Method, apparatus, and system for facilitating healthcare workflows

Abstract

Provided herein is a method, apparatus, and system for a method, apparatus, and system for facilitating healthcare workflows, and more specifically, to improving the efficiency with which healthcare activities, particularly of a nurse, are performed through the use of artificial intelligence and natural language processing, voice to text capability, wearable technology, bi-directional access to the electronic health record and members of the care team.

Description

METHOD, APPARATUS, AND SYSTEM FOR FACILITATING HEALTHCAREWORKFLOWSCROSS-REFERENCE TO RELATED APPLICATIONS

[0001] This application claims priority to U.S. Provisional Application Serial No. 63 / 639,033, filed on April 26, 2024, the contents of which are hereby incorporated by reference in their entirety.TECHNOLOGICAL FIELD

[0002] An example embodiment of the present disclosure relates to a method, apparatus, and system for facilitating healthcare workflows, and more specifically, to improving the efficiency with which healthcare activities, particularly of a nurse, are performed through the use of artificial intelligence (Al), natural language processing (NLP) - including large language models (LLM), voice-to-text (Automatic Speech Recognition) systems, and wearable technology supported by visual video projections, artificial reality, and / or augmented reality.BACKGROUND

[0003] Healthcare professionals, and particularly nurses are generally responsible and accountable for hospitalized patients twenty-four hours a day, seven days a week, and as the frontline providers of care serve as care coordinators on behalf of the team and the primary safety net. The nurse role and workflow differ from of all other professional members (e.g., medical doctors (MDs), dietitians, physical therapists, social workers, etc.) on the patient’s team who are not at the bedside at all times. It thus is crucial to ensure nurses are supported with the tools needed to achieve the desired patient outcomes successfully. Clinician communication today, however, is mired in a bureaucratic technological chaos deeply compromising the quality of patient care. Nurses are leaving the profession at unprecedented rates with high levels of burnout. The average national hospital registered nurse (RN) turnover rate is higher than most professions and vacancy rates remain persistently well over 10%.

[0004] Before the implementation of Electronic Health Records (EHRs) nurses spent on average 9% of their time on documentation but by 2015 (post-EHR implementation) this amount of time had more than doubled to nearly 24%. Nurse documentation time during a 12-hour workshift has continued to steadily climb to be as high as 40-60%. Documentation burden has been directly linked to burnout and is now considered a national crisis by top health policy organizations including the American Nurses Association, the American Medical Informatics Association, and the National Academy of Medicine. All of these organizations are collaborating with each other and clinicians, the EHR vendors, other healthcare organizations, and insurance entities to alleviate the burden.BRIEF SUMMARY

[0005] Embodiments of the present disclosure provide a method, apparatus, and system for facilitating healthcare workflows, and more specifically, to improving the efficiency with which healthcare activities, particularly of a nurse, are performed through the use of artificial intelligence, natural language processing, voice to text and wearable technology, and visual video projections of EHR related data inputs and outputs.

[0006] Embodiments provided herein include a wearable device including: a microphone; a processor; a communications interface; where the processor is configured to: receive spoken instructions via the microphone; process the spoken instructions using natural language processing; generate an update to an electronic health record; and provide feedback via the communications interface associated with the update to the electronic health record. The communications interface of an example embodiment includes: at least one display device; and at least one sensor, where the at least one display device presents feedback to a wearer of the wearable device, and wherein the at least one sensor detects an interaction with the feedback.

[0007] According to some embodiments the at least one display device includes a projector to project a user interface on a surface. According to certain embodiments the at least one sensor includes at least one of a motion sensor or an image sensor, where the at least one sensor detects an interaction with the user interface projected on the surface. According to certain embodiments the interaction with the user interface projected on the surface includes a user selecting an object within the user interface projected on the surface, and where the processor is configured to perform an action based on the interaction.

[0008] The processor configured to process the spoken instructions via natural language processing includes in some embodiments processing the spoken instructions using a large language model to identify at least one command within the spoken instructions based at least inpart on a context of the spoken instructions. According to some embodiments the processor configured to generate the update to the electronic health record includes generating a Health Level Seven (HL7) message. The processor of an example embodiment is further configured to provide the HL7 message to an electronic health record system.

[0009] Embodiments provided herein include a method including: receiving, via a microphone of a wearable device, a spoken instruction; processing, using a processor of the wearable device, the spoken instruction using natural language processing; generating, using the processor, an update to an electronic health record based on the spoken instruction; providing feedback via a communications interface of the wearable device, the feedback associated with the update to the electronic health record. The method of some embodiments further includes providing for display of the feedback to a wearer of the wearable device; and detecting an interaction with the feedback.

[0010] According to some embodiments display of the feedback is provided using a projector of the wearable device to project a user interface on a surface. The method of some embodiments further includes detecting an interaction with the user interface projected on the surface using at least one of a motion sensor or an image sensor of the wearable device. The interaction with the user interface projected on the surface includes, in some embodiments, a user selecting an object within the user interface projected on the surface, and wherein the method further comprises performing an action based on the interaction.

[0011] According to some embodiments processing the spoken instruction using natural language processing includes processing the spoken instruction using a large language model to identify at least one command within the spoken instruction based at least in part on a context of the spoken instruction. According to certain embodiments generating an update to the electronic health record includes generating a Health Level Seven (HL7) message. The method of an example embodiment further includes providing the HL7 message to an electronic health record system and updating the electronic health record in response to the HL7 message.BRIEF DESCRIPTION OF DRAWINGS

[0012] Figure 1 illustrates a communication diagram of the device and system according to an embodiment of the present disclosure;

[0013] Figure 2 illustrates a wearable device worn about a wrist of a user according to an example embodiment of the present disclosure;

[0014] Figure 3 is a schematic diagram of an apparatus implemented to provide control of the wearable device described herein according to an example embodiment of the present disclosure; and

[0015] Figure 4 illustrates a flowchart of a method according to an example embodiment of the disclosure.DETAILED DESCRIPTION

[0016] Some example embodiments of the present disclosure will now be described more fully hereinafter with reference to the accompanying drawings, in which some, but not all embodiments of the invention are shown. Indeed, various embodiments of the disclosure may be embodied in many different forms and should not be construed as limited to the example embodiments set forth herein; rather, these example embodiments are provided so that this disclosure will satisfy applicable legal requirements. Like reference numerals refer to like elements throughout.

[0017] Embodiments provided herein addresses the clinical documentation burden placed on nurses revolutionizing nurse communication by replacing cumbersome processes and hardware with a solution that enables hands free any where / any time communication. Through a single wearable device, the nurse’s voice can activate hands free bidirectional communication with 1) patients and members of their care teams, and 2) the patient’s record (electronic health record - EHR). The wearable translates the nurse’s voice request / communication to text and sends to middleware where it is processed connecting it with the applicable data sources (in the patient’s record) needed to return the expected response to the wearable device as a voice, text or visual projection. Together the two anywhere / anytime device capabilities streamline and reduce communication and documentation time improving the efficiency and effectiveness of care decisions, reducing communication errors, and reducing dangerous iatrogenic infections caused by hands-on exposure to contaminated surfaces (e.g., computer hardware). Of special note are the interactions with the patient’s EHR (data entry and query) facilitated by the device and system’s artificial intelligence (e g., LLM and NLP) algorithms that substantially reduce documentation time and deliver high quality nurse decision support more usable and efficient, than has ever existed.

[0018] Embodiments of the device, systems, and methods described herein builds on the extensive research on care planning in the EHR that holistically addresses ongoing barriers toefficient and effective communication among nurses, patients, other healthcare team members and the EHR. Embodiments described herein reduce documentation time, improve EHR content supporting better decisions and care, and satisfy patients and nurses. Embodiments further include a component that allows direct communication (voice to voice, text to text, email) with nurses and other members of the healthcare team.

[0019] In the current healthcare environment, nurses typically rely on a variety of types of computer hardware (e.g., desktop computers, computers on wheels (COWs), and iPads) and locations of them to enter and access information while attending to patients. It also takes time for nurses to find and communicate directly with colleagues (team members) not in the same location (e.g., nurse down the hall, physician not on the unit). Both situations result in inefficiencies and potential errors due to the inefficiencies. The common use of computer hardware to document at the point of care, however, also serves as a barrier to nurse / patient interactions compromising the quality of care. The practice limits nurse eye contact and attention both crucial to establishing a rapport with the patient enabling the capture of key information and visual cues that can dramatically impact the decisions about and outcomes of care. Embodiments described herein provide an innovative solution that supports effective nurse communication with team members and also allows nurses to engage patients continuously and seamlessly while ensuring accurate and efficient data entry and retrieval and high-quality decisions about care.

[0020] Embodiments of the method, apparatus, and systems described herein introduce a novel solution designed to enhance and transform nurse-patient interactions, care, and clinician to clinician communication in healthcare settings. Embodiments replace traditional hardware used to a) communicate directly with other team members (nurses, physicians, other healthcare workers) and b) access, document, and retrieve electronic health record care data (desktop computers, computers on wheels (COWs), iPads etc.) with a simple multi-purpose smart wearable technology and middleware infrastructure. This innovation allows the nurse to interact directly with a) other health care providers and b) the patient’s record through voice commands (entering, retrieving, correcting EHR content) and supports the video projections of the nurse requested outputs (anytime and anywhere on the patient’s unit.

[0021] The patient’s record component of example embodiments enables nurses to access and interact with the patient’s record system (EHR) without the need of traditional computer hardware for entering, viewing, and retrieving patient information or clinical decision support. Additionally,the capture of nurses’ and patients’ voices with the device-setup allows for automated data entry and optimization of the documentation and retrieval processes. A variety of artificial intelligence (Al) tools are used to interpret and record the speech commands that drive data entry; correction of errors; synthesis and retrieval, clinical decision support, and display format of outputs. The video projection capabilities of device-setup support the convenient visualization of patient information in desired formats enabled by any flat surface (requiring no additional hardware or equipment). The video projections allow “air touch” as another form of data entry requiring no additional hardware but delivering the capabilities similar to touch screens on conventional hardware. With the device-setup nurses have the real-time capability to document and evaluate critical information anytime anywhere promoting informed decision-making and improving patient care outcomes at the point of care. By implementing the device set-up and method, nursepatient interactions are enhanced, documentation time is reduced, and care quality is improved.

[0022] A smart wearable device (e.g., watch, lanyard or other) enables two types of bidirectional communication anytime / anywhere: A) direct communication nurse to nurse or other members of the health team and B) interfacing directly with the patients’ records - entering information / data, requesting information, displaying output.

[0023] Embodiments provide voice activated direct communication of nurse with other team members not present in location of nurse anywhere / anytime (e.g., seeking help of another nurse, providing information to team member, contacting physician for support or order).

[0024] The device of example embodiments provides voice activated seamless bi-directional interaction with the patient’s record to enter data / information, query, retrieve, and display requested outputs. The interface will allow the nurse to ultimately add or change information in the patient’s record, query the patient’s record, request information including decision support, and view patient data, reports, and clinical decision support via the video functionality through intuitive gestures (jaw movement detection of speech) and voice commands. Visualizations of responses are in turn video projected from the wearable device via voice commands and movement of the wrist (for wearable worn on the wrist). The wearable will directly perform some of the simple functionalities and route the more complex functions through middleware that in turn will directly interact with the patient’s record on the EHR server.

[0025] The key capabilities of patient record function of embodiments include advanced voice capabilities in which commands are processed using a variety of Al tools (e.g., large languagemodels (LLM), machine learning, deep learning techniques) to record data, and / or locate and synthesize patient record information and generate requested outputs in user or system specified formats (e.g., provide suggestions for care plan content represented with standardized terminologies; warn of errors) for effective visualization. The Al tools collectively minimize manual data entry errors, streamline the documentation process, and enable the delivery of reports and clinical decision support at the point of care tailored to the user’s needs. This capability in part was made possible by the regulations promulgated by the 21st Century Cures Act. As a result of this legislation healthcare organizations (via their EHR vendors) are now required to provide “access to all data elements of a patient’s electronic health record to the extent permissible under applicable privacy laws”. These elements, called the United States Core Data Set for interoperability (USCDI), were created by and are updated each year by the Office of the National Coordinator (ONC). The USCDI provides directions for standardizing local data elements and making them available for use in improving the interoperability of patient data. The legislation and regulations have officially removed barriers to extracting and utilizing patient data gathered in vendor built EHRs. This new legislation is a major driver enabling our innovation to dramatically and positively impact documentation burden, quality of care, and patient and nurse satisfaction.

[0026] According to some embodiments described herein, the smart wearable contains video projector capability that allows the nurse to visualize key patient record data extracted and synthesized from the EHR in the format supporting high quality and timely decision-making at the point of care. The projector can display the key patient record information on any flat surface existing in a hospital patient room or outpatient setting. For example, nurses can view care plans, specific laboratory results, medical histories, or a synthesized summary of “today’s” patient record entries compared to yesterday. The compact display allows nurses to access key (up to date) information to monitor the patient’s status effectively anytime and anywhere. Nurses can also provide a personalized and collaborative experience with patients by sharing the record visualizations. Nurses, through voice commands can make edits / corrections / additions to the information being displayed in real-time, with the patient’s participation, providing a personalized interactive experience with the patient record and the care being provided.

[0027] The overall structure of embodiments of the present disclosure is designed to support interoperability across all systems that utilize the system setup which is vendor neutral. This meansthat data gathered, processed and returned through use of the system setup will be standardized and can thus be readily exchanged and compared.

[0028] In sum the system setup innovatively enables through a single wearable a) nurse to team member direct communication and b) eliminates external computer hardware for accessing the patient’s record enhancing data capture, access and evaluation of the patient related information in the EHR and the tailored visualizations of the outputs. The benefits are specifically enabled by voice recognition, mobile / wearable video projection, and use of Al tools to enhance the quality of outputs all through the device and system any time / any where communication system. Finally, the elimination of external computer hardware significantly reduces the barriers to effective nurse-patient interactions, reduces cost of computer hardware maintenance, reduces iatrogenic infections, and enhances patient engagement and nurse and patient satisfaction.

[0029] Figure 2 illustrates an example embodiment of a wearable device 210 worn about a wrist 210 of a user. As shown, the wearable device 210 includes at least one display 215 and a projector 220. The display 215 may include a touchscreen display where a user can provide input via the display, such as to control the projector 220. The projector 220 projects display 240 along dashed lines 225. The display 240 can be presented on any surface such as a floor, table, wall, patient bed, etc. The wearable device 210 further includes sensor 230. The sensor 230 can include a motion sensor, image sensor, or the like and is used to track user input on the display 240. The field of view of the sensor 230 is depicted in dotted line 235 and encompasses the area of the display 240. The sensor 230 can enable a user to touch a location on the projected display 240 and the sensor can interpret the input to correspond to a particular user interface element, for example. This enables interaction with the projected display 240 on any surface.

[0030] The wearable device of embodiments provided herein may be embodied by apparatus 300 which can embody the wearable device. Figure 3 is a schematic diagram of an example of a apparatus 300 that may be implemented to provide control of the wearable device described herein. The apparatus 300 may include or otherwise be in communication with a processor 310, a memory 320, a communications module 330, a user interface 340, and one or more sensors 350. As such, in some embodiments, although devices or elements are shown as being in communication with each other, hereinafter such devices or elements should be considered to be capable of being embodied within the same device or element and thus, devices or elements shown in communication should be understood to alternatively be portions of the same device or element.

[0031] In some embodiments, the processor 310 (and / or co-processors or any other processing circuitry assisting or otherwise associated with the processor) may be in communication with the memory 320 via a bus for passing information among components of the apparatus. The memory 320 may include, for example, one or more volatile and / or non-volatile memories. In other words, for example, the memory 320 may be an electronic storage device (e.g., a computer readable storage medium) comprising gates configured to store data (e.g., bits) that may be retrievable by a machine (e.g., a computing device like the processor). For example, the memory 320 could be configured to buffer input data for processing by the processor 310. Additionally or alternatively, the memory could be configured to store instructions for execution by the processor.

[0032] The processor 310 may be embodied in a number of different ways. For example, the processor 310 may be embodied as one or more of various hardware processing means such as a coprocessor, a microprocessor, a controller, a digital signal processor (DSP), a processing element with or without an accompanying DSP, or various other processing circuitry including integrated circuits such as, for example, an ASIC (application specific integrated circuit), an FPGA (field programmable gate array), a microcontroller unit (MCU), a hardware accelerator, a specialpurpose computer chip, or the like. As such, in some embodiments, the processor may include one or more processing cores configured to perform independently. A multi-core processor may enable multiprocessing within a single physical package.

[0033] In an example embodiment, the processor 310 may be configured to execute instructions stored in the memory 320 or otherwise accessible to the processor 310. Alternatively or additionally, the processor 310 may be configured to execute hard coded functionality. As such, whether configured by hardware or software methods, or by a combination thereof, the processor 310 may represent an entity (e.g., physically embodied in circuitry) capable of performing operations according to an embodiment of the present invention while configured accordingly. Thus, for example, when the processor 310 is embodied as an ASIC, FPGA or the like, the processor 310 may be specifically configured hardware for conducting the operations described herein. Alternatively, as another example, when the processor 310 is embodied as an executor of software instructions, the instructions may specifically configure the processor 310 to perform the algorithms and / or operations described herein when the instructions are executed. However, in some cases, the processor 310 may be a processor of a specific device configured to employ anembodiment of the present invention by further configuration of the processor 310 by instructions for performing the algorithms and / or operations described herein.

[0034] The communications module 330 may include various components, such as a device or circuitry embodied in either hardware or a combination of hardware and software that is configured to receive and / or transmit data for communicating data between an electronic health record system and the wearable device, for example. In this regard, the communications module 330 may include, for example, an antenna (or multiple antennas) and supporting hardware and / or software for enabling communications wirelessly. Additionally or alternatively, the communications module 330 may include the circuitry for interacting with the antenna(s) to cause transmission of signals via the antenna(s) or to handle receipt of signals received via the antenna(s). For example, the communications module 330 may be configured to communicate wirelessly such as via Wi-Fi (e g., vehicular Wi-Fi standard 802. l ip), Bluetooth, mobile communications standards (e.g., 3G, 4G, or 5G) or other wireless communications techniques.

[0035] The user interface 340 may be in communication with the processor 310, such as the user interface circuitry, to receive an indication of a user input and / or to provide an audible, visual, mechanical, or other output to a user. As such, the user interface 340 may include, for example, one or more buttons, light-emitting diodes (LEDs), a display, a speaker, and / or other input / output mechanisms. The user interface 340 may also be in communication with the memory 320 and / or the communications module 330, such as via a bus. The user interface 340 may include an the projected user interface from the projector 220 described above.

[0036] The communications module 330 may facilitate communication between network elements where the apparatus 300 communicates remotely such as with a hospital system and / or an electronic health records system. The communications module 330 may be capable of operating in accordance with various first generation (1G), second generation (2G), 2.5G, third-generation (3G) communication protocols, fourth-generation (4G) communication protocols, fifth-generation (5G) communication protocols, Internet Protocol Multimedia Subsystem (IMS) communication protocols (e.g., session initiation protocol (SIP)), and / or the like. For example, a mobile terminal may be capable of operating in accordance with 2G wireless communication protocols IS-136 (Time Division Multiple Access (TDMA)), Global System for Mobile communications (GSM), IS-95 (Code Division Multiple Access (CDMA)), and / or the like. Also, for example, the mobile terminal may be capable of operating in accordance with 2.5G wireless communication protocolsGeneral Packet Radio Service (GPRS), Enhanced Data GSM Environment (EDGE), and / or the like. Further, for example, the mobile terminal may be capable of operating in accordance with 3G wireless communication protocols such as Universal Mobile Telecommunications System (UMTS), Code Division Multiple Access 2000 (CDMA2000), Wideband Code Division Multiple Access (WCDMA), Time Division-Synchronous Code Division Multiple Access (TD-SCDMA), and / or the like.

[0037] The apparatus 300 may optionally include or be connected to one or more sensors 350, such as an image sensor, a motion sensor, or the like for sensing interaction of a user with a projected display. Such a sensor 350 could optionally detect gestures, motions, and other interactions through which commands can be provided to the apparatus 300.

[0038] Figure 4 illustrates a flowchart of a method according to an example embodiment of the disclosure. It will be understood that each block of the flowchart, and combinations of blocks in the flowchart, may be implemented by various means, such as hardware, firmware, processor, circuitry, and / or other devices associated with execution of software including one or more computer program instructions. For example, one or more of the procedures described above may be embodied by computer program instructions. In this regard, the computer program instructions which embody the procedures described above may be stored by the memory 320 of an apparatus 300 employing an embodiment of the present invention and executed by the processor 310 of the apparatus. As will be appreciated, any such computer program instructions may be loaded onto a computer or other programmable apparatus (e g., hardware) to produce a machine, such that the resulting computer or other programmable apparatus implements the functions specified in the flowchart blocks. These computer program instructions may also be stored in a computer-readable memory that may direct a computer or other programmable apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture the execution of which implements the function specified in the flowchart blocks. The computer program instructions may also be loaded onto a computer or other programmable apparatus to cause a series of operations to be performed on the computer or other programmable apparatus to produce a computer-implemented process such that the instructions which execute on the computer or other programmable apparatus provide operations for implementing the functions specified in the flowchart blocks.

[0039] Accordingly, blocks of the flowcharts support combinations of means for performing the specified functions and combinations of operations for performing the specified functions for performing the specified functions. It will also be understood that one or more blocks of the flowcharts, and combinations of blocks in the flowcharts, can be implemented by special purpose hardware-based computer systems which perform the specified functions, or combinations of special purpose hardware and computer instructions.

[0040] According to the flow chart of Figure 4, a spoken instruction is received at 410. This spoken instruction can be received, such as via user interface 340 which can include a microphone for example. The spoken instruction is processed at 420 using a natural language processing technique. This may include, for example, a large language model and may be processed by processor 310. An update to an electronic health record can be generated at 430 based on the spoken instruction. Feedback is then provided at 440 associated with the update to the electronic health record. This may be provided, for example, by a display device such as a projector as shown in Figure 2.

[0041] In an example embodiment, an apparatus for performing the method of Figure 4 above may comprise a processor (e.g., the processor 310) configured to perform some or each of the operations (410-440) described above. The processor may, for example, be configured to perform the operations (410-440) by performing hardware implemented logical functions, executing stored instructions, or executing algorithms for performing each of the operations. Alternatively, the apparatus may comprise means for performing each of the operations described above. In this regard, according to an example embodiment, examples of means for performing operations 410- 440 may comprise, for example, the processor 310 and / or a device or circuit for executing instructions or executing an algorithm for processing information as described above.

[0042] In some embodiments, certain ones of the operations above may be modified or further amplified. Furthermore, in some embodiments, additional optional operations may be included. Modifications, additions, or amplifications to the operations above may be performed in any order and in any combination.

[0043] Many modifications and other embodiments of the inventions set forth herein will come to mind to one skilled in the art to which these inventions pertain having the benefit of the teachings presented in the foregoing descriptions and the associated drawings. Therefore, it is to be understood that the inventions are not to be limited to the specific embodiments disclosed and thatmodifications and other embodiments are intended to be included within the scope of the appended claims. Although specific terms are employed herein, they are used in a generic and descriptive sense only and not for purposes of limitation.

Claims

CLAIMS:

1. A wearable device comprising: a microphone; a processor; a communications interface; wherein the processor is configured to: receive spoken instructions via the microphone; process the spoken instructions using natural language processing; generate an update to an electronic health record; and provide feedback via the communications interface associated with the update to the electronic health record.

2. The wearable device of claim 1, wherein the communications interface comprises: at least one display device; and at least one sensor, wherein the at least one display device presents feedback to a wearer of the wearable device, and wherein the at least one sensor detects an interaction with the feedback.

3. The wearable device of claim 2, wherein the at least one display device comprises a projector to project a user interface on a surface.

4. The wearable device of claim 3, wherein the at least one sensor comprises at least one of a motion sensor or an image sensor, wherein the at least one sensor detects an interaction with the user interface projected on the surface.

5. The wearable device of claim 4, wherein the interaction with the user interface projected on the surface comprises a user selecting an object within the user interface projected on the surface, and wherein the processor is configured to perform an action based on the interaction.

6. The wearable device of claim 1 , wherein the processor configured to process the spoken instructions via natural language processing comprises processing the spoken instructions using a large language model to identify at least one command within the spoken instructions based at least in part on a context of the spoken instructions.

7. The wearable device of claim 6, wherein the processor configured to generate the update to the electronic health record comprises generating a Health Level Seven (HL7) message.

8. The wearable device of claim 7, wherein the processor is further configured to provide the HL7 message to an electronic health record system.

9. A method comprising: receiving, via a microphone of a wearable device, a spoken instruction; processing, using a processor of the wearable device, the spoken instruction using natural language processing; generating, using the processor, an update to an electronic health record based on the spoken instruction; providing feedback via a communications interface of the wearable device, the feedback associated with the update to the electronic health record.

10. The method of claim 9, further comprising: providing for display of the feedback to a wearer of the wearable device; and detecting an interaction with the feedback.

11. The method of claim 9, wherein display of the feedback is provided using a projector of the wearable device to project a user interface on a surface.

12. The method of claim 11, further comprising: detecting an interaction with the user interface projected on the surface using at least one of a motion sensor or an image sensor of the wearable device.

13. The method of claim 12, wherein the interaction with the user interface projected on the surface comprises a user selecting an object within the user interface projected on the surface, and wherein the method further comprises performing an action based on the interaction.

14. The method of claim 9, wherein processing the spoken instruction using natural language processing comprises processing the spoken instruction using a large language model to identify at least one command within the spoken instruction based at least in part on a context of the spoken instruction.

15. The method of claim 14, wherein generating an update to the electronic health record comprises generating a Health Level Seven (HL7) message.

16. The method of claim 15, further comprising providing the HL7 message to an electronic health record system and updating the electronic health record in response to the HL7 message.

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