‘Tis The Season For The Gift Of Voice Recognition In Healthcare IT

The holiday shopping season is in full swing, and while the gift of voice recognition may not be at the top of the average consumer’s wish list, it is shaping up to be an important building block in physicians’ efforts to create effective revenue cycle and patient engagement strategies.

Porter Research recently sat down with Dr. Nic van Terheyden, Chief Medical Information Officer at Nuance Communications – a business best known by consumers for its Dragon voice-recognition tools, and just as well-recognized in the healthcare community for its clinical language understanding technologies - to get his take on the part voice-recognition tools will play in healthcare’s pursuit of improved reimbursement, and adoption of digital patient engagement methods.

Porter Research: It seems that revenue cycle is given short shrift in news coverage these days when compared to mobile health and HIT in general. What do you think is the unsung benefit to driving revenue cycle improvements via technology?

Dr. Nic van Terheyden: “Using technology in revenue cycle process ultimately allows for appropriate reimbursement for the care delivered. It enables clinicians to focus on what they want to do - take care of patients with enough information.

“I’ll pick one data element that came up recently in a spread I was tracking. It was the issue of cost associated with a treatment. Honest to God, it was an Australian informatics colleague who jumped in on this thread and said, ‘I can’t believe that your clinicians don’t know how much it costs!’ We disconnect the people that actually incur the cost from the information about the cost.

“I think physicians have wanted to abdicate that responsibility to other people, and said, ‘We don’t want to get ugly and get involved in the cost of care.’ The reality is that we are involved in it. The value of revenue cycle and being inclusive with clinicians is that it allows them to become more engaged and more importantly, informed, so they not only make the best clinical decisions, but also the best financial decisions. You don’t go out and buy a car without thinking about the price. If we did, we’d all go out and buy a Ferrari. Improvement in the overall cost of delivery is going to take some care.”

As accountable and coordinated care programs continue to form, do you foresee revenue cycle challenges being paid more attention to by the industry as a whole?

“We think there’s a better way of doing things that leverages technology, much as we did with technology applied to the documentation industry. We’ve found it’s possible to squeeze tremendous efficiency out of speech-recognition technology. We have 120-percent improvement in this sort of back-end transcription process.

“The natural extension to us is to ask what else can we do with that documentation process given that, today, we touch 450,000 clinicians. We have a tremendous opportunity in front of us to allow for better use of information that historically - let’s be frank - has been locked away.

“That’s useful information, but it’s hard to access because it’s contained in this narrative that isn’t semantically interoperable. Applying our crown jewel – our clinical language understanding, and then tying that together with some of the tools we’ll be incorporating through the Quantim and J.A. Thomas acquisitions, will enable us to improve documentation efficiencies, data availability and accessibility, and more importantly, affordability, so that more people can use it. That is clearly part of our strategic goal and direction.”

Fall conference season seems to be winding down. Have your physician customers brought up any challenges at these events that have surprised you?

“There’s been much more interest and focus on patient engagement, which has surprised me in a good way as I’m quite passionate about it. I think customers are definitely challenged by this. You hear this a lot from clinicians who say, ‘Gosh, how can you hold me accountable for whether or not somebody accesses their medical record online?’ I understand the resistance: it’s like saying to a banking customer ‘We’re going to measure the quality of banking service by whether you access your online tools or not.”

“I’ve certainly been surprised by the level of conversation around it - both good and bad. Some people see it in a negative way, but I think the focus of attention is important, because I see patient engagement as part of this overall change for the healthcare system – it’s going to be critical.”

Is Nuance doing anything specifically tied to patient engagement right now?

“Our view of this is, how do we facilitate or help patients interact with those tools – voice-enabling of products. We’ve seen a number of instances of that. Siri is a generic example, and we’ve developed Nina (Nuance Interactive Natural Assistant) now for mobile apps. We also see it with the television at the patient’s bedside.

“One of the great things about Nuance, and the reason I love working here is that I get to benefit from the investments made outside of healthcare. We’ve done a lot of work with the TV. It sounds almost superfluous - who cares if you can talk to your TV? But I’m willing to bet that most households have the same challenge as I do – when dad isn’t home, nobody can work those 15 different remotes you’ve got for those different devices.

Wouldn’t it be so much easier to say, what’s on tonight? We’re really enabling that, and I think we’re going to see that technology transition into healthcare much in the same way, but from the healthcare perspective. How’s my weight today? Can I afford to eat this cookie? Those are genuine issues and concerns. Having something engaging and interactive is going to help with that process, and help people be less intimidated by what voice really does.”