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5 Future Initiatives on the Healthcare IT Horizon

November 2, 2011
by Pete Rivera
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Natural language processing,  EMR voice reminders, and more!

When you try to forecast what is on the horizon for Healthcare IT, it is like reading a Horoscope. You sort of want to believe it if it is good. But you also want to ignore it if it’s bad. So let’s dive in and let me know if I left anything out:

  1. Natural Language Processing (NLP) for EMR’s. There have been some posts about speech recognition, but NLP will be more of a personal assistant like Apple Siri. In fact it would be great if Siri could be licensed for health care use. Talk to any physician specialist and they will tell you that they will give up there dictation microphone when you pry out of their cold dead fingers. So in order to effectively populate clinical data, meet Meaningful Use and data mine Clinical Quality measures, you have to go beyond basic note dictation. NLP would enable the provider to have a dialogue with the EMR and easily navigate through med lists, send reminders and post data in the right places. You can do this with Dragon (to a certain extent) but it requires the right commands in the right places. Not natural language.
  2. Voice Reminders from the EMR. The EMR will use the same NLP to call patients when requested by the provider, and remind them about their appointment, PAP, colonoscopy or other preventive medical procedures triggered by a date milestone. It will authenticate the person on the other end of the phone based on challenge questions and responses.
  3. Clinical Applications will use more Dashboards. Look for Clinical quality dashboards to pop up across all clinical applications. These will be tied to PQRI, Meaningful Use, Patient Centered Medical Home, ACO’s and Pay per Performance. As organizations run to meet the quality requirements, they will also provide financial incentives for physicians to meet them. Clinical Quality dashboards will be a must have for these application. Peer review sites will expand towards many more specialists so they can measure themselves against each other. More clinical applications will weave these quality measures in an export file than can be easily uploaded.
  4. So many HIE’s, so little time! We have all lost count of how many HIE vendors are out there. So a super HIE will emerge. This will be a cloud based system that “pulls” all the data out to corporate or regional HIE’s that meets the matching criteria. This may be another thing the government jumps in and tries to regulate, or leverages the VA backbone. Either way, it will be needed if the data is truly going to be accessed outside of regions or states (outside of multi-state health systems).
  5. Kiosks-all over again. Seems like everyone had a kiosk solution at one point or another. They just did boring stuff, like verify demographics. New Kiosks will be smart devices like an iPad or similar that replaces the clipboard that most patients still get at check in. The difference is they will enter their medical history, update meds and problem list and update demographics. It will go to the physician to sign off electronically and be part of the clinical data. This is already being offered by some vendors, but will become a standard feature for all. Patients will also have the option of doing this prior to their visit through their patient portal.



Great post. Just to build a little on your item one, NLP.

Dialogues with the computer are likely to become necessary. Reviews of current documentations shared at AMIA made it clear that doctors don't provide enough specifics today to adequately resolve many I-10 codes, or state adequate criteria for many eMeasures, or fully reconcile their meds. At AHIMA last month, several vendors were revealing such dialogues - beyond navigation and speech recognition. The systems are actually asking "did you mean to say RIGHT hip fracture?" No more post hoc queries to physicians, hours to days after they dictate?  Seriously cool stuff.

Thanks for your forecast.

Peter - I think you are dead on with all (5) especially (1) & (3)! The list may indeed need to include new usability standards and esMD as we look to the future and read the tea leaves. Certainly the roll over impacts of HIE's (or better said HIH's) and "unintended consequences of EHR implementations". NIST, CMS and ONC driving at the speed of light, sound leadership behind the wheel, NwHIN super highway, but still need more cars. fyi-great job on the site pages (kudos CMS) - thank you Peter