Clinical documentation requirements can be extensive and time-consuming. Although concurrent documentation is taught and encouraged, it is a skill that takes time to master – and even if done well, can cause a physician to feel or appear distracted during a patient visit.
CHALLENGE
Trying to actively listen and provide high-quality care while having to focus on accurately and completely recording the details of the conversation in a note can be a challenge even for an experienced therapist. Completing notes after a session leaves room for errors or incomplete and/or delayed documentation.
“Our employees have regularly expressed that they feel overwhelmed and are unable to keep up with documentation requirements,” said Marcie Dearth, chief operating officer of Impower, based in Longwood, Florida. “On average, they spent 20-25% or more of their work time taking notes. Morale was down and we were struggling with productivity.
“As a nonprofit, Impower serves many underinsured and uninsured clients,” she continued. “Reimbursement rates often do not fully cover the cost of services. This makes efficiency and quantity crucial – but we never want to sacrifice quality or impact. “Finding a solution to solve this problem didn’t seem realistic, but AI technology promised to do just that.”
APPLICATION
About two years ago, Impower was introduced to vendor Eleos at a behavioral health conference. The company’s artificial intelligence technology was presented as an creative way to assist reduce the time clinicians spend taking session notes, assist improve compliance and enable staff to better focus on client care.
“We were intrigued from the beginning, and when we heard from other providers who had used Eleos and what positive results they had seen, we knew we had to try it too,” Dearth explained. “In the simplest terms, the system runs in the background during the session, using environmental data collection to extract insights and include suggested text in the clinical note.
“Staff are assigned a small box-shaped machine that collects data, communicates with a computer and converts it into text in real time,” she added. “Staff still need to add and modify details, but the software provides a flowchart that speeds completion and improves accuracy. It can be used for telemedicine or in-person services.”
She said the preparation and implementation were quite uncomplicated. The practice spent about six months working with the vendor’s development team to adapt the AI technology to the practice. The next few months were devoted to testing the system and then training staff.
MEETING THE CHALLENGE
Impower is still in the early stages of using this technology and is learning more each week. It initially started in delayed summer 2024 with just a few therapists in the outpatient therapy unit. After initial tests and opinions, the remaining employees were trained, and the practice was launched in early October.
“Although it was not legally required – the system does not make any audio recordings – we have notified all our customers and modified our consent forms to reflect the use of artificial intelligence,” Dearth noted. “We were concerned that there might be some pushback from customers, but apart from a few questions, surprisingly very few refused to apply it or even questioned it.
“Interestingly, most of the resistance was internal,” she continued. “Some members of our clinical team were hesitant to learn something modern, a couple expressed fear or distrust of the technology, and several others weren’t convinced it would make much of a difference. After a miniature training, some coaching and a few question and answer sessions, we cleared up all the doubts and implemented the project quite smoothly.
The AI was only available for English-speaking customers. Today, Impower is also starting to apply it with Spanish-speaking customers. It is also in beta testing for apply in its psychiatric clinic; Impower hopes to have this up and running by the end of the first quarter of 2025 and also hopes to begin using the technology in its housing program soon.
RESULTS
“It is too early to present any concrete results, but we are already very motivated by what we see,” Dearth said. “We have 17 therapists actively using this technology and most say it helps them be more present with their clients during sessions.
“We are seeing more detailed clinical notes,” she added. “Anecdotally, we are seeing better compliance with documentation submissions – fewer late notes – and so far the technology has demonstrated a 23% reduction in the time it takes to complete session notes. We expect that as the AI continues to learn common topics and phrases used in sessions, this will be further reduced.”
At Impower, we are seeing a decline in delayed documentation. Generally, clinical staff love AI, which helps not only improve efficiency but also morale.
“We expect this will help us serve more people over time,” Dearth said. “We haven’t conducted customer satisfaction surveys yet, but we intend to do so soon so we can compare pre-Eleos data.”
ADVICE FOR OTHERS
Technology is advancing patient care at a rapid pace – and in the behavioral health space, its apply will become necessary to stay relevant and competitive, Dearth noted.
“We have already experienced this over the last 10 years,” she said. “Impower was a pioneer in the application telehealth to provide behavioral health services in Florida after transitioning our practice to a fully virtual model in 2013.
“When the world stopped a few years ago, we were fortunate to be ahead of the curve,” she continued. “Because we had a fully functioning telemedicine practice, we didn’t miss a beat – and in many ways, we were ready to help even more people.”
She said that now that the rest of the world had caught up with the competition, Impower no longer had an advantage.
“As an organization, our focus now is on continuing to improve its use and innovate,” she concluded. “Artificial intelligence helps us with this.”