Speech Understanding automatically converts the spoken work into structured and encoded clinical data that provides access to relevant diagnostic support, evidence based medicine and real time alerts. Unlocking the data tucked away in the vast mountain of documents produced as part of delivering care to patients is possible today with Speech Understanding, the next generation of speech recognition technology that not only improves the overall efficiency of the documentation process by producing higher quality, more accurate clinical data but also produces structured encoded clinical data that can populate EMR’s that are crying out for high quality input. This information is encoded using the HL7’s Clinical Document Architecture (CDA) and Common Document Types (CDA4CDT). With knowledge of the meaning the output from Speech Understanding is now able to identify concepts, organize documents into meaningful categories and create a semantically interoperable document .