© ABBYY Confidential

ABBYY TechnologySummit2016

ABBYY NAHQ, 2016

Fuchang Yin

athenahealth, Inc.

© ABBYY Confidential

Million-Scale OCR at athenahealth

clinical document processing

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What does athenahealth do?

Cloud-based Electronic Health Record (EHR) that allows doctors to delegate work, document easily and stay focused on patients

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More specifically…

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What does an EMR look like?

Mail, phone, fax, & internet technologies carry information across the healthcare system

• Providers prefer established, fast, convenient, and secure communication technologies

• Extraordinary amounts of information are exchanged between patients, providers, pharmacies, labs, hospitals, insurance companies, and the government even in the course of routine care

• Fax is King – and the volume of paper is bewildering

www.sthlny.com/news/viewarticle.asp?a=2264

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Clinical Document Transmission Methods

• External documents:– FAX– Interface– Secure email

• Internal documents:– FAX– Scan– Upload– Mobile capture

Too Much Volume, Even for “Best Practices”

All of this volume ends up in a chart!

www.drchrono.com/blog/new-york-times-article-on-ehr-benefits/

Practices employ people, whose only job day-in and day-out, is to take documents from the fax machine and file them in charts…

www.sthlny.com/news/viewarticle.asp?a=2264

External FAX for Clinical Practices

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Document Automation Powered by OCR

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Document Classification

• 15 document classes

• 43 document sub classes

• Use natural language processing techniques to classify documents

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Demographic Data Capture

• Content:

– Provider– Patient– Clinical Provider– Other information

• Methods:

– Templates– Mouse select– OCR assisted key-in

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The Switch to ABBYY FineReader Engine

• Comparison:– Tesseract– Other commercial OCR engines– ABBYY FRE

• Performance Gain:– 50% automation gain over Tesseract, without tweaks– Eliminates spelling-check steps– Automatic page direction detection and layout analysis– Greatly reduced errors

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Implementation Insights

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Large OCR Volume at athenahealth

Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 -

2,000,000

4,000,000

6,000,000

8,000,000

10,000,000

12,000,000

14,000,000

16,000,000

18,000,000

20,000,000

20M

Per Month

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FAX and OCR System

• 100’s of telecom channels at multiple data centers

• Tens of thousands inbound FAX numbers

• Queueing system

• Distributed storage

• Scale up to hundreds of CPUs to perform OCR

• Batch processing in each ABBYY FRE process

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A Day of OCR Activity at athenahealth

12:00 AM 2:00 AM 4:00 AM 6:00 AM 8:00 AM 10:00 AM 12:00 PM 2:00 PM 4:00 PM 6:00 PM 8:00 PM 10:00 PM 12:00 AM0

100

200

300

400

500

600

700

800

900

Time of Day

Num

ber o

f Acti

ve F

RE P

roce

sses

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Distribution of OCR Time on Each Page

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 300%

5%

10%

15%

20%

25%

30%

35%

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Exception Handling in Workflow

• Long running OCR for a document– Over soft limit, keep OCR running and move on to next step– Over hard limit, terminate OCR process

• OCR errors– Fuzzy match with expected values– Aggregate multiple fields to make decision

• Human QA– Results of all automated steps are reviews by human QA

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Growing Use Cases of ABBYY OCR

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Making Doctors More Efficient

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• Automated Document Processing– Document label recognition– Clinical lab result capture – Duplicate document removal

• Full Document Search

• Many Others

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Questions?

ABBYY NAHQ, 2016

Fuchang Yin

athenahealth, Inc.

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Thank You!