Nuance's vision of healthcare transformation & AI regulation

Nuance's Chief Clinical Information Officer Dr Simon Wallace shares his thoughts both on AI’s role in healthcare and how to effectively regulate its use

Nuance is a technology pioneer, with market leadership in conversational AI and ambient intelligence. Last year it was acquired by Microsoft and the company is now working together to drive better decision-making, improve clinician and patient experiences, create more meaningful connections and improve the quality of healthcare.

Dr Simon Wallace is the Chief Clinical Information Officer at Nuance in the UK and Ireland. Over the years, he’s worked as a GP, hospital and public health clinician in both Brighton and London.

“I’m really passionate about giving back and have a keen interest in the voluntary sector,” says Wallace. “I spent seven years as a Trustee for Fitzrovia Youth in Action, a London based charity focused on helping children and young people. In addition to this, I spent two and a half years as a Board Trustee for the Dublin Well Woman Centre, an organisation that helps Irish women access family planning, counselling and sexual health services.”

Wallace’s interest in health informatics began back in the 1990s when he spent a year at the King’s Fund, investigating the impact of the internet on shared decision making between patients and healthcare professionals. 

“Although many hospitals were in the very early stages of their digital transformation journeys at the time, the benefits were already clear to see,” he says. “It was obvious to me that this revolution was here to stay, and I wanted to be at the forefront of change.”

At Nuance, the team specialises in healthcare solutions that support a more natural approach to clinical documentation. 

Wallace says: “Our AI-powered solutions - which are utilised by over 10,000 healthcare organisations worldwide - help clinicians, radiologists and care teams across the health sphere to streamline the documentation process, revolutionising the doctor-patient relationship and driving better clinical outcomes.”

The Dragon Medical One solution uses conversational AI to accurately capture voice generated content directly into clinical systems. Compatible with all leading EPR systems used in the NHS, Dragon Medical One can help deliver improved quality of documentation and support national standards such as those recommended by the PRSB. 

“We’re proud that the technology is currently used within NHS Trusts up and down the country in both primary and secondary care, as well as community and mental health,” says Wallace.

The impact of generative AI in healthcare 

The recent explosive growth of foundation and large language models, such as GPT-4, point to a future in which clinicians and patients are empowered with personalised medicine, clinical decision support, increased patient access and workforce optimisation. 

“But while the overarching promise for the future of generative AI in healthcare is potentially huge, there are ways in which this technology is already shaping healthcare delivery today,” says Wallace. “For example, the healthcare industry is laden with administrative processes; many of which are manual, paper-based, time-consuming and error-prone.”

Modern technologies, such as AI–powered speech recognition, can be used to help relieve some of these pressures, enabling clinicians to work more efficiently and intelligently. These technologies are designed to recognise and record passages of speech, converting them into detailed clinical notes, regardless of how quickly the clinician speaks. 

“By reducing repetition and supporting standardisation across departments, they can enhance the accuracy as well as the quality of patient records,” says Wallace. “Frimley Health NHS Trust is a prime example of an organisation that has benefited from this technology. 

“In the past, the trust has relied on transcription services and handwritten reports for document and letter creation. This process worked, but it was slow and inefficient. 

“Paper records had to be scanned, then entered into electronic systems. Letters had to be typed up and sent out to patients and GPs. With the move to an Epic EPR, the Trust wanted to keep its staff using their voices - but it also wanted to ensure they could create documents and letters in a much more efficient, real-time way.” 

Frimley chose Nuance’s cloud-based speech recognition solution, Dragon Medical One, which accurately translates the voices of doctors, nurses and allied health professionals into detailed clinical narratives that feed directly into a Trust’s EPR.

However, Wallace believes that the use of AI in healthcare must be carefully regulated.

Regulation of AI use in healthcare 

“The conversation around regulation and AI in healthcare is ongoing – and rightly so,” he says. “As these tools become more powerful and embedded into our daily lives, we must ensure that they are safe.” 

As more regulation comes into force, the team at Nuance, is committed to ensuring that its AI platforms are both safe and secure.

“This is why we are getting behind Microsoft's Responsible AI Standards which guide the development of AI through every stage of its process and implementation. We want to ensure that patients and clinicians are at the forefront of this new technology but still feel as though their privacy is protected and their safety is prioritised.” 

Another example of healthcare innovation is 3D printing for prosthetics. Research from The Worldwide Health Organization suggests that 0.5% of the global population requires prostheses, but 95% do not have the access - which is where 3D printing can help. The Microsoft Accessibility Innovation offers support for those in low- and middle-income countries in the use of prosthetics 3D printing, to change the lives of many.

The adoption and use of AI is already transforming the delivery of services and treatment across the healthcare sector. Over the next 12 months, Wallace predicts that this will continue to expand.

“Next-generation AI has the potential to revolutionise healthcare by empowering clinicians to focus on a more personalised patient-centred medicine, strengthening the human interaction in medicine, reducing costs, and easing the administrative and cognitive burdens providers face,” he says.

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