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Cover Story

(acoustic profi le) to a massive library of words that we own and will continue to grow through our millions of users, as well as through data processed by our NLP engines.

Looking toward the future Advanced voice- and language-understanding components that are Watson-like or have been created in tandem with Watson efforts will begin to make their way into products before the end of 2012. You can imagine a Watson-powered smartphone app where a physician could ask for treatment protocols, drug information for migraine headaches, informa- tion on clinical trials and more. Nuance has a whole series of understanding and reasoning products that will be introduced this year.

Innovation unlocks information and value The whole world seems to be excited about Watson, but

Photos courtesy Nuance Healthcare

A radiologist reviews a patient’s diagnostic image and simultaneously speaks review notes for the ordering physician, delivering fully detailed analysis on exam results.

INSET: A clinician dictates patient notes directly into an EHR. Words appear in real time, allowing her to make corrections if needed via voice to fi nalize notes without additional processes.

Watson-driven clinical decision support a reality in healthcare is for Watson to understand exactly what a physician is asking. Given the complexity of patient care, physicians’ questions are complex and oftentimes multi-dimensional – they’re very seldom simple. Through a combination of voice and NLP ca- pabilities, Watson will be able to fi gure out exactly what was asked, the intent of what was asked and will be able to swiftly identify the most relevant information associated with the question, as well as with the answer to the question. From a medical perspective, understanding what a physician is asking, whether it be about an adverse drug reaction vs. a treatment vs. dosing requirements vs. trying to draw analytics from a data repository, is extremely important to the ultimate value Watson will deliver to healthcare. At Nuance, we’re focused on the “speech-to-understanding-to-reasoning” component, and without that initial recognition and understanding, we’ll never get to meaningful, high-value reasoning. Nuance leverages its own NLP capabilities to hone and im- prove its speech-recognition accuracy by applying rules-based techniques, as well as statistical and stochastic techniques. We believe that state-of-the-art voice recognition is achieved through a combination of these things. We’re evolving our recognition solutions beyond simply recognizing the spoken word to being able to understand intent based on certain words that are said, as well as surrounding words that are spoken. With recognition, we’ve already achieved out-of-the- box levels at the 95 percent mark and above. Now, a major focus is to further evolve recognition toward understanding and intelligent reasoning. Every word has an audio signature, and we’ve purpose-built our solutions to map each word

10 March 2012

Watson performing on television vs. Watson performing in a clinical scenario are two very different things. In the not- so-distant future, the healthcare industry will experience what so many other industries have: a technology evolution. Doctors considering a patient’s diagnosis will have a tool at their fi ngertips or a voice command away to aid in decision making, instantly accessing reference materials, prior cases and the latest knowledge in medical journals. Healthcare organizations will be able to easily uncover ineffi ciencies and reduce readmissions through real-time access to key informa- tion from past discharge summaries and trends across patient populations. Watson-like technologies will change healthcare by helping medical professionals confi dently determine the best course of action.

Understanding the many players and realizing there is a difference between data, information and intelligence will be the keys to solving our healthcare system’s many problems. We have the technology but now must leverage it. Paying close attention to how information is captured, how it is understood and how it is applied will be critical to navigating ahead. HMT

Photo courtesy Nuance Healthcare

A team of clinicians leverages Dragon Medical Mobile Search, a mobile app that allows users to simply speak a request to conduct fast and easy searches on various medical websites such as MedScape, MedLine, Epocrates and Google.


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