Steve Whitehurst, CEO at Health Fidelity in San Mateo, Calif., discusses the future standard of natural language interfaces and speech capabilities in healthcare as well as what needs attention when it comes to health IT innovation.
Responses have been lightly edited for clarity and length.
Question: Where do you see the biggest need for innovation to improve the healthcare system in the future?
Steve Whitehurst: Right now, our healthcare system is drowning in information yet barely getting wet. The focus of health IT innovation must be on helping real humans to get better care from other humans by delivering insights based on all available information — clinical results, claims data, patient-specific diagnostic data, etc. — at key decision points along the patient lifecycle. At every stage, from identifying and scheduling the patients most in need of a clinical intervention to defining a treatment plan based on the very latest, most patient-specific clinical knowledge, we are leveraging only a fraction of the relevant information that exists. Technologies such as natural language processing are removing the barriers to accessing, analyzing, interpreting and utilizing this information, freeing it to be delivered at the precise moment when it can inform and improve decisions by those who need it.
Q: How do you feel about the use of voice recognition technology, such as Amazon's Alexa and Google Assistant, in healthcare?
SW: The human voice, along with scribbled physician notes, has been the primary and most natural input/output mechanism in healthcare for centuries. In a sense, EHRs have proliferated a decade too soon, as they rely on the antiquated input/output mechanisms — keyboard, mouse, monitor — that have not evolved substantially since the '70s. Natural language interfaces, especially voice, are slowly restoring a more organic, familiar means of interacting with technology. Voice technology is already being used widely by physicians to document patient encounters within the EHR, and there are a host of companies trying to bring voice-powered virtual assistants into the clinical setting.
There are innumerable areas — placing orders for tests and medications, for example — in which the use of EHR has rendered a previously simple, spoken action burdensome and needlessly complex. Using speech recognition to initiate and manage orders within the EHR will save time and reduce physician frustration, without compromising the process rigor and structured data capture that the EHR enables. As with iPhones, which would never have been supported by hospital IT organizations without having first proliferated in the consumer space, the rapid adoption of virtual assistants at home will drive their use inside a clinical setting. Amazon and Google may eventually dominate the virtual assistant market within healthcare, but speech capabilities will rapidly become standard within most healthcare applications.
Q: What's the biggest misconception about health IT?
SW: The idea that health IT will eventually replace providers and, to a lesser degree, that it stands in opposition to a more personalized healthcare experience for patients is completely off base. That is the consensus feeling today, as the most visible outcome of healthcare IT has been clinicians staring into EHR applications on monitors in the treatment room. But as natural language interfaces proliferate, and relevant clinical data is more effectively captured and channeled to the point of care, patients and clinicians will be able to re-engage in a more humanistic way. Treatment plans will then be far more specific to a patient's unique circumstances and background. This should be the mission of health IT, collectively, even as we acknowledge that the deployment of new technologies has so far stood in opposition to that experience.
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