Voice Integration

Implementing voice capabilities in your clinical workflow

Voice Integration Overview

Speech-to-Text

Convert clinical conversations into structured SOAP notes with medical-grade accuracy.

  • • 98.5% accuracy on medical terminology
  • • Real-time transcription
  • • Multi-language support
  • • Noise filtering for clinical environments

Voice Commands

Control SynThera hands-free with voice commands for sterile environments.

  • • EHR navigation
  • • Medication ordering
  • • Lab result queries
  • • Patient data retrieval

AI-Generated Audio

Convert clinical insights and reports into natural-sounding speech.

  • • Patient summaries
  • • Medication instructions
  • • Procedure explanations
  • • Multi-language synthesis

Technical Architecture

Voice Processing Pipeline

Audio Capture

High-quality microphone input with noise cancellation

AI Processing

Whisper-based medical ASR with clinical NLP

Clinical Output

Structured SOAP notes and clinical insights

Core Components

Medical ASR Engine

  • • Custom Whisper model trained on 50M+ clinical hours
  • • Medical vocabulary: 500K+ terms and abbreviations
  • • Specialty-specific language models
  • • Real-time streaming with low latency (<200ms)
  • • Speaker diarization for multi-participant conversations

Clinical NLP Pipeline

  • • Named Entity Recognition (NER) for medical concepts
  • • Clinical relationship extraction
  • • Negation and uncertainty detection
  • • Temporal reasoning for medical events
  • • SNOMED CT and ICD-10 code mapping

Voice Command Engine

  • • Wake word detection ("Hey SynThera")
  • • Intent classification and slot filling
  • • Context-aware command interpretation
  • • Multi-turn conversation support
  • • Voice biometric authentication

Text-to-Speech Synthesis

  • • Neural voice synthesis with medical pronunciation
  • • SSML support for complex medical terms
  • • Multiple voice personas and languages
  • • Emotional tone adaptation
  • • Real-time streaming synthesis

SDK Integration

Quick Start

Get voice capabilities up and running in your application in minutes with our SDKs.

JavaScript/React Integration

// Install SynThera Voice SDK
npm install @synthera/voice-sdk

// Initialize the voice client
import { VoiceClient } from '@synthera/voice-sdk';

const voiceClient = new VoiceClient({
  apiKey: 'your-api-key',
  endpoint: 'https://api.synthera.health',
  features: {
    speechToText: true,
    voiceCommands: true,
    textToSpeech: true
  }
});

// Start voice transcription
const startTranscription = async () => {
  try {
    const session = await voiceClient.startTranscription({
      language: 'en-US',
      specialty: 'internal-medicine',
      realTime: true,
      onTranscript: (transcript) => {
        console.log('Transcript:', transcript.text);
        // Update your UI with the transcript
        setTranscript(transcript.text);
      },
      onStructured: (structured) => {
        console.log('SOAP Note:', structured);
        // Process structured clinical data
        updateSOAPNote(structured);
      }
    });
    
    return session;
  } catch (error) {
    console.error('Transcription failed:', error);
  }
};

// Voice command handling
voiceClient.onCommand((command) => {
  switch (command.intent) {
    case 'navigate_to_patient':
      navigateToPatient(command.entities.patientId);
      break;
    case 'order_medication':
      orderMedication(command.entities.medication);
      break;
    case 'query_lab_results':
      queryLabResults(command.entities.testType);
      break;
  }
});

// React component example
function ClinicalVoiceInterface() {
  const [isListening, setIsListening] = useState(false);
  const [transcript, setTranscript] = useState('');
  const [soapNote, setSoapNote] = useState(null);

  const toggleListening = async () => {
    if (isListening) {
      await voiceClient.stopTranscription();
      setIsListening(false);
    } else {
      await startTranscription();
      setIsListening(true);
    }
  };

  return (
    <div className="voice-interface">
      <button 
        onClick={toggleListening}
        className={isListening ? 'listening' : 'idle'}
      >
        {isListening ? 'Stop Listening' : 'Start Voice Transcription'}
      </button>
      
      <div className="transcript">
        <h3>Live Transcript</h3>
        <p>{transcript}</p>
      </div>
      
      {soapNote && (
        <div className="soap-note">
          <h3>Generated SOAP Note</h3>
          <div>
            <h4>Subjective:</h4>
            <p>{soapNote.subjective}</p>
            <h4>Objective:</h4>
            <p>{soapNote.objective}</p>
            <h4>Assessment:</h4>
            <p>{soapNote.assessment}</p>
            <h4>Plan:</h4>
            <p>{soapNote.plan}</p>
          </div>
        </div>
      )}
    </div>
  );
}

Python Integration

# Install SynThera Voice SDK
pip install synthera-voice-sdk

# Python implementation
from synthera.voice import VoiceClient
import asyncio

class ClinicalVoiceAssistant:
    def __init__(self, api_key, specialty='general'):
        self.client = VoiceClient(
            api_key=api_key,
            endpoint='https://api.synthera.health',
            specialty=specialty
        )
        
    async def start_transcription_session(self):
        """Start a voice transcription session"""
        session = await self.client.create_session(
            language='en-US',
            real_time=True,
            noise_suppression=True,
            medical_vocabulary=True
        )
        
        # Set up event handlers
        session.on('transcript', self.handle_transcript)
        session.on('structured_data', self.handle_structured_data)
        session.on('command', self.handle_voice_command)
        
        await session.start()
        return session
    
    def handle_transcript(self, transcript):
        """Handle real-time transcript updates"""
        print(f"Transcript: {transcript['text']}")
        print(f"Confidence: {transcript['confidence']}")
        
        # Process medical entities
        if 'entities' in transcript:
            for entity in transcript['entities']:
                print(f"Entity: {entity['text']} -> {entity['type']}")
    
    def handle_structured_data(self, structured):
        """Handle structured clinical data"""
        soap_note = structured.get('soap_note', {})
        
        if soap_note:
            print("Generated SOAP Note:")
            print(f"S: {soap_note.get('subjective', '')}")
            print(f"O: {soap_note.get('objective', '')}")
            print(f"A: {soap_note.get('assessment', '')}")
            print(f"P: {soap_note.get('plan', '')}")
            
        # Extract clinical codes
        codes = structured.get('clinical_codes', [])
        for code in codes:
            print(f"Code: {code['code']} ({code['system']}) - {code['description']}")
    
    def handle_voice_command(self, command):
        """Handle voice commands"""
        intent = command['intent']
        entities = command.get('entities', {})
        
        if intent == 'navigate_patient':
            patient_id = entities.get('patient_id')
            print(f"Navigating to patient: {patient_id}")
            
        elif intent == 'order_medication':
            medication = entities.get('medication')
            dosage = entities.get('dosage')
            print(f"Ordering medication: {medication} {dosage}")
            
        elif intent == 'query_labs':
            test_type = entities.get('test_type')
            patient = entities.get('patient')
            print(f"Querying {test_type} for {patient}")

# Usage example
async def main():
    assistant = ClinicalVoiceAssistant(
        api_key='your-api-key',
        specialty='cardiology'
    )
    
    session = await assistant.start_transcription_session()
    
    # Keep the session running
    try:
        while True:
            await asyncio.sleep(1)
    except KeyboardInterrupt:
        await session.stop()
        print("Session ended")

if __name__ == "__main__":
    asyncio.run(main())

Configuration Options

Audio Configuration

// Audio input configuration
const audioConfig = {
  // Microphone settings
  sampleRate: 16000,          // 16kHz for optimal ASR performance
  channels: 1,                // Mono audio
  bitDepth: 16,               // 16-bit depth
  
  // Noise suppression
  noiseSuppression: {
    enabled: true,
    aggressiveness: 'high',   // 'low', 'medium', 'high'
    adaptiveFilter: true      // Adapt to environment noise
  },
  
  // Echo cancellation
  echoCancellation: {
    enabled: true,
    mode: 'medical'           // Optimized for clinical environments
  },
  
  // Automatic gain control
  autoGainControl: {
    enabled: true,
    targetLevel: -18,         // dBFS target level
    compressionGain: 6        // dB compression
  },
  
  // Voice activity detection
  vad: {
    enabled: true,
    sensitivity: 0.7,         // 0.0 to 1.0
    timeout: 3000            // 3 seconds silence timeout
  }
};

// Language and model configuration
const languageConfig = {
  primary: 'en-US',
  fallback: ['en-GB', 'en-AU'],
  
  // Medical specialty models
  specialty: 'cardiology',    // or 'internal-medicine', 'surgery', etc.
  
  // Custom vocabulary
  customVocabulary: [
    'synthera',
    'echocardiogram',
    'troponin',
    'beta-blocker'
  ],
  
  // Pronunciation hints
  pronunciationHints: {
    'warfarin': 'WAR-far-in',
    'acetaminophen': 'uh-see-tuh-MIN-uh-fen'
  }
};

Clinical Processing Configuration

// Clinical NLP configuration
const clinicalConfig = {
  // SOAP note generation
  soapGeneration: {
    enabled: true,
    autoStructure: true,
    includeAssessment: true,
    includePlan: true,
    confidenceThreshold: 0.85
  },
  
  // Medical entity extraction
  entityExtraction: {
    medications: true,
    conditions: true,
    procedures: true,
    anatomy: true,
    dosages: true,
    timeExpressions: true
  },
  
  // Clinical coding
  clinicalCoding: {
    icd10: true,
    snomed: true,
    cpt: true,
    rxnorm: true,
    loinc: true
  },
  
  // Negation and uncertainty detection
  contextualAnalysis: {
    negation: true,           // "No chest pain"
    uncertainty: true,        // "Possible pneumonia"
    temporality: true,        // "Previous MI"
    experiencer: true         // "Family history of diabetes"
  },
  
  // Quality assurance
  qualityChecks: {
    spellCheck: true,
    medicalValidation: true,
    consistencyCheck: true,
    completenessCheck: true
  }
};

// Real-time processing options
const streamingConfig = {
  // Transcription streaming
  streaming: {
    enabled: true,
    chunkSize: 1000,          // milliseconds
    interimResults: true,
    punctuation: true,
    capitalization: true
  },
  
  // Structured data streaming
  structuredStreaming: {
    enabled: true,
    entityUpdates: true,
    soapUpdates: true,
    codeUpdates: true
  },
  
  // Performance settings
  performance: {
    lowLatency: true,         // Prioritize speed over accuracy
    batchProcessing: false,   // Process in real-time
    cacheResults: true        // Cache for faster subsequent processing
  }
};

Voice Commands Reference

Wake Word

All voice commands must start with the wake word: "Hey SynThera"

Navigation Commands

"Hey SynThera, open patient John Smith"

Navigate to specific patient record

"Hey SynThera, show lab results"

Display recent laboratory results

"Hey SynThera, go to imaging"

Navigate to imaging module

"Hey SynThera, show medication list"

Display current medications

"Hey SynThera, open new note"

Start new clinical documentation

Clinical Commands

"Hey SynThera, order CBC with diff"

Place laboratory order

"Hey SynThera, prescribe lisinopril 10mg daily"

Add medication to prescription

"Hey SynThera, schedule follow-up in two weeks"

Create appointment reminder

"Hey SynThera, add allergy to penicillin"

Update allergy information

"Hey SynThera, search for hypertension guidelines"

Access clinical decision support

Documentation Commands

"Hey SynThera, start dictation"

Begin voice-to-text transcription

"Hey SynThera, new paragraph"

Format dictation with paragraph break

"Hey SynThera, correct that to hypertension"

Make corrections to transcription

"Hey SynThera, save and sign note"

Complete documentation

"Hey SynThera, generate assessment and plan"

AI-assisted clinical reasoning

System Commands

"Hey SynThera, what's my schedule today?"

Query daily appointments

"Hey SynThera, show me urgent tasks"

Display priority action items

"Hey SynThera, read latest lab result"

Text-to-speech for hands-free review

"Hey SynThera, set timer for 15 minutes"

Clinical timer management

"Hey SynThera, help with voice commands"

Display command reference

Security and Privacy

HIPAA Compliance

All voice data is processed with enterprise-grade security and full HIPAA compliance.

Data Protection

End-to-End Encryption

AES-256 encryption for all voice data in transit and at rest

Zero-Knowledge Processing

Voice processing without persistent storage of PHI

Local Processing Options

On-device processing for maximum privacy

Audit Logging

Complete audit trail for all voice interactions

Privacy Controls

Voice Biometric Authentication

Verify clinician identity through voice patterns

Selective Recording

Choose which conversations to transcribe

Automatic Data Purging

Configurable retention policies for voice data

Privacy Mode

Disable voice features in sensitive conversations

Security Configuration

// Security configuration
const securityConfig = {
  // Encryption settings
  encryption: {
    algorithm: 'AES-256-GCM',
    keyRotation: '24h',
    tlsVersion: '1.3'
  },
  
  // Authentication
  authentication: {
    voiceBiometrics: true,
    multiFactorAuth: true,
    sessionTimeout: 3600,     // 1 hour
    maxFailedAttempts: 3
  },
  
  // Data retention
  dataRetention: {
    voiceData: '0h',          // Immediate deletion
    transcripts: '7d',        // 7 days
    structuredData: '7y',     // 7 years (compliance)
    auditLogs: '10y'         // 10 years
  },
  
  // Privacy controls
  privacy: {
    allowRecording: true,
    patientConsentRequired: true,
    anonymizeTranscripts: false,
    localProcessingOnly: false
  },
  
  // Compliance settings
  compliance: {
    hipaa: true,
    gdpr: true,
    auditTrail: true,
    accessLogging: true
  }
};

Troubleshooting

Common Issues

Microphone Not Detected

Voice transcription not starting or no audio input detected.

// Check microphone permissions
navigator.mediaDevices.getUserMedia({ audio: true })
  .then(stream => console.log('Microphone access granted'))
  .catch(err => console.error('Microphone access denied:', err));

// List available audio devices
navigator.mediaDevices.enumerateDevices()
  .then(devices => {
    const audioInputs = devices.filter(d => d.kind === 'audioinput');
    console.log('Available microphones:', audioInputs);
  });
  • • Check browser permissions for microphone access
  • • Verify microphone is connected and working
  • • Test with different browsers (Chrome recommended)
  • • Check system audio settings

Poor Transcription Accuracy

Transcripts contain errors or miss medical terminology.

// Optimize audio quality
const audioConfig = {
  sampleRate: 16000,
  noiseSuppression: { enabled: true, aggressiveness: 'high' },
  echoCancellation: { enabled: true },
  autoGainControl: { enabled: true }
};

// Use specialty-specific models
const voiceClient = new VoiceClient({
  specialty: 'cardiology',  // Improves medical term recognition
  customVocabulary: ['custom', 'medical', 'terms'],
  confidenceThreshold: 0.8
});
  • • Speak clearly and at moderate pace
  • • Reduce background noise in clinical environment
  • • Use headset microphone for better audio quality
  • • Select appropriate medical specialty model
  • • Add custom vocabulary for institution-specific terms

Voice Commands Not Recognized

Voice commands are transcribed but not executed.

// Debug command recognition
voiceClient.onCommand((command) => {
  console.log('Command recognized:', command);
  console.log('Intent:', command.intent);
  console.log('Entities:', command.entities);
  console.log('Confidence:', command.confidence);
});

// Enable command debugging
voiceClient.enableDebug({
  commandRecognition: true,
  intentClassification: true,
  entityExtraction: true
});
  • • Always start with wake word "Hey SynThera"
  • • Use exact command phrases from documentation
  • • Speak commands slowly and clearly
  • • Check that voice commands are enabled in settings
  • • Verify user has appropriate permissions for actions

Performance Optimization

// Performance monitoring
const performanceMonitor = {
  // Track transcription latency
  trackLatency: () => {
    const startTime = performance.now();
    voiceClient.onTranscript(() => {
      const latency = performance.now() - startTime;
      console.log(`Transcription latency: ${latency}ms`);
    });
  },
  
  // Monitor audio quality
  trackAudioQuality: () => {
    voiceClient.onAudioQuality((quality) => {
      console.log('Audio quality metrics:', {
        snr: quality.signalToNoise,
        volume: quality.averageVolume,
        clarity: quality.clarityScore
      });
    });
  },
  
  // Resource usage
  trackResources: () => {
    setInterval(() => {
      console.log('Memory usage:', performance.memory);
      console.log('CPU usage:', navigator.hardwareConcurrency);
    }, 5000);
  }
};

// Optimization settings
const optimizedConfig = {
  // Reduce processing overhead
  streaming: {
    chunkSize: 2000,          // Larger chunks for less frequent processing
    interimResults: false     // Disable interim results for better performance
  },
  
  // Batch processing for non-real-time scenarios
  batchProcessing: {
    enabled: true,
    batchSize: 10,            // Process 10 audio chunks together
    processingInterval: 1000   // Process every second
  },
  
  // Model optimization
  models: {
    useQuantized: true,       // Use smaller, faster models
    cacheEnabled: true,       // Cache model predictions
    prioritizeSpeed: true     // Speed over accuracy for real-time use
  }
};