Challenges of developing a digital scribe to reduce clinical documentation burden.

Clinicians spend a large amount of time on clinical documentation of patient encounters, often impacting quality of care and clinician satisfaction, and causing physician burnout. Advances in artificial intelligence (AI) and machine learning (ML) open the possibility of automating clinical documentation with digital scribes, using speech recognition to eliminate manual documentation by clinicians or medical scribes. However, developing a digital scribe is fraught with problems due to the complex nature of clinical environments and clinical conversations. This paper identifies and discusses major challenges associated with developing automated speech-based documentation in clinical settings: recording high-quality audio, converting audio to transcripts using speech recognition, inducing topic structure from conversation data, extracting medical concepts, generating clinically meaningful summaries of conversations, and obtaining clinical data for AI and ML algorithms

Combining automatic speech recognition with semantic natural language processing in schizophrenia

Natural language processing (NLP) tools are increasingly used to quantify semantic anomalies in schizophrenia. Automatic speech recognition (ASR) technology, if robust enough, could significantly speed up the NLP research process. In this study, we assessed the performance of a state-of-the-art ASR tool and its impact on diagnostic classification accuracy based on a NLP model. We compared ASR to human transcripts quantitatively (Word Error Rate (WER)) and qualitatively by analyzing error type and position. Subsequently, we evaluated the impact of ASR on classification accuracy using semantic similarity measures. Two random forest classifiers were trained with similarity measures derived from automatic and manual transcriptions, and their performance was compared. The ASR tool had a mean WER of 30.4%. Pronouns and words in sentence-final position had the highest WERs. The classification accuracy was 76.7% (sensitivity 70%; specificity 86%) using automated transcriptions and 79.8% (sensitivity 75%; specificity 86%) for manual transcriptions. The difference in performance between the models was not significant. These findings demonstrate that using ASR for semantic analysis is associated with only a small decrease in accuracy in classifying schizophrenia, compared to manual transcripts. Thus, combining ASR technology with semantic NLP models qualifies as a robust and efficient method for diagnosing schizophrenia.</p

The digital scribe in clinical practice: a scoping review and research agenda

The number of clinician burnouts is increasing and has been linked to a high administrative burden. Automatic speech recognition (ASR) and natural language processing (NLP) techniques may address this issue by creating the possibility of automating clinical documentation with a "digital scribe". We reviewed the current status of the digital scribe in development towards clinical practice and present a scope for future research. We performed a literature search of four scientific databases (Medline, Web of Science, ACL, and Arxiv) and requested several companies that offer digital scribes to provide performance data. We included articles that described the use of models on clinical conversational data, either automatically or manually transcribed, to automate clinical documentation. Of 20 included articles, three described ASR models for clinical conversations. The other 17 articles presented models for entity extraction, classification, or summarization of clinical conversations. Two studies examined the system's clinical validity and usability, while the other 18 studies only assessed their model's technical validity on the specific NLP task. One company provided performance data. The most promising models use context-sensitive word embeddings in combination with attention-based neural networks. However, the studies on digital scribes only focus on technical validity, while companies offering digital scribes do not publish information on any of the research phases. Future research should focus on more extensive reporting, iteratively studying technical validity and clinical validity and usability, and investigating the clinical utility of digital scribes.Analysis and support of clinical decision makingDevelopment and application of statistical models for medical scientific researc

The dawn of the human-machine era: a forecast of new and emerging language technologies

New language technologies are coming, thanks to the huge and competing private investment fuelling rapid progress; we can either understand and foresee their effects, or be taken by surprise and spend our time trying to catch up. This report scketches out some transformative new technologies that are likely to fundamentally change our use of language. Some of these may feel unrealistically futuristic or far-fetched, but a central purpose of this report - and the wider LITHME network - is to illustrate that these are mostly just the logical development and maturation of technologies currently in prototype. But will everyone benefit from all these shiny new gadgets? Throughout this report we emphasise a range of groups who will be disadvantaged and issues of inequality. Important issues of security and privacy will accompany new language technologies. A further caution is to re-emphasise the current limitations of AI. Looking ahead, we see many intriguing opportunities and new capabilities, but a range of other uncertainties and inequalities. New devices will enable new ways to talk, to translate, to remember, and to learn. But advances in technology will reproduce existing inequalities among those who cannot afford these devices, among the world's smaller languages, and especially for sign language. Debates over privacy and security will flare and crackle with every new immersive gadget. We will move together into this curious new world with a mix of excitement and apprehension - reacting, debating, sharing and disagreeing as we always do. Plug in, as the human-machine era dawn