Austin Regional Medical Clinic, a multispecialty medical group serving central Texas, provides primary and specialty healthcare to more than 475,000 area residents in 25 locations across ten cities. The group practice wanted to improve patient engagement and reduce physicians’ time entering data into its Epic electronic health record.

THE PROBLEM

Physicians today are challenged by working in electronic health records, said Dr. Manish Naik, chief medical information officer at Austin Regional.

“The user interface is suboptimal and clunky, leading to increased cognitive load,” he said. “Physicians are acting as the most highly trained data entry clerks in the world to complete many of their EHR workflows. To cope with these challenges, physicians have begun to bring the EHR into the exam room with their patients, taking focus away from the patient.”

Austin Regional had been searching for a solution that could help reduce the clerical burden on physicians, introduce efficiencies into their interactions with the EHR, and allow them to focus more on patients.

PROPOSAL

Austin Regional turned to vendor Notable Health for the solution to its challenge. Notable Health’s technology leverages an Apple Watch to document physician-patient discussions and uses speech recognition, AI, machine learning and natural language processing to parse the conversation down to its relevant pieces and accurately record them directly into the patient’s electronic record.

“The software assists with physician documentation because the physician can simply dictate their findings into the Apple Watch before, during and after a visit,” Naik explained. “Simply by stating the section that is being dictated, such as ‘HPI’ or ‘physical exam,’ the technology places the text in the correct section of the note.”

"This improved efficiency has also led to decreased symptoms of burnout from EHR documentation."

Dr. Manish Naik, Austin Regional Medical Clinic

The note is created using a combination of artificial intelligence and human quality checks. The physician reviews and signs the note in the EHR. The technology is able to incorporate certain types of templates for documentation for standardization and ease of use.

Further, the technology is able to integrate with the group practice’s Epic EHR to reduce the manual work associated with order entry, service codes and routine visits.

MARKETPLACE

There are many speech recognition technologies for physician dictation on the market, from vendors including Nuance Dragon Medical One, Fusion SpeechEMR, M*Modal, NuScribe, Radekal, VoiceboxMD and ZyDoc.

MEETING THE CHALLENGE

Austin Regional currently has more than 30 physicians successfully using the technology – and is adding new physicians every week – across various specialties: OB/GYN, internal medicine, general surgery, orthopedics, family practice, pediatrics, rheumatology and cardiology.

Specialists use the technology to both capture their visit documentation and reduce the administrative burden associated with common orders and visit codes.

“Incredibly, while the software is integrated on top of our Epic EHR, going live with Notable Health required very little work from our internal IT and EHR teams,” said Naik.

“At the onset, we certainly were skeptical that the software would be able to integrate so seamlessly with Epic,” he said. “But Notable Health’s team did all of the heavy lifting for us, and we were able to go live within a couple of weeks of signing the contract with them.”

Naik also is happy with the support the vendor provides. From the first day working with them, he explained, it was clear that the vendor’s team cared about the well-being of the group practice’s physicians and the vendor has continued to remain committed to providing an excellent experience to each new physician that goes live with the technology.

“Given the success, other teams utilizing this data are starting to look at how we can use this technology to seamlessly collect and transfer data from patients through payers accurately,” he said.

RESULTS

The project went live in just two weeks. Six months after implementation, physicians have seen meaningful improvements in clinical workflows and patient engagement. Physicians save critical documentation time (1-2 hours per day) enabling enhanced patient care and reducing the documentation burden that often leads to burnout.

“This improved efficiency has also led to decreased symptoms of burnout from EHR documentation,” Naik remarked. “Physicians have reported that they are able to see more patients throughout the day, focus more on their patients during office visits, and still leave the office earlier to spend more time with their families.”

ADVICE FOR OTHERS

“I would recommend that healthcare organizations evaluate their options for improving physician documentation efficiency, because there is clear evidence that physicians are feeling overburdened by the EHR, with many experiencing symptoms of burnout,” Naik advised.

“The effects of these burnout symptoms extend across an organization,” he said, “from the clinical staff that works with the MDs to the front desk team to the billing and coding organizations.”

Collecting data should not be difficult, and with technologies that provide intelligent automation, organizations now can be adventurous to explore new opportunities with voice, AI and seamless integration, Naik said.

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com