WOHIT 2009 - Product Tutorial “ How to improve clinical documentation by combining speech recognition and clinical knowledge systems” 11/4/08

Overview of the Tutorial Presenters: Drew Karl, Business Development Manager, Elsevier Clinical Decision Support Klaus Stanglmayr, Strategic Product Marketing Manager, with Speech Magic

Presenters:

Drew Karl, Business Development Manager, Elsevier Clinical Decision Support

Klaus Stanglmayr, Strategic Product Marketing Manager, with Speech Magic

Overview of the Tutorial Summary We will showcase SpeechMagic's interoperability with Elsevier’s clinical reference and decision support tools. This will allow caregivers to use speech recognition, coupled with instant contextual access to clinically actionable, evidence-based content at-the-point-of-care, and in real-time. Our focus on the healthcare market is complemented by a solid clinical understanding, which leads to clinical documentation solutions with higher accuracy, convenience and efficiency. Both companies share a commitment to achieving higher levels of patient safety.

Summary

We will showcase SpeechMagic's interoperability with Elsevier’s clinical reference and decision support tools.

This will allow caregivers to use speech recognition, coupled with instant contextual access to clinically actionable, evidence-based content at-the-point-of-care, and in real-time.

Our focus on the healthcare market is complemented by a solid clinical understanding, which leads to clinical documentation solutions with higher accuracy, convenience and efficiency.

Both companies share a commitment to achieving higher levels of patient safety.

Objectives of the Tutorial Recognize the role of speech recognition technology in the daily work of healthcare professionals with their clinical systems Understand the benefits of combining clinical reference and decision support tools and speech recognition for improved care processes Learn how to improve your clinical documentation solutions with higher accuracy, convenience and efficiency

Recognize the role of speech recognition technology in the daily work of healthcare professionals with their clinical systems

Understand the benefits of combining clinical reference and decision support tools and speech recognition for improved care processes

Learn how to improve your clinical documentation solutions with higher accuracy, convenience and efficiency

Leading worldwide multiple-media publisher of Scientific, Technical and Medical information products and services. 7,000 Employees 70 Offices Worldwide 2,000 Journals Annually 1,900 Books Annually Also bibliographic databases and online reference works in support of clinical personnel across the globe. About Elsevier

Leading worldwide multiple-media publisher of Scientific,

Technical and Medical information products and services.

7,000 Employees

70 Offices Worldwide

2,000 Journals Annually

1,900 Books Annually

Also bibliographic databases and online

reference works in support of clinical

personnel across the globe.

About SpeechMagic Speech is the easiest and most common way to communicate between People …. ...and Technology!

Recognized Market and Clinical Leadership Industry Pioneer First continuous speech recognition First to introduce ISI First Citrix Ready vendor First Collaboration with Elsevier‘s ImageConsult and MDConsult Leading-Edge Innovation On the forefront of technological innovation Large network of integration partners (250+) Global Leadership The world‘s most successful speech recognition technology for professionals 9000 sites 63 nations 25 languages #1 front-end speech recognition solution “powered by SpeechMagic” 2006 and 2007 Best solution to increasing healthcare efficiency Diana Princess of Wales Hospital, Radiology Technology Idea of the Year USPE Hospitales for SpeechMagic implementation in Radiology University Hospital Virgen del Rocío for SpeechMagic integration into EMR Health Imaging and IT – Top 25 Innovators in Healthcare 2007 Stephen E. Rosenthal, MD, Associate Director, Emergency Department, Sir Mortimer B. Davis – Jewish General Hospital, Montreal, Quebec Technology Leadership Market leadership in European healthcare Best Practices Awards 2007 Global Excellence Award in Speech Recognition Technology Awards:

Industry Pioneer

First continuous speech recognition

First to introduce ISI

First Citrix Ready vendor

First Collaboration with Elsevier‘s ImageConsult and MDConsult

Leading-Edge Innovation

On the forefront of technological innovation

Large network of integration partners (250+)

Global Leadership

The world‘s most successful speech recognition technology for professionals

9000 sites

63 nations

25 languages

#1 front-end speech recognition solution “powered by SpeechMagic”

2006 and 2007

Best solution to increasing healthcare efficiency

Diana Princess of Wales Hospital, Radiology

Technology Idea of the Year

USPE Hospitales for SpeechMagic implementation in Radiology

University Hospital Virgen del Rocío for SpeechMagic integration into EMR

Health Imaging and IT – Top 25 Innovators in Healthcare 2007

Stephen E. Rosenthal, MD, Associate Director, Emergency Department, Sir Mortimer B. Davis – Jewish General Hospital, Montreal, Quebec

Technology Leadership

Market leadership in European healthcare

Best Practices Awards

2007 Global Excellence Award in Speech Recognition Technology

CDS use with proper guideline adherence can: Decrease Medication Errors Increase Monitoring & Surveillance Improve Overall Patient Care Improve Appropriate Resource Utilization Save Money Benefits

CDS use with proper guideline adherence can:

Decrease Medication Errors

Increase Monitoring & Surveillance

Improve Overall Patient Care

Improve Appropriate Resource Utilization

Save Money

ECDS offers a comprehensive suite of evidence-based, electronic knowledge solutions, delivering intelligence at the point of care – to all healthcare team members. Physicians Nurses Pharmacists Other Healthcare Professionals

ECDS offers a comprehensive suite of evidence-based, electronic

knowledge solutions, delivering intelligence at the point of care –

to all healthcare team members.

Physicians

Nurses

Pharmacists

Other Healthcare Professionals

Improving clinical outcomes, enhancing patient care and streamlining workflow, while introducing highly-effective efficiencies: Smart Applications User/System-friendly Integration No Info Overload Reduced Errors & Liabilities Accelerated Adoption of new Medical Research Benefits

Improving clinical outcomes, enhancing patient care and

streamlining workflow, while introducing highly-effective

efficiencies:

Smart Applications

User/System-friendly Integration

No Info Overload

Reduced Errors & Liabilities

Accelerated Adoption of new Medical Research

Relevant content that’s: Intelligent. Flexible. Timely. Unsurpassed. Delivered at the point of care Organized around Clinical Workflow Automatically Available. Immediately Actionable. Available at the Right Depth (Quick to Full) Adjusted for the Patient (directly from EHR) Features and Functionality

Relevant content that’s:

Intelligent. Flexible. Timely. Unsurpassed.

Delivered at the point of care

Organized around Clinical Workflow

Automatically Available. Immediately Actionable.

Available at the Right Depth (Quick to Full)

Adjusted for the Patient (directly from EHR)

Partnering with >500,000 practicing clinical experts, creating unrivaled content. First Consult MD Consult Procedures Consult Mosby’s Nursing Consult Mosby’s Nursing Skills Clinical Pharmacology Alchemy CPM Resource Center MEDai Brands Behind the Solution

Partnering with >500,000 practicing clinical experts, creating

unrivaled content.

First Consult

MD Consult

Procedures Consult

Mosby’s Nursing Consult

Mosby’s Nursing Skills

Clinical Pharmacology

Alchemy

CPM Resource Center

MEDai

Addressing Rapid Clinical Reference – The “Short Answer” FIRSTConsult is a web and PDA-based clinical information system that provides continuously-updated , evidence-based guidance on the latest in patient evaluation, diagnosis, and management — all written and designed for rapid access at the point of care ! FIRSTConsult offers: 1,800 potential diagnosis More than 800 medical topics Procedures on surgical and diagnostic procedures

Addressing Rapid Clinical Reference – The “Short Answer”

FIRSTConsult is a web and PDA-based clinical information system that provides continuously-updated , evidence-based guidance on the latest in patient evaluation, diagnosis, and management — all written and designed for rapid access at the point of care !

FIRSTConsult offers:

1,800 potential diagnosis

More than 800 medical topics

Procedures on surgical and diagnostic procedures

First Consult

Leverages patient information (in this case, Age) to narrow content selection Here, the user clicks a symptom and is taken directly to content relevant to both the symptom AND this patient’s age

Leverages patient information (in this case, Age) to narrow content selection

Here, the user clicks a symptom and is taken directly to content relevant to both the symptom AND this patient’s age

Tab-based metaphor presents content in easy to find sections and sub-sections Links allow drill-down into more detail on further pages

MD Consult Medical referential content integrated by web-based searching via right-click or search shortcut. Content powered by MD Consult. Deeper Information through books and journals – The “Long” Answer

Medical referential content integrated by web-based searching via right-click or search shortcut. Content powered by MD Consult.

MD Consult is designed to help physicians answer clinical questions and stay abreast with new developments in medicine. 51 leading medical textbooks in CORE 70+ full-text journals/clinics with MEDLINE Over 20,000 drug medications The latest medical news Peer-reviewed practice guidelines 9,500 customizable patient handouts 500+ Practice Guidelines POCKETConsult – included for your PDA www.mdconsult.com

51 leading medical textbooks in CORE

70+ full-text journals/clinics with MEDLINE

Over 20,000 drug medications

The latest medical news

Peer-reviewed practice guidelines

9,500 customizable patient handouts

500+ Practice Guidelines

POCKETConsult – included for your PDA

Physician Alert Fatigue One of the biggest [ sic ] , he says, is the annoying alerts that constantly pop up onscreen as he orders a patient’s dosage. "I honestly haven’t paid attention to a pop-up alert in years," says Halpern, who like many doctors believes that alerts should be limited only to those that might help avoid a serious medical error. "I just click right through them as quickly as possible and I think most doctors do the same thing," he says. Dr. Scott Halpern Hospital of the University of Pennsylvania

One of the biggest [ sic ] , he says, is the annoying alerts that constantly pop up onscreen as he orders a patient’s dosage. "I honestly haven’t paid attention to a pop-up alert in years," says Halpern, who like many doctors believes that alerts should be limited only to those that might help avoid a serious medical error. "I just click right through them as quickly as possible and I think most doctors do the same thing," he says.

Alchemy Benefits Eliminates False Positives (getting an alert when there should none) Eliminates False Negatives (not getting an alert when there should be one) Active and inactive allergy screening Unlimited Food/Lifestyle factors Eliminates “noise” for accepted duplicate therapies Assign multiple values to pregnancy warnings Updated Daily

Eliminates False Positives (getting an alert when there should none)

Eliminates False Negatives (not getting an alert when there should be one)

Active and inactive allergy screening

Unlimited Food/Lifestyle factors

Eliminates “noise” for accepted duplicate therapies

Assign multiple values to pregnancy warnings

Updated Daily

Drug to Drug Drug to Herb Interactions Drug to Food Drug to Lifestyle Interactions Drug Allergy & Allergy Cross-Sensitivity Drug Pregnancy Ratings Duplicate Therapy Alert Excessive controlled substances Decision Support Modules

Drug to Drug

Drug to Herb Interactions

Drug to Food

Drug to Lifestyle Interactions

Drug Allergy & Allergy Cross-Sensitivity

Drug Pregnancy Ratings

Duplicate Therapy Alert

Excessive controlled substances

Complex process of caring for patients Physicians, when questioned, 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

Physicians, when questioned, 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

Information overload The volume of information is growing at such a rate that is impossible to keep abreast of all the latest advances in clinical medicine. medical knowledge doubles every 18 months 55 clinical trials/day; 800 primary care guidelines/year total number of articles published in biomedical journals every year has reached 5000 (Prof. Paul Glasziou, 2005).

The volume of information is growing at such a rate that is impossible to keep abreast of all the latest advances in clinical medicine.

medical knowledge doubles every 18 months

55 clinical trials/day; 800 primary care guidelines/year

total number of articles published in biomedical journals every year has reached 5000 (Prof. Paul Glasziou, 2005).

The evolution of Speech Recognition Taking Intelligent Speech Interpretation - one step further

More than words Doctors simply dictate freeform Doctors do not think about layout, format and wording What you mean is what you get Only information counts Feels like an information exchange between experts Input is free form dictation and output is a structured report

Doctors simply dictate freeform

Doctors do not think about layout, format and wording

What you mean is what you get

Only information counts

Feels like an information exchange between experts

Input is free form dictation and output is a structured report

SpeechMagic InterOp 6.1 front-end SR instant documentation interactive real-time input is free form and output is a structured report instant feedback assistance at the point of dictation use of standardized medical terminology use of clinical reference and decision support tools

front-end SR

instant documentation

interactive real-time

input is free form and output is a structured report

instant feedback

assistance at the point of dictation

use of standardized medical terminology

use of clinical reference and decision support tools

SpeechMagic InterOp 6.1 Elsevier Product Demonstration