MedCity Influencers, Artificial Intelligence

The promise of conversational AI in helping restore the doctor-patient relationship

EMR systems were designed with billing in mind, not physician efficiency, so it goes without saying that if technology can help alleviate the documentation burden, everybody wins

Artificial intelligence (AI) is known for using big data to detect anomalies in medical imaging, predict health outcomes, personalize treatment plans, even perform robotic surgery. One of the newest entrants to the AI movement is a form of “conversational AI” aimed at helping restore the doctor-patient relationship by alleviating the documentation burden.

Impact of electronic medical records on the doctor-patient relationship
Few would argue the quality of the doctor-patient relationship has been declining in recent years. A study by The Doctors Company showed that 54 percent of doctors believe the doctor-patient relationship is negatively impacted by electronic medical record (EMR) systems. Doctors report having a difficult time entering data to a computer while also observing the patient.

Documenting in the EMR also eats into visit time. A study published in the Annals of Medicine observed that doctors spend nearly twice as much time doing administrative work as seeing patients: 49 percent versus 27 percent. Inside the exam room, about half their time is spent in face-to-face discussions and care, while 37 percent is spent on EMR and other administrative work.

Opportunities for artificial intelligence to reduce the clinical documentation burden
The authors of The Doctor-Patient Relationship With Artificial Intelligence, published February 2019 in the American Journal of Roentgenology, described the potential of AI to address this critical issue: “Our most important role as physicians will be cultivated as AI alleviates the burden of performing the numerous tedious, repetitive, and often difficult tasks that physicians face, such as adding documentation to electronic medical records. AI may allow us to be more attentive to our patients and listen to their concerns instead of attending to documentation on the electronic medical record.”

Conversational AI is well suited to helping doctors realize this aspirational outlook. Voice-enabled technology is able to listen to conversations between doctors and patients that occur naturally during an encounter, whether in person or through a telehealth platform. The AI then captures, interprets and transforms the content required for the medical record, such as a SOAP note. No command language or trigger words are used, doctors just speak normally.

This type of AI serves as a catalyst for medical visits that are free of the distractions, demands and interruptions commonly present when doctors are tasked with documenting in the EMR concurrent to the exam itself.

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A Deep-dive Into Specialty Pharma

A specialty drug is a class of prescription medications used to treat complex, chronic or rare medical conditions. Although this classification was originally intended to define the treatment of rare, also termed “orphan” diseases, affecting fewer than 200,000 people in the US, more recently, specialty drugs have emerged as the cornerstone of treatment for chronic and complex diseases such as cancer, autoimmune conditions, diabetes, hepatitis C, and HIV/AIDS.

Dr. Eric Topol, author of Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again, recently said in a Tech Talks interview: “AI-derived notes from natural language processing and machine learning are quite remarkable. AI could be the greatest way to improve and restore the patient-doctor relationship, because of the gift of time.”

The Promise of a Better Patient Experience
So, imagine doctors having an additional six minutes inside a customary 12-minute visit to devote wholly to the patient . . . to ask the questions, do the screenings and explore the options that make the difference between good care and great care. They wouldn’t have to worry about documentation or feel like they’re racing against the clock. As importantly, patients wouldn’t feel rushed, but rather listened to and heard.

This ideal state was captured by the authors of a JAMA Viewpoint article, Promoting Trust Between Patients and Physicians in the Era of Artificial Intelligence: “Through greater automation of low-value tasks, such as clinical documentation, it is possible that AI will free up physicians to identify patients’ goals, barriers and beliefs, and counsel them about their decisions and choices, thereby increasing trust.”

EMR systems were designed with billing in mind, not physician efficiency, so it goes without saying that if technology can help alleviate the documentation burden — allowing doctors to spend more time with patients and deliver higher-quality care — everybody wins.

The good news is, that technology has arrived.

Photo: venimo, Getty Images

Dr. Graham Hughes has more than 25 years’ experience defining and delivering innovative healthcare technology solutions that address the unmet needs of clinical users. Hughes currently serves as President and Chief Medical Officer of Saykara, a Seattle-based startup pushing the boundaries of conversational artificial intelligence and long-form natural language understanding in a mission to liberate physicians from the burdens of electronic medical record documentation. Before joining Saykara, Hughes was Chief Executive Officer of Sutherland Healthcare Solutions, a leading business process transformation company. He previously served as Chief Medical Officer of the SAS Institute Center for Health Analytics & Insights, where he developed novel big data and population health solutions aimed at improving care quality, clinical operations and patient outcomes. Earlier in his career, Hughes spent six years as Chief Medical Informatics Officer and Vice President of Product Strategy at GE Healthcare IT, leading an advanced digital healthcare technologies innovation team and spearheading the organization’s knowledge platform strategy. Hughes is recognized for implementing the world's first fully paperless electronic medical record system. Over his career, he has worked closely with numerous luminary organizations, such as Mayo Clinic, Intermountain Healthcare and Cleveland Clinic. Hughes gained a medical degree as well as an undergraduate degree in neurobiology and neurosciences from King’s College London, University of London. He began his career as a practicing internal medicine specialist.