and correct grammatical mistakes, handle rephrasing, and format based on individual preferences.

As EMRs from vendors like Allscripts, ChartLogic, Eclipsys, Epic Systems, NextGen, and Practice Partners incorporate more speech interfaces, doctors will also be able to use voice commands "not only to create reports, but to tie into how they communicate and share those reports," Vaughan says. The move to electronic records will also introduce other speech technologies into the medical field. Because of increasingly stringent doctor/patient confidentiality standards—which will only get tougher as the federal government moves forward with the Health Insurance Portability and Accountability Act (HIPAA)—voice biometric applications will limit information access to qualified healthcare practitioners, insurance providers, pharmacists, and support personnel.

HIPAA, which thoroughly covers patients’ medical records, mandates electronic data be protected with two-factor authentication, one of which is likely to be voice. But these measures have yet to see wide adoption rates across the industry because the government keeps delaying HIPAA compliance deadlines, according to Judith Markowitz, a consultant who specializes in speech systems and voice biometrics.

Still, medical institutions have already made strides. Late last year, AssistMed added a layer of voice-based security to its DictAide dictation/transcription platform by incorporating VoiceVault Caller Authentication. Physicians and other healthcare professionals need only speak a few words to establish a voiceprint that validates their identity before allowing them access to electronic files.

Markowitz also notes that several organizations, including HealthNet, are compiling databases of voice files so that third-party physicians and hospitals can vocally access confidential patient files.

Beyond Dictation
The same information security concerns prevalent in hospital records-keeping also exist in call centers where patients access test results, check on the status of health insurance claims, and schedule medical appointments.

In addition, voice has begun to play a role in the mobile healthcare space. MediVoice’s service enables doctors to create and send prescriptions directly to pharmacies via their mobile devices using such simple commands as Write a script for John Doe; Medication: Lipitor; and Send to CVS on Main Street. A visual representation for verification is always presented before processing an order. The solution also leverages Nuance’s Voice Control to speechify access to EMRs.

Additionally, healthcare organizations and insurance providers using speech more efficiently manage wellness and disease prevention programs. MicroAutomation offers outbound calling to healthcare organizations and insurance providers that want to proactively remind patients of medical schedules and instructions.

Using iReminder’s Compliance for Life, disease management firms, pharmacy benefit managers, and managed care organizations send automated messages by phone, email, or SMS, reminding patients to take their medicines, review regimen instructions, justify their medications, improve symptom awareness, and obtain self-management strategies.

Translation services also allow doctors and caregivers to relay vital patient information to non-English speakers. In the past, hospitals and medical practitioners relied on a patient’s friends or family members to act as translators. Once HIPAA enforcement initiates, those methods will be obsolete as automated solutions will solidify doctor-patient confidentiality.

Regardless of speech’s role in the medical field, protecting patient information will remain the governing principle. "One of the scariest things is to have your health information compromised," Markowitz says.

That risk will expand as information moves from paper stored in filing cabinets to electronic data stored on networked servers. "Many of these technologies will be available hospitalwide, so how do you make sure the person logging in to access and modify files is the right person?" she asks. "Voice authentication is a great option. To secure those kinds of records, the industry should be looking to biometrics of all sorts, not just voice."

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