Machine learning, AI can help ease the trend of physician burnout

Dr. Steven Waldren, vice president and chief informatics officer at the American Academy of Family Physicians, right, and Dr. Kamel Sadek, director of informatics at Village Medical, speak at the HIMSS22 conference in Orlando.

Photo: Jeff Lagasse/Healthcare Finance News

ORLANDO, Fla. – Even before COVID-19 made the business of healthcare a nightmare for countless physicians and clinicians, burnout was a prevalent issue. And even the slow, still-ongoing emergence into normalcy hasn't been enough to ease this trend: Clerical burdens, including clinical documentation, are a major contributor.

But for primary care physicians in particular, a new class of technology, including AI-powered digital assistants, is improving their capacity and capability, while reducing their administrative and cognitive burden.

Dr. Steven Waldren, vice president and chief informatics officer at the American Academy of Family Physicians, cited data showing that the average patient visit to a PCP takes about 18 minutes, and of that time, 27% is dedicated to face-to-face time with a patient. Forty-nine percent is consumed by EHR and desk work.

"A lot of the technology is not really designed to connect with patients," said Waldren. "Physicians and nurses don't necessarily give EHRs a passing grade."

The three main challenges to primary care, he said, are clerical burden, value-based payments and AI and machine learning, which fundamentally change what it means to be a physician. But innovations in the marketplace can be applied to the clinical setting, said Waldren, and if they focus on initial contact, comprehensiveness, and coordinated and continuous care, practices can improve both costs and quality while tackling the burnout issue.

In 2018, AAFP sought to do just that, developing processes to assess the value of AI-based solutions for primary care. The group called them "innovation labs," with the goal of gauging the value of emerging technology solutions.

"We have a lot of innovators in family medicine and primary care who are doing great things," said Waldren. "We try to help our doctors find a doctor like them and a practice like theirs. They have to find peers who have been there, done that and been successful. If you don't do that you're going to have a hard time doing this."

The innovation labs identify products that address the challenges of EHRs and clerical burden, and they're geared to be adaptable and usable by family physicians. 

To reduce EHR burden, the labs pinpointed a voice-assisted AI assistant for documentation. Instead of the typical voice recognition technology that simply transcribes a doctor's dictations onto a screen, the program understands commands and can respond to them, removing dictation from the equation entirely. 

In testing this particular piece of technology, the labs gathered 132 members from small practices across 40 states, with all reporting much higher satisfaction. That's largely because of a 50% reduction in documentation time.

"It's geared toward those with documentation burden," said Waldren. "Its key features arte integration into the EHR, mobility and it's affordable and adaptable at about $200 per month."

For the problem of clerical burden, the labs identified technology that resulted in a 70% decrease in physician prep time, and a 38% increase in RAF scores. Physicians ranked it 9.6 out of 10.

One of those physicians, Dr. Kamel Sadek, director of informatics at Village Medical, joined Waldren on the stage and testified to the solution's efficacy.

"It's been a year since we tested the product," said Sadek. "We just adopted it, and within 10 days, we had 230 physicians who wanted to start using the product. We're on the onboarding process as we speak. Many physicians want to use the dictation. So far it's been a very, very successful pilot study and adoption.

"You're not connected to the computers," he said. "You can use your phone, iPad, laptop, you can use it from your car, or while your kid is playing soccer. It's bidirectional. That gives you the brief information of what you've done, and based on that you can finish the note."

What convinced Sadek to utilize this approach was the efficacy and the practical aspect of being able to dictate from anywhere, to say nothing of reducing wasted time.

"With all of these things we have to right now in the notes, with value-based care, you have to monitor a lot of things that come from different departments," said Sadek. "In order to perform well, you have to look at all these things."

According to Waldren, health IT hasn't been very consumer-friendly to date. But newer apps are being built by companies that have experience in the more user-friendly consumer space, so the situation is beginning to improve. The best part is that they don't require a large up-front investment or complicated integration.

"One of the biggest challenges of getting a solution in is our doctors are so burned out," said Waldren, "and they don't want to look at something and decide if this is something that's going to work."
 

Twitter: @JELagasse
Email the writer: jeff.lagasse@himssmedia.com