klaus stanglmayr friday, february 23, 2007 improvement in the quality of automated dictation by...

Klaus StanglmayrFriday, February 23, 2007

Improvement in the quality of automated dictation by making explicit use of semantic knowledge

2Klaus Stanglmayr, Tuesday, April 18, 2023

Philips Speech Recognition Systems


• A business unit of Royal Philips Electronics

• 12 years continuous speech recognition

• The world‘s most successful speech recognition technology for professionals

- 8000 sites- 50 nations

• Large network of integration partners (200+)

• On the forefront of technological innovation

Philips Speech Recognition Systems


Bringing sense and simplicity to life


...and technology!

Speech is the most common and easiest means of communication between people...


Speech Recognition in healthcare

7Klaus Stanglmayr, Tuesday, April 18, 2023 4

Healthcare Expenditures will grow from ~8% of worldwide GDP to ~10% in 2010

49%

28%

8%

2%

13%

North America

Western Europe

Japan

China/Hong Kong

Rest of the World

Worldwide Healthcare Expenditure: US$3,300 bln in 2002

North America makes up 49%of the worldwide spent

Source: Medistat

0%

2%

4%

6%

8%

10%

1950 2000 2010Source: WHO

Healthcare is the world’s largest service sector


Sources: Russ Coile, Futurescan 2003, SG-2

Imagingearlier diagnosis saves lives and reduces costs

Minimally invasive surgeryreducing patient trauma and costs

Healthcare IT Right Information at the right time

enables better treatment and lower costs

Molecular MedicinePreventing disease from happening

Medical technology continues to transform Healthcare

Around 70% of the survival improvement in heart attack mortality is a result of changes in technology.” Cutler & McClellan, 2001


Hands-free Interaction in the Hospital

• Advanced voice control technology

• Enables clinicians to interact with medical equipment when their hands are already occupied


Clinical Documentation – primarily by speech• Primary use of Speech

Recognition in healthcare is for clinical documentation

• A large chunk of patients health records was dictated; free text

• Clinician dictates as usual• Speech recognition

technology creates a draft that is reviewed edited by medical transcriptionist using keyboard or speech

• Transcript is returned to clinician for review and authentication and insertion into record


Medical Transcription

Transcription Costs

Technology

0

5

10

15

20

Billion $

2005 Future

Technology replaces Medical Transcription Costs

•Estimated $18 to $25 billion industry

•Estimated 300,000 to 400,000 MTs in US


Documentation is the lifeblood of healthcare


Complex process of caring for patientsClinical documentation comprises the essential building blocks for all healthcare processes

Each step must be accurately and thoroughly documented

Delivering care is a complex process with many potential failure points.

Errors in medical care are usually not due to negligence by medical staff

Physicians, when surveyed, indicate that they are most interested in capabilities

- that reduce documentation time- positively affect their communications with

patients, other physicians, and payers- provide clinical information to minimize their

time away from non-patient functions


Challenges in Healthcare

Diminished quality of healthcare

-Inadequate information

-Illegible entries

-Misinterpretations

-Lack of shareable information

-Lack of uniform capture


NLP/NLU• One of the tasks that an NLP system can perform is the parsing of a

sentence to determine its syntax. Determining the semantic meaning of a sentence is a much harder task to perform. When an NLP system can achieve this, we can talk about Natural Language Understanding (NLU).

• "Understanding" language means, among other things, knowing what concepts a word or phrase stands for, and knowing how to link those concepts together in a meaningful way. It's ironic that natural language, the symbol system that is easiest for humans to learn and use, is hardest for a computer to master. Long after machines have proven capable of inverting large matrices with speed and grace, they still fail to master the basics of our spoken and written languages.


SPEECH UNDERSTANDING • Understands the entire context of dictation and recognizes the

physician’s intent, while adapting to a variety of speaking styles and dictation habits

• Technology has the flexibility to handle the way people really speak—with varying accents, dialects, styles, and speeds

• Converts free text into structured information• Organizing Meaning

• Technology gleans meaning from spoken words and organizes it automatically into meaningful categories

• Automatically structured documents enable efficient review• Automatically adds normals, templates, macros

• Encoding Data• Services process dictation, encode clinical facts, like

medications, dosages, allergies, measurements like blood pressure readings, and much more.

• Semantic Interoperability


Intelligent Speech Interpretation (ISI)

Challenges for traditional speech recognition systems

•human speech/human speakers are not perfect

•punctuation omitted•disfluent speech •hesitations •pauses•silences•redundant speech•repetitions/corrections

Focus on optimizing speech recognition: “make it work in the “real” world”


Challenges – A perfect speaker?POSTOPERATIVE_DIAGNOSIS[AAHHMMMMM] Status post complete oral and dental rehabilitation PERIODNEXT_PARAGRAPH [OOHHMMMMM][NEXT SECTION] OPERATION PERFORMED Complete oral and dental rehabilitation PERIODNEXT_PARAGRAPH[cough]ANESTHESIAGeneral anesthesia by the anesthesia staff PERIOD NEXT_LINEDuration of surgery: Close to 45 minutes.Incision: none.NEXT_PARAGRAPH[NEXT SECTION] [________________][paper rustling] [________________]FINDINGS [AAHHMMMMM] The patient is a 22-year-old male with missing teeth and permanent dentition COMMA mental retardation COMMA seizure disorder COMMA microcephaly COMMA and gastroesophageal reflux disease PERIOD Since [__] March first 2004 COMMA there has not been much change in the appearance of the patient PERIOD [AAHHMMMMM] The patient also had periodontal disease evidenced by moderate bone loss COMMA hyperplastic gingiva and to three to seven millimeter pockets PERIODNEXT_PARAGRAPHThis is the end of dictation, thank you


Dictated Text Recognized Text

Standard phrases End of dictation. Thank you. Does not appear in final document.

Redundant phrases Send copy of report to Does not appear in final document.

Section headings Condition on/at/upon/of/ dischargeNext is condition...Next section is condition..

Condition on Discharge

Dates May five two thousand twoMay fifth two thousand two...

May 5, 2002

Automatic punctuation

No chills fevers night sweats weight loss... No chills, fevers, night sweats, weight loss...

Silences/pauses There has not been (------pause----) much change... There has not been much change.

Non-speech dictation There has not been (paper rustling) much change... There has not been much change...

Hesitations There has not been (AAHHMMMMM) much... There has not been much...

Contraction There hasn‘t been There has not been

Orthographic variants She is here today because she has a letter from her (obgyn) resident from the university...

She is here today because she has a letter from her Ob-Gyn or ob/gyn or ob-gyn or Ob/gyn (customizable) …

Understanding more...Intelligent Speech Interpretation


Final Report

POSTOPERATIVE DIAGNOSISStatus post complete oral and dental rehabilitation. OPERATION PERFORMED Complete oral and dental rehabilitation. ANESTHESIAGeneral anesthesia by the anesthesia staff.Duration of surgery: Close to 45 minutes.Incision: none. FINDINGS The patient is a 22-year-old male with missing teeth and permanent dentition, mental retardation, seizure disorder, microcephaly, and gastroesophageal reflux disease. Since March 1st 2004, there has not been much change in the appearance of the patient. The patient also had periodontal disease evidenced by moderate bone loss, hyperplastic gingiva and to 3-7 millimeter pockets.

John Smith, MDPhilips Hospital ViennaTriester Straße 64A1101 Vienna, Austria

Klaus Stanglmayr, Tuesday, April 18, 2023 22

For further information please contact: [email protected].: +43-1-60101-4110

http//www.philips.com/speechrecognition

All truth passes through three stages. First, it is ridiculed. Second, it is violently opposed. Third, it is accepted as being self-evident.

Arthur Schopenhauer

klaus stanglmayr friday, february 23, 2007 improvement in the quality of automated dictation by...

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