The adoption of electronic health records (EHR) in hospitals and physician offices has been widely promoted as a single solution to a wide variety of health care issues. Yet 84% of small and medium business (SMB) physician practices in the US have not adopted EHR systems. Interventional Dynamics Corporation (IDC) has conducted more than 200 primary care physician interviews, finding that the major disincentives to adoption are workflow delay and expense. The single greatest factor in the reduction of workflow speed is the data input process. IDC's proposed project has this specific aim: Utilize an innovative voice entry technique and open source code systems to develop a low-cost, automated solution to allow primary care physicians to complete a primary care note entirely during the patient examination process. The narrative speech input will be analyzed in a context-sensitive, domain-restricted manner to produce structured clinical data that can be readily integrated into standards-compliant electronic medical records. By using speech inputs that are converted directly to relevant EHR entries, physicians can increase the accuracy of their notes, eliminate third party transcription errors and avoid workflow delays. The project approach will include: Further testing and final development of DocTalk, the IDC patent pending speech system that allows accurate natural language processing of structured medical information; Development of a proof-of-concept data system that converts physician voice input from voice to text to structured text to EHR data using domain enhanced open source code; The evaluation of the effectiveness of the proof-of-concept system against traditional EHR input methods with the following goals: Achieve 50% or more reduction in charting time, achieve 90% or more accuracy in output, and score greater than 4 of 5 on subjective metrics including learnability, workflow fit, usability, and overall satisfaction. Successful completion of the proposed program will provide IDC with a viable technology platform that can immediately be useful to primary care physicians in generating structured documents for use with their current EHR platforms. Furthermore, the technology developed and refined within this program can be expanded in multiple ways.
Public Health Relevance: The IDC technology is designed to circumvent the normal barriers to adoption in the SMB market and allow for quick increases in workflow and quality of patient care at a minimal price point. IDC will provide physicians who currently use pen and paper a more natural and faster way to input clinical data, eliminating time spent on hunt-and-peck keyboard entry or complicated EHR screen navigation. The system will generate structured clinical data that enables the exchange of health information, the portability of patient records, billing, data analytics (both local practice and public health), marketing, and other benefits, resulting in the reduction of overall healthcare costs.
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