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June 5, 2013 Readers Write 4 Comments

The Year is 2025…
By Nick van Terheyden, MBBS 

6-5-2013 9-45-36 PM

In 1963, Spock uttered the words: “Computer, compute to the last digit the value of Pi," and with that launched us into a world of human to computer interaction. Reaching that vision took many more years and it was not until the 1990s that the first realistic tools emerged onto the market.

By 2001, it was clear that speech recognition technology was set to revolutionize healthcare’s clinical documentation industry, but there were many naysayers stuck in the paradigm of dictation and transcription who were unconvinced that the technology could ever be better than a human at transcribing doctors notes from audio into text. Acceptance of speech recognition took longer than many had hoped, but innovation helped accelerate adoption.

Still, delivering on the vision laid out in the Star Trek episode mentioned above would require a little longer since that vision included not just speech recognition, but also intelligent understanding.

I recently had a conversation with an analyst about how healthcare technology would evolve by 2025. Today, the pace of change in speech recognition is incredible, and I’m seeing something similar in the field of natural language understanding (NLU). As such, it is clear to me that we will see a similar explosion of NLU, making it pervasive in every aspect of our interaction with technology.

NLU will in time make technology fluent in human communication. The days of learning a system are numbered as we move away from requiring humans to learn a “language” to communicate with technology. NLU is poised to reinvent the relationship between people and technology, and nowhere is the potential of this innovation more pervasive than healthcare.

To get a sense of how deeply natural language technology has already entered our lives, you need only to sit in your car, pick up the phone, or even start talking to your television. In healthcare, these intelligent systems equate to allowing clinicians to spend more time practicing medicine vs. filling in forms and entering data.

A recent study found that medical interns spend 12 percent of their time examining and talking to patients, but more than 40 percent of their time behind a computer. And it’s not just clinicians who want to change this statistic – it’s patients who are frustrated with focus being placed on the technology instead of the patient-doctor interaction.

My daughter remarked on this lack of human-to-human connection after a recent doctor’s visit, which opened my own eyes even more so to both the benefits and downfall of technology in healthcare. Luckily, tools like speech recognition and natural language understanding can help streamline the transition to digital care and enable the physician to focus their efforts on the patient instead of the extensive documentation process and check boxes associated with the visit.

As I look ahead, by 2025 I think NLU will be readily available for physicians and patients alike and will have a profound impact on healthcare as such. Here’s an example of a patient interaction I imagine taking place in the not too distant future:

“Please book the next available appointment with Dr. Jones for my annual checkup.”

The system knows my calendar and Dr. Jones’ calendar and my health coverage. As a result, it is able to compare the two schedules to find the next convenient slot for a 30-minute appointment. It would also know that the standard 10-minute appointment would be insufficient. It offers me the options, I confirm, and the appointment is set in both calendars.

If we add this type of medical intelligence to the world of the physician, the interaction would look something like Project “Florence.” Today, the first virtual assistants for healthcare, like Florence, are just entering adolescence. As intelligence capabilities improve, we can expect to see NLU permeate throughout the patient-physician interaction, intelligently listening in to the exchange and extracting out clinically actionable data for summarization and presentation to the patient and clinician for review.

In essence, smart NLU will help drive complexity out of how physicians and patients engage with technology as part of the two-way care process. That’s something even Spock would be excited for.


Nick van Terheyden, MBBS is CMIO of Nuance.

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Currently there are "4 comments" on this Article:

  1. Nitpick: Mr. Spock instructs a computer to “compute to the last digit the value of Pi” in the Star Trek episode, Wolf in the Fold, which first aired on December 22, 1967, not 1963.

  2. Even more nitpicking: Pi is an irrational number (i.e. doesn’t end) so it’s pretty nonsensical to ask a computer to calculate pi to the last digit – it’s like asking someone to count to infinity.

  3. Re: Pi – the fact that it is an irrational number is the point. He gave the command to crash the computer. A lesson in error handling and input sanatizing for all.

  4. Star Trek was known for these little logic traps. My favorite being…

    Everything I say is the truth…

    I am a Liar







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