Natural language processing: Opportunities and challenges for patients, providers, and hospital systems

In medicine, language, such as “history” of present illness and “chief complaints,” is used to understand patients’ experience. Language is a rich source of data by which physicians make inferences, build therapeutic alliances, document formulations in the electronic health record, and care for patients. In psychiatry, language is the main source of data as there are no objective laboratory tests for diagnosis of psychiatric illness. It is also a therapeutic tool in psychotherapy. There now exist computer-based automated approaches to language analysis that can serve as tools for diagnosis, documentation, and treatment. Here, we review the history of natural language processing and provide examples of its use in psychiatry, such as psychosis prediction and detection of intoxication, and in extraction of information from psychiatric portions of the electronic health record. We also review future directions for studying discourse (and turn-taking), and potential applications of automated analysis to concurrent modes of communication, including prosody, pauses, face expression, and gesture.