The potential of advanced tech to reduce clinician burnout
Ambient listening and generative AI can be brought together to reduce physicians’ work in patient encounters, cutting burnout and aiding patient interactions.
Electronic health records have long been associated with physicians’ workloads. In fact, a study reported in the Journal of the American Medical Informatics Association concluded that for every eight hours of scheduled patient time, ambulatory physicians spend more than five hours working in their EHR.
“Burdensome EHR systems are a leading contributing factor in the physician burnout crisis and demand urgent action,” according to Christine Sinsky, MD, the AMA’s vice president of professional satisfaction. She cites the need to “change EHR technology into an asset to medical care and not a demoralizing burden.”
Many hold out hope that artificial intelligence can be an enabling technology to reduce clinician burden, particularly in getting clinical findings into patients’ records. That’s beginning to happen, as systems powered by artificial intelligence and supported by ambient capabilities and generative AI have the potential to offer relief from documentation burdens.
Some major EHR technology providers are already making these capabilities available. For example, MEDITECH is integrating its records system with multiple voice assistant vendors to leverage ambient listening devices as digital scribes. Also, Oracle Cerner and Athena began the integration of Suki Assistant, which will enable the use of ambient listening and generative AI to automatically generate notes.
And this January, Epic reported that it’s embedded DAX Copilot as fully integrated within its electronic health records system. DAX Copilot – the result of a partnership between Microsoft, Nuance and Epic – automates the creation of clinical documentation during patient exams, drafting clinical notes, recording in-office and telehealth encounters in an Epic mobile application. It produces a draft clinical note that physicians can then review, change and approve.
The capability now is generally available to 150 health systems, hospitals and medical centers that use Epic to automate documentation.
How it works in practice
Early use of the ambient and generative AI solution has produced encouraging results. In 2023, Epic surveyed clinicians who had used the technology, and the clinicians reported a 50 percent reduction in time spent on documentation; a decline in cognitive burden, reducing feelings of burnout and fatigue by 70 percent; and an increase in the number of patients seen per days, with an average of seven minutes saved per encounter.
Use of the DAX Copilot occurs through Haiku, Epic’s mobile application, securely drafting clinical notes, says Brent Lamm, CIO at UNC Health, who says both clinicians and patients are seeing benefits. “Our providers are impressed, feeling confident that it will change how they work for the better,” Lamm adds. “We’re also hearing patients say how much they value the conversational interactions they have with their providers, and how they truly feel seen and heard during visits.”
UNC Health has been an Epic user for nearly 10 years, nearly the same length of time as it’s used Nuance Dragon. The transition to the new product has made sense, especially in light of additional workloads clinicians are facing after the COVID-19 pandemic.
“Coming out of the pandemic, we saw a 620 percent increase in the number of MyChart messages providers were receiving, and it was overwhelming them,” Lamm says. “We needed to make sure our providers weren’t burnt out, which meant removing as much administrative burden from them as possible.”
Explaining the benefits
Moving to using the DAX Copilot technology has been seamless, says Kristina Hines, DO, a family medicine clinician at its Grays Creek facility. “It is easy to use within Haiku on the phone, and most patients are very open to it,” she says. “It has increased my efficiency, helped me complete administrative tasks throughout the day instead of at the end of the day or only during administrative time,” which often occurs after a patient encounter.
As a typical clinician, Hines attests to the pressure she faces and how her clinical workload is grinding her down. Before moving to the documentation tool, “I used to have anxiety about coming to work on Mondays because of all the work I would have to do,” she admits. “Now, I come in, get my administrative tasks done, finish all my notes, and can pick my baby up from daycare on time – not missing time with him at home to finish notes and other work.”
Relieving clinician burden can help clinicians adapt to changing requirements in patient visits, care gaps to close or new initiatives, Hines says. “For once, this is something that makes my job easier,” she says. “The biggest long-term benefit is the most important thing to my generation, which is work-life balance. I think it will significantly reduce burnout rates … This might sound far out, but I believe this could become a huge recruiting tool when trying to hire physicians.”
UNC Health is still in the middle of its pilot implementation of DAX Copilot, and it’s looking for its own preliminary data to quantify benefits, Lamm notes. “We’re taking a purposeful approach to outcomes that are unique to our organization,” he adds. “We’re expected to be able to quantify time saved on documentation, minutes saved per patient encounter, and we can also expect to see additional appointments scheduled resulting from these time savings.”
Nuance has taken feedback from its clinicians and adapted the product, he adds. “We have plans to roll out DAX Copilot more widely – beginning in December, we have (expanded its use to) GI, cardiology and oncology providers, and we are seeing a lot of demand from them.”