Ambient Listening Transforms the Voice of Our Patients
Houston Methodist is piloting a new technology that can take a patient’s voice and transcribe it into a physician’s note in Epic. It’s called ambient listening, and it’s transforming the way we collect our patients’ medical information. Powered by artificial intelligence (AI), this technology captures each patient’s story, improving the exam room experience and saving time for our physicians.
This software works by securely converting the natural conversation between a doctor and a patient into a clinical note in Epic. This allows the provider to focus on the patient’s needs first and foremost, as opposed to having to physically capture all the information and document it. It provides a personal touch to patient visits by removing the data entry that can detract from meaningful conversations. Plus, clinicians aren’t bogged down typing while speaking and are better able to engage with, and actively listen to, their patients.
How it works
Last fall, a group of 25 HM physicians began using this technology, called Nuance DAX. They use an app on their mobile devices as they chat with patients and family members. The app securely captures medically pertinent information as AI technology organizes the data and creates a clinical note. The note is then sent to a human scribe who edits and confirms the summary within four hours, then forwards it to the provider for review. Once approved, the data is seamlessly added to Epic.
“We invited Nuance to visit with a group of physicians who were instructed to act like patients,” said Stephen Spielman, senior vice president and chief operating officer, Houston Methodist Physician Organization. “The physicians threw everything they had at the technology. One physician went on for 15 minutes pretending she was an elderly patient who wanted to talk about her nephew and her gardening abilities, only briefly mentioning that her knees were killing her when it’s cold outside. At the end of the mock visit, the technology was flawless — it picked up all the medical information and discarded all the chit chat. The physicians were impressed.”
Promising early feedback
Since last fall, this technology has supported more than 9,000 patient encounters. As more data is collected, HM plans to expand this technology to other areas. With improved clinical documentation efficiency, physicians are saving time, which allows them to see more patients, and HM can offer more appointment openings.
“Ambient listening with DAX is a tool that truly empowers our care teams,” said Dr. Jordan Dale, HM chief medical information officer. “It reduces the significant cognitive burden for a physician to remember and track all the details to construct their clinical notes and ensures higher quality notes for the clinic staff and patient to review after the visit. Physicians can now have more direct eye contact with their patients and focus on delivering care with empathy and compassion, rather than being distracted by the notes they must create.”
Spielman added that medical assistants (MAs) are also enjoying ambient listening. “When they’re asked questions by patients through MyChart, assistants can go back and read these detailed medical notes from the visit and have more context to get patients the right answers,” he said.
Comparing products
Later this spring when HM upgrades to the latest version of Epic, physicians in the pilot group will begin using another Nuance product called DAX Copilot, which is fully automated, with no human reviewers involved. Patient notes will be automatically drafted and delivered to Epic in real time.
At the same time HM is testing Copilot, we’ll conduct another pilot with a competing technology called Ambience. “It’s a new industry, there are a lot of players in it, and we’re trying to determine the best one for us,” Spielman said. He added that by mid-year, we’ll have about 50 physicians using these products and about 100 physicians by year’s end. “We hope to have a final decision on which vendor we’re going to go with by the end of this year,” he said.
Here to stay
In Houston, HM is currently the furthest along with this technology, according to Spielman, but other health care organizations are less than six months behind. “There are a couple of health systems nationally that are about a year into this fully-AI version of Nuance and are showing really great results, so we’re optimistic,” he said. “It’s such a hot topic right now in the physician practice arena nationally that I think it’s going to become a basic expectation that everyone has this.”
Spielman said he predicts health systems equipped with ambient listening technology eventually will be able to recruit physicians because of the time savings and efficiency. “Even at this early stage, it’s already an instant game changer,” Spielman added. “Physicians are saying they’re saving an hour or more a day. I foresee this technology integrating with other AI technologies to eventually help physicians with medical coding and to offer prescription suggestions. Ambient listening is here to stay.”