Artificial intelligence and capturing quality information into your EHR

by Janet Dillione

Are we ready to deliberate on how artificial intelligence will be used in healthcare? While the future role of innovation as part of healthcare is certain, it’s critical that we first focus on achieving what is possible and absolutely necessary today.

There’s been tremendous attention on IBM’s work with Nuance to bring Watson (supercomputer) to healthcare, and rightfully so, it’s a fascinating application of technology. However, as I hear and read the many discussions, ideas and concerns about how artificial intelligence will impact healthcare, it’s occurred to me that we ought not get ahead of ourselves or too easily shift our healthcare IT focus. The prospects for advanced computing are undeniable, but the foundation for this innovation relies on the work we undertake today.

Over the years the industry has made remarkable progress on an aspiration that was seeded decades ago. In 1965 CEO Thomas J. Watson, Jr. — son of the IBM CEO for whom the Watson computer was named – said, “The widespread use [of computers] … in hospitals and physicians’ offices will instantaneously give a doctor or a nurse a patient’s entire medical history, eliminating both guesswork and bad recollection, and sometimes making a difference between life and death.” His vision emulates the technological future the healthcare industry continues to work toward and in some care settings, because of electronic health records (EHRs), is taking shape today. However, we’re not all the way there yet. Many doctors are fearful they won’t be able to effectively use in an EHR. Whether there are fundamental challenges with typing, fear of losing efficiency or stubborn reluctance to workflow change, physicians have viable concerns. With the looming deadline to implement EHRs and achieve “Meaningful Use” our immediate priorities should converge on building an interoperable, healthcare IT infrastructure that supports physicians’ effective use of technology today and can be a launching pad for the future.

Stage 1 Meaningful Use criterion goes into effect this year and meeting it will be no easy task. According to a recent survey of 150 hospital execs, which was released by Dell and covered in the press this month, 79 percent of the hospital execs are apprehensive about training clinicians to use an EHR. Meaningful Use is complex; it’s not just about deployment, it’s about usability and ensuring quality information is captured, preserved and shared. Only when used, can an EHR show its value. Because of the beauty of innovation, however, as EHRs have come to the forefront so have other technologies that enable use, provide flexibility and even extend EHR features. There are EHR supportive mobile apps, speech recognition for all specialties, as well as streamlined information search and coding tools.

In the case of the EHR, clinicians need to find a balance between clinician-owned tasks, telling the patient story, and computer-owned tasks, structuring key medical data. Once clinicians find that balance, we can begin to discuss additional ways to leverage computers, i.e., Clinical Language Understanding. Being patient is not simple and in most cases is not exciting, but to fully achieve our future vision for healthcare IT we first need to set the groundwork for high-quality clinical information.

As emphasized in Welcome Our New (doctor) Computer Overlords, the use of computers should free doctors to fulfill bigger, more complicated tasks. Until clinicians are fully on board and en route to Meaningful Use we must not leap too far, too fast, as we risk discounting the value and impact of today’s innovations. The future of healthcare IT is bright. Be excited, let advanced computing motivate you, but let’s not forget the task at hand, for the work we do today will prepare for the advancements we see tomorrow.

Janet Dillione is executive vice president and general manager of Nuance Healthcare, a leading healthcare IT provider of medical intelligence solutions: speech-enabled clinical documentation, computer-assisted clinical documentation, decision support and analytics solutions.

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  • http://http//healthtrain.blogspot.com Gary Levin MD

    A.I.or Artificial Intelligence still has some way to go. However as we see now voice recognition has improved tremendously with increased processing power. AI wil require computers such as Watson. This is impractical for medical practices currently. However the shift to the ‘cloud’ will enable AI for many physicians and healthcare providers. Cloud computing is already in use by businesses for many tasks. It offers massive processing power that can be accessed via the internet, as some EMRs are already accomplishing. This is a strong reason for looking seriously at basing your EMR in the ‘cloud’ Social media will also play a larger role in medical business, and not just as it relates to patient-doctor communications. Follow my posts on this topic at Health Train Express.

  • Marc Gorayeb, MD

    The quote attributed to Thomas Watson Jr. shows how off-target the basic premise is. No one has yet shown that “eliminating both guesswork and bad recollection” is a substantial issue that needs to be addressed systemically, or that it makes “a difference between life and death” to any significant extent. If your assumptions about the problem are wrong, your proposed solutions will not survice a cost/benefit analysis.

    And current experience already tells us that placing a patient’s medical information on a distant server that is accessible to third parties cannot yet be done safely and securely. The government, insurance companies and pharmaceutical companies already have too much acess to our private, personal information. If it’s in the cloud, it can be hacked.

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