How AI in the Exam Room Could Reduce Physician Burnout

A surge of new healthcare products, from wearable health trackers to diagnostic algorithms promising to improve medical outcomes, is prompting physicians and hospital executives to ask a fundamental question: “Are these technologies solving the right problems?”

Two ongoing developments add scale and urgency to this question. The first is a virtual gold rush of technology vendors looking to stake a claim in the healthcare information technology market, which is projected to top $390 billion by 2024 . The second is what the World Medical Association is calling a “pandemic of physician burnout,” caused by a staggering workload of electronic paperwork to document patient care for insurance coverage, financial reimbursement and medicolegal liability protection.

Healthcare information technology development should begin with a deep understanding of how clinicians need and want to work. Ambient clinical intelligence, or ACI, is one promising approach.

As the name indicates, ACI is not a device, but rather a set of capabilities as unobtrusively present and available in the exam room as light or sound. ACI takes the form of an inconspicuous array of microphones capturing the interaction between a patient and his physician through speech recognition technology. The data is then processed behind the scenes, in back-end and cloud-based systems. The system is able to interact with the physician through a flat-screen display.

ACI can provide diagnostic guidance and clinical intelligence. For example, it can highlight potentially overlooked diagnoses based on patient history and symptoms, as well as possible drug interactions and recommended alternative medications. The system responds in real time when the doctor asks to view patient histories or test results, prescribes medications, orders tests and schedules follow-up appointments. Once the patient visit is over, it creates a summary for the patient, updates the patient’s record and enters appropriate billing codes for the physician to review, edit and submit in the electronic health record, or EHR.

Patient privacy is necessarily integral to ACI. The patient data collected must be closely guarded, stored with the patient’s consent and repurposed only in anonymized form for clearly defined clinical purposes.

Today, an array of providers, including Nuance (where co-author Petro is chief technology officer), Microsoft (which has partnered with Nuance to accelerate ACI development and deployment), Google, Amazon.com and Apple are developing versions of the technology. Two of us (Ash and Rab) began pilots of Nuance systems at our institutions earlier this year. Early data and personal reports from physicians using ACI have been encouraging. For example, 95 percent of patients whose doctors used ACI during a visit have consented to being recorded, and turnaround time for ACI to complete reports in the EHR is 50 percent shorter than what we had anticipated.

One physician said that ACI “allows me to go back to being a physician versus a data-entry clerk and allows us to do what we wanted to do in a way that doesn’t fracture the patient-physician relationship.”

ACI and other new AI technologies can transform healthcare. But technical advancements alone cannot achieve the improvements we need in costs, quality and outcomes. That can happen only by designing technology that supports clinicians.

Copyright 2019 Harvard Business School Publishing Corp. Distributed by The New York Times Syndicate.