Medical records for practicing physicians have been a challenge since the creation of the medical chart. During his many years of practice, Dr. Will Carracino, chief medical information officer at the nonprofit health system Lee Health in Florida, recalls struggling with records from the first day he became a doctor.
PROBLEM
“It’s hard to put on a chart exactly what the patient feels,” Carracino explained. “When I was in practice, I would buy a really nice fountain pen to encourage myself to spend extra time charting, convincing myself that I would enjoy charting more with that accessory.
“Physicians appreciate the time spent serving and supporting each patient individually,” he continued. “Charting is time-consuming, taking away from the limited time a physician has with patients. This process also affects the quality of the patient-physician interaction. Taking notes, often on a computer, can be distracting and intrusive for both physician and patient.”
Although this process is sometimes burdensome, clinical documentation is an vital part of a practicing physician’s role. It is the documentation of the patient’s experience. The information and summary provided, also available to the patient, supports the improvement of the health and well-being of each person.
APPLICATION
“Historically, we’ve looked at different solutions for medical records,” Carracino noted. “The opportunity The utilize of generative AI has been presented as a solution that could improve the patient and doctor experience. Previously, the utilize of human transcription was a proven solution, but this option proved to be high-priced and involved the risk of human error.
“We started using voice recognition and natural language processing over a decade ago,” he continued. “The initial iterations were tedious. I used to explain that voice recognition software for natural language processing is like trying to train your spouse. There are things you can change over time, but for other things you just have to work within the structure of the relationship.”
He added that generative AI will require less training, give doctors back the ability to interact with patients without technology interfering with the conversation, and allow doctors to reclaim valuable time for both the patient experience and personal development, helping to prevent burnout.
MET THE CHALLENGE
Carracino said the fresh generative AI functionality is a game-changer.
“By simply placing a listening device in the room after receiving patient consent, the conversation is similar to that in a coffee shop, except it is medical,” he explained. “Gone are the days of the patient watching the doctor type away to document their experience. The AI focuses on medical issues, extracts social subtleties, and organizes the note into an easy-to-read, well-formatted medical document.
“We started with a pilot group of 20 providers,” he continued. “The provider profile included internal medicine, cardiology, pain management and pediatrics. Our plan was to find providers who could support new technologies but had the potential to improve documentation time or patient throughput.”
Lee Health’s AI transcription technology, Abridge, integrates seamlessly with Epic’s electronic health records. Providers find the process significantly less burdensome than previous documentation techniques.
RESULTS
Lee Health is still working to verify the exact results data, but Carracino listed five beneficial effects for now:
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Improved note completion, now occurring the same day for more than half of clinicians. Improved provider productivity and satisfaction; key to supporting providers and combating burnout. Based on pilot group pre/post survey questions, 74% of clinicians spent less time working off-hours, improving provider satisfaction and work-life balance.
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86% of physicians now feel they have enough time to document. Lee Health is monitoring the impact of this to improve patient access by allowing providers to add an additional patient per day to their schedule. This allows patients to schedule more quickly, already adding an average of two patients per week. By having time to document during their regular workday, physicians are able to complete their work.
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Reduced documentation errors. Increased charting time ensures that physicians can enter detailed and right patient information, reducing the likelihood of errors.
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Patients benefit from more attentive care and detailed consultations, which translates into higher levels of overall satisfaction with healthcare.
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Lee Health predicts improved physician retention rates. As burnout decreases, fewer physicians feel the need to leave the profession, which helps maintain a stable and experienced medical workforce, which further contributes to the overall quality of care. This improved workflow efficiency allows physicians to maintain a better work-life balance, reducing stress and improving job satisfaction.
ADVICE FOR OTHERS
“I don’t think anyone can deny that “Generative AI is going to transform healthcare in our country,” Carracino said. “The question is, how can that happen in a safe, productive, and effective way?”
“We have an AI governance committee in our organization, and that committee is made up of both operational and clinical leaders,” he advised others. “The committee looks at the value of implementing new technologies and capabilities to analyze what they can do for the patient and the provider.”
While each product has its own purpose, not all will be aligned with Lee Health’s mission and vision as a healthcare system.
“This will be an exciting piece of our medical history, and we need to approach it appropriately, both with the enthusiasm the vision deserves and by applying our classic techniques of evaluating a product for value and safety,” he concluded.
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