Delivering More Accurate, Timely Information

The command and control techniques of virtual assistants will allow doctors to use dialogue to pull up important information in an EHR, such as a patient’s lab results. Natural-language processing in the cloud makes this possible, Petro noted. Doctors can say “Pull up patient John Doe” or “Let me see the results.”

“Navigating through an EHR in a point-and-click scenario is a daunting task,” said Petro. “By the use of voice, you can package clicks into a simple voice command, and that will get you to the point directly in the application.” The virtual assistant acts like a macro to allow doctors to skip over several clicks while navigating an EHR database, he said.

Doctors can also tap into specific information in an EHR, such as a patient’s drug-interaction episode or a computerized order entry form for amoxycillin, said Petro. In addition, virtual assistants such as Nuance’s Florence prototype can enable dialogue back and forth between doctors and an EHR.

Virtual assistants can let a doctor know if they’re missing information—such as frequency or dosage—during the medication-ordering process, called CPOE. “If a piece is missing for a [medication] order, the system will ask the user to complete the scenario,” which could be ordering 250 milligrams of amoxicillin, said Petro. They can also alert doctors to scenarios such as drug interactions, he said.

Doctors face a time crunch in which they can only spend a few minutes with patients. Virtual assistants could allow them to spend more time with patients and less time on administrative duties, said Petro. One out of three doctors spends 30 percent or more of the day on administrative tasks, according to a Nuance survey. The time could be spent helping patients if doctors use voice-enabled virtual assistants, particularly on mobile devices, he said. “If they can do it with the device that’s actually in their pockets and create more time within their day, the virtual assistant definitely assists them in that goal,” said Petro.

Seventy-three percent of respondents in the survey believed virtual assistants can help caregivers coordinate care. “There’s a long-term scenario relative to the virtual assistant that helps with patient flow and patient hand-off,” said Petro. “You can imagine a care team having a dialogue about a given patient where they’re basically talking back and forth in almost like a Twitter script, [and] speech to text is actually a big part of that.” Virtual assistants can help deliver messages from the doctor on the floor to the doctor coming on duty and also help transfer patients from one location to another, he said.

With biometrics, a virtual assistant creates a “voice fingerprint,” said Petro, and can provide secondary authentication with narcotics prescriptions. “The problem with fingerprint readers is you need to add another piece of hardware to the system,” he explained. “With the virtual assistant, a microphone is already resident on the phone.” The system allows a physician to read a sentence on-screen to access an EHR, and the CLU technology processes it in the cloud. “Voice biometrics is something you’ll see more and more,” said Petro.

Virtual assistants can allow patients to prepopulate an EHR before an exam and manage their active medication list using a patient portal, said Petro. “By doing that with speech, you’re taking the typing out of the mix,” he said. It also allows for dialogue with clinical staff. By patients entering some of this information earlier, doctors can save time during exams. “Using voice to allow a patient to engage and do these things is a big part of where we’re going in the future,” said Petro.

The voice-driven tools can provide patients with guidance on taking their medication and keep them from being readmitted into the hospital. “One of the big problems is whether or not a patient adheres to physician-prescribed medication and care protocols after discharge from the hospital, Petro said. “Keeping patients out of the hospital will be as important as treating them well when they’re inside the hospital,” said Petro. “We believe speech and virtual-assistant technology will be a big part of that.”

A full 80 percent of respondents said virtual assistants can better engage patients in their care and prompt them to modify their behaviors, according to the Nuance survey. The question-and-answer capabilities of virtual assistants can bring information to patients to help them maintain a healthy lifestyle, said Petro.