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Continued progress in reinventing the relationship between people and technology.

What is the big a-ha moment with your end users when you first demo your mHealth application for them?

Hermes SmartGuide Dictation is a voice-powered, digital assistant and dictation system that helps physicians get exactly what they need from Electronic Medical Records (EMRs) and medical knowledge sources. It enables physicians to create comprehensive, thoughtful clinical notes without the use of rigid templates.

Just as physician starts dictating the first sentence of a complex medical problem and then struggles to remember the key points that need to be addressed, they automatically appear in front of their eyes. Hermes recognizes what is being said in the dictation and automatically pulls information relevant to the dictation content. This can include a link to a recent clinical journal article or even the patient’s test results so this information can readily be integrated into the clinical note.

What are the top three features you view as most important when designing and building a mHealth app for physicians and/or patients?

  • The app needs to fit smoothly into the physician’s workflow, not the other way around.
  • The app needs to assist the physician in completing the main task, as well as other related tasks, without having to jump around to other pages or applications.
  • The app needs to be reliable and ready to use in an instant.

What challenges or needs did you see and/or experience in the industry that drove you to build this application?

EMRs, in their effort to capture more granular data, end up forcing a doctor to “pigeon -hole” their patients into a specific template or series of check boxes. This doesn’t fit into the physician’s workflow and makes clinical documentation look machine-generated. Moreover, the Centers for Medicare and Medicaid Services (CMS) already stated that providers who use template-based documentation may be subject to greater scrutiny. However, creating comprehensive documentation without templates is challenging and time-intensive. It’s difficult to remember all the key points needed to satisfy specific medical, legal and coding standards for the vast number of medical problems a doctor sees in a given day.

Also, physicians are constantly exposed to new medical knowledge through journals and Continuing Medical Education (CME) programs but when they see a patient, that knowledge is not easily accessible. To overcome this limitation, doctors carry “cheat sheets” or small notebooks containing pre-printed or handwritten notes on how to manage and document different medical conditions that they may encounter in practice.

Hermes helps address these hurdles by allowing the physician to dictate the clinical encounter using natural speech, rather than a rigid template. Hermes, however, goes beyond just a dictation system. It listens to what the user is dictating and based on the spoken content and context of the dictation, it unobtrusively presents to the physician an outline containing key points that may need to be addressed. In addition, a link or an excerpt from a pertinent knowledge source can be shown to the user.

Let’s take a simple example to illustrate this capability. Suppose a physician is dictating that a patient has a swollen leg. Hermes recognizes this and displays text suggesting that a leg DVT (blood clot) may need to be considered in the differential diagnosis. In addition, Hermes can show a standardized clinical prediction tool, such as the Wells’ criteria for diagnosing a DVT. This way, the user has the option of including this information in the clinical documentation.

What are the top features/benefits of your App?

Hermes SmartGuide Dictation is a patent-pending, digital assistant that integrates Nuance’s cloud-based speech recognition to streamline clinical documentation. Hermes can be integrated into any EMR or be used as a stand-alone app. The app allows a physician to easily dictate a clinical narrative, while providing user-specific, intelligent guidance based on the content as it is being spoken.

In one sentence, tell us what you think the future of mobile health will look like.

Mobile health will not be about one device or one app. It will be about the seamless integration of multiple devices – desktops, smartphones, tablets and novel devices like Google Glass – that will deliver anywhere, anytime access.

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Jonathon Dreyer

About Jonathon Dreyer

Jonathon Dreyer is the vice president of solutions marketing for Nuance where he is driving a physician-first approach to medicine by bringing cloud-based speech recognition and clinical language understanding technology to a worldwide community of healthcare IT developers and provider organizations. Prior to his current role, Jon worked as the solutions marketing manager for Diagnostic Imaging at Nuance and previously headed up marketing at Commissure Inc., a provider of clinical documentation and healthcare communication solutions. Jon graduated with Summa Cum Laude honors at Wayne State University where he earned a B.S business administration.