Intermountain Healthcare, MModal test mobile speech-enabled CPOE app

By: Neil Versel | Feb 26, 2013        

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Intermountain Healthcare LiVE app

Another iOS app from Intermountain Healthcare: LiVE, a wellness app for teenagers.

Healthcare speech recognition technology vendor MModal is teaming up with Utah’s Intermountain Healthcare to prototype and develop what MModal is calling the first mobile app for speech-enabled computerized physician order entry (CPOE).

“We don’t know anyone who’s ever done this before,” MModal CMIO Dr. Jon Handler tells MobiHealthNews.

Franklin, Tenn.-based MModal and Intermountain, of Salt Lake City, announced their partnership Friday. They will demonstrate a prototype Apple iOS app at next week’s Healthcare Information and Management Systems Society (HIMSS) conference in New Orleans.

With the app, clinicians can speak orders into an iPhone. Voice orders get sent to an MModal server in the cloud, where a natural-language processing engine that MModal calls “speech understanding” recognizes spoken words and translates the information into text, according to Handler.

The server sends information back to the clinician’s phone in a structured format, where the user can proofread and edit the order. After the clinician verifies the data and hits “send,” the MModal server formats the order in a way Intermountain’s CPOE system can understand.

The app also works with iPads, since voice commands are transmitted via the app, not as phone calls. “It really only does require an Internet connection,” Handler says. By the same token, the system currently does not work with standard landline or cellular phones or non-Apple smartphones.

Initially, Intermountain will use the system only for medication orders, but clinicians there will be testing the app for such tasks as laboratory, imaging and observation orders, according to Handler. “Part of our development at Intermountain Healthcare will be testing to see what kinds of workflows work” with this technology, he explained.

“The ability for a physician to dictate common prescription orders and have them seamlessly integrated into our electronic medical record system can create better productivity and improve patient safety,” Intermountain CIO Marc Probst says in a press release. Probst was not immediately available for further comment.

“We looked at the scenarios where there’s a clinician out and about,” Handler continues. Speech-enabled CPOE would come in handy in some but not all situations. “Either they forgot to do something or they just received some new information.”

Since this app is intended to be a convenience for specialists on call and others who might not be immediately available in person at Intermountain hospitals, do not expect physicians there to place major orders such as chemotherapy regimens by voice. “This is not the place where you would do a complex or risky order,” Handler says. It might be appropriate for treating more common ailments like minor rashes or pain, he says.

Simple is the rule since the quality of mobile voice recordings can vary so much. “There’s not an infinite amount of things you can do with this,” Handler says. “It’s a lot hard when you have to understand a lot of things.” However, he reports that the experience so far has been “shockingly excellent” and notes that there is the “human check” before orders get sent.

Intermountain is a development site for GE Healthcare and has an extensive health IT infrastructure in place, so it was imperative for MModal, formerly known as MedQuist, to create an app that worked with the existing electronic health record and CPOE system, Handler says. The user interface is less complex than that of an EHR, the MModal CMIO says, and both partners are working to make sure the app is “extensible to other customers.” That means it needs to work with more than just GE Centricity EHRs, he adds.

MModal is looking at a general release of the yet-unnamed app sometime this fall, but that will depend on how the prototype performs with practicing clinicians. “We want to make sure we give this thing a good test in the real world,” Handler says.