From foe to friend: Transforming the EHR with virtual provider assistants

July 28, 2021 / By Adam Rothschild, MD

Over the past 40 years or so, the technology used to interact with medical records has changed dramatically. First there was paper. Then electronic health records (EHRs) came along, offering—among other touted advantages—legible notes and the promise of leveraging computers to help health care providers make better decisions and fewer mistakes.

Although that promise has borne some fruit, to health care providers, the EHR has largely become just a computer-based information entry and retrieval tool … and a clunky one at that. Hidden in a complicated user interface, many features go unused. Tasks that were once simple for a health care provider to perform on paper (e.g., order entry) now require multiple frustrating and time consuming steps of graphical user interface (GUI) navigation.

Over the past few years, voice user interface (VUI) virtual assistants have become ubiquitous in the consumer marketplace. Consumers, health care providers among them, have become accustomed to performing everyday activities using their voice, from ordering products online to checking the weather. Given the advanced state of continuous speech recognition and (to a lesser extent) natural language understanding technologies in health care, as well as the need to improve the user experience with EHRs, the advent of virtual provider assistants (VPAs) was practically inevitable. For this I am grateful.

There is no limit to the number of tasks that we burnt out health care providers would like VPAs to perform for us. Give us features that save us time, eliminate tedium and help us to become more astute clinicians. We realize that some advanced features will take time to develop, but many useful features are within reach of current technology.

Let us use our voice to enter orders as we would when giving a verbal order to a nurse or pharmacist. Help us easily find hidden bits of information in a patient’s record by simply asking a question (e.g., “When was this patient’s last colonoscopy?” or “What medications has this patient tried for migraine?”). Allow us to invoke our already proven speech-to-text software in a hands-free fashion. Automated ambient documentation will become available over time, as will increasingly advanced clinical decision support functionality.

A VPA makes possible many useful features that we hadn’t even imagined with our current EHRs. If executed well, I believe that VPA technology will transform the EHR from physician’s sometimes foe into our trusted helper by solving problems much bigger than illegible handwriting. The difficult stuff is going to take time, but there is so much value that VPAs can add right now. As Arthur Ashe famously said, “Start where you are. Use what you have. Do what you can.”

Adam Rothschild is a clinical informaticist with 3M Health Information Systems.

Focus on the patient while the technology works in the background.