Patient reception and related manual activities performed early before a medical visit are a key element of the healthcare system’s operational efficiency and clinical quality.
As a result, some hospitals and primary care practices are experimenting with artificial intelligence and vast language models to focus on note-taking and writing.
With physicians burned out from spending more and more time in electronic health records (EHRs), could this technology be applied to other departments beyond the exam room?
Dr. Josh Reischer is CEO of Health Note, a platform provider that can automate pre-visit documentation and support optimize time spent in the exam room by reducing EHR time. We talked to him about the role of artificial intelligence in the patient admission process and other activities that improve workflow.
Q. You deal with ways to automate patient intake and manual tasks that arise before a doctor’s visit. Why is this area crucial to the overall performance of the health care system?
AND. Pre-visit interactions set the tone for the entire healthcare experience. If done well, patients and physicians can have a better encounter, administrative staff can be more competent, and organizations are best positioned to receive payment for the care they provide. If they are done poorly, you end up with the system we have today.
You wouldn’t show up to a job interview unprepared, but it’s the norm for doctors, and patients know when they need to re-share the exact information they filled out at home or in the waiting room. Doctors don’t have much choice in the matter, and the demands on them are overwhelming.
The goal should be to escalate efficiency for patients, staff and physicians. This means freeing everyone from telephone manipulation, paper surveys, repeated questionnaires and other unnecessary medical details. Moreover, when physicians are well-informed about their patients, it has the potential to improve the visit. They can ask recommendations, non-repetitive questions that will reassure the patient and lead to a better diagnosis.
We see physicians spending more time in the EHR. This is compounded by endless notes and “pajama time” that I struggled with slow at night because doctors have to code and summarize patient interactions in the EHR.
Only one in five doctors say they have enough time for documentationIn the same survey, 42% of respondents felt they had little control over their responsibilities, and more than one in two spent an excessive amount of time at home completing paperwork.
Income integrity and compliance is another group in healthcare systems that could benefit from a streamlined, automated process for accepting and receiving benefits. Depending on the type of billing, there are different documentation requirements and patient-reported outcomes that must be collected for each.
The solution is to collect appropriate patient-reported results prior to the start of the visit. Thanks to this, the doctor is reminded to confirm the need and does not have to worry about forgetting to add it. Traditionally, such updates require training and delays. However, workflow automation can support integrate these updates across all physicians and patients simultaneously.
Q. Healthcare systems are increasingly experimenting with AI and vast language models for note-taking and writing. Does this technology work in settings outside the exam room, or is it a one-trick pony?
AND. Generative AI is an amazing technology because it is so adaptable. I think AI will uproot some areas of our industry, but I don’t think it should displace humans. Most importantly, AI will support healthcare become more human than it is today.
It can feel like healthcare technology is in the awkward teenage years – still figuring out what its purpose is. Today’s healthcare technology is complicated and stupid and doesn’t always live up to expectations. Generative artificial intelligence seems to be the beginning of the next phase of maturity.
Scribes is a good first step for generative AI, but there are many apply cases in the patient-doctor journey that could be improved with technology beyond the visit. Yes, it starts with basic manual tasks and chores that are dated and unnecessary in healthcare today, but I’m excited about how healthcare can be better for everyone.
There are some significant benefits to applying AI to the front-end healthcare experience. For example, when a patient is admitted, a chatbot or clever engine can work with the patient to recognize their pain level, medical history, social factors that have been exacerbated in the past, or simply recall a previous medical visit.
Generative AI can communicate in multiple languages, translate medical transcripts, and empathize with patients. That’s a huge win for organizations that serve diverse and underserved populations.
Even throughout my career, I have seen the industry move away from paper templates and keyboards to buttons and touchscreens. I believe that artificial intelligence will unlock novel, more intuitive ways for us to communicate with each other and the technology that supports us.
Question: Physicians are spending more time working in EHRs, which is contributing to physician burnout. How can technology be improved so physicians can apply their time more efficiently and effectively?
AND. It was found that Clinician time spent on the EHR increased by 28 minutes from 2019 to 2023. This simply cannot happen, especially at a time when more and more healthcare workers are signaling that they want to leave the industry. Technology makes everyday life better and allows physicians to practice at the highest level of their license.
As cliché as it sounds, it’s true. Today’s tools would encourage me to stay in patient care. In 2018, I left internal medicine to co-found Health Note. We all want to see the eradication of paper notes; we constantly replay every minute of our patient interactions—the good, the bad, and the ugly—for the purpose of accounting and an dated billing model.
Artificial intelligence is already changing this, with documentation companies handling this part. We need to extend this to the medication process and other areas so that doctors can spend more time with patients and sleep better at night. Bottom line: Doctors can rely on technology to escalate personalization and get to know patients before interactions in the doctor’s office.
Q. Are there other ways in which health informatics design has failed? If so, how can it be fixed?
AND. In this first wave of innovation, doctors, nurses, and clinicians were completely bypassed at the design stage. I saw a lot of disagreement and misunderstanding about the applications of technology. That’s why I think more doctors like me are now developing much more practical tools.
We will need to work with EHRs for the foreseeable future – but it may evolve. Point solutions will disappear in the near future. Now it’s about enterprise platforms that can penetrate a variety of care settings and specialties, from urology to musculoskeletal. Healthcare has so many layers that you can’t design with just one apply case in mind.
It must be versatile enough to be applied to such a wide range of environments and populations, from rural Appalachia to Recent York City. As we brace for the Silver Tsunami of the aging Boomer generation, where 10,000 people turn 65 every daywe all expect health care utilization to escalate. Therefore, we urgently need to build a sustainable physician workflow and enable a personalized experience to meet the volume load.
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