The future of healthcare: CMIOs weigh-in on the promise of virtual assistants

It's no secret that the healthcare industry is experiencing several profound disruptions, including new regulations, changing consumer demands and aging patient populations. These changes have created several serious obstacles for individual providers and healthcare organizations.

To improve outcomes and meet the demands of more-discerning patients, providers are reconstructing clinical approaches to care and attempting to create more personalized experiences for patients. While providers are armed with more tools and patient data than ever, wielding these advantages in a way that improves patient care can be a challenge. Learning new workflows and navigating information overloads can place a considerable burden on clinicians, which may contribute to widespread burnout.

In early 2018, Medscape published the results of its first "National Report on Physician Burnout and Depression." The report was based on survey responses from more than 15,000 U.S. physicians. Forty-two percent of respondents reported burnout and 15 percent reported experiencing some type of depression. Two of the top five factors contributing to burnout listed by respondents included being required to complete too many bureaucratic tasks and increasing reliance on EHRs.

So, how can hospitals and health systems empower clinicians with the technologies needed to improve patient care without overburdening them? Enter the virtual assistant.

While voice recognition technologies have supported accurate and convenient clinical documentation for some time, virtual assistant technology powered by artificial intelligence (AI) has taken a leap forward in the last year. With leading software developers like Nuance continuing to drive innovation in this space, the technology is poised to take yet another major step forward in the near future.

During Nov. 28 advisory call with several health system chief medical information officers, Nuance Vice President Kenn Harper described his company's current efforts to continuously evolve its AI-powered Dragon Medical Virtual Assistant platform. The call was hosted by Becker's Hospital Review and sponsored by Nuance, where Mr. Harper is Vice President of Healthcare Virtual Assistants. On the call, Mr. Harper described Nuance's work with virtual assistants as fitting into one of two buckets: user-initiated capabilities and fully automated ambient clinical intelligence. Several products with user-initiated capabilities have already come to market and will continue to advance in the coming years. These products allow clinicians to use voice-activated commands to streamline information requests and task completion in the EHR, such as navigating a patient chart or ordering a prescription. Fully automated ambient clinical intelligence is an emerging technology that automatically creates patient interaction summaries and compiles clinical facts from live physician-patient encounters.

"At Nuance, these are the two buckets that we're building out and bringing to market," Mr. Harper said. "We're excited about what's going to be showing up in the hospital over the course of the next couple of years."

With advancements in virtual assistant technology on the immediate horizon, Mr. Harper engaged the CMIOs on the call in a discussion about their experience with virtual assistant technology to date and where they believe the technology could be most helpful in the future.

Here are three key takeaways from the conversation:

1. Advancements in voice-recognition capabilities could improve physician adoption of virtual assistant technology. The CMIO of a health system in the southeast said his organization previously deployed voice-recognition solutions created by an EHR developer to help streamline processes within the EHR. While many physicians found the technology helpful, the organization struggled to achieve widespread adoption. According the CMIO, the training required to use the technology involved learning pre-selected verbal cues, which hindered buy-in.

"It has been a little frustrating because we just haven't had a lot of adoption," he said. "Making it easier for folks to [use], so they don't have to remember specific phrases … I think that's important."

Nuance has brought AI-powered voice-recognition solutions to market equipped with natural-language capabilities that do not require the user to learn pre-selected phrases, but rather are ready to handle a physician’s commands out-of-the-gate. These solutions could help organizations overcome barriers to adoption and improve user proficiency.   

"With natural language understanding we're able to [implement virtual assistants] without [that type of] training," Mr. Harper said. "Our hope would be that as more virtual assistants get out there … there's going to be this immediate awareness and mindfulness that there isn't this training that's required and there are useful things that these [solutions] can do." 

2. Care team burnout is still a problem in need of a solution. While multiple studies and surveys have identified an association between EHR use and physician burnout, the industry has yet to find a definitive solution to the problem. The CMIO of a health system in the northeast said his organization made addressing physician burnout a major priority, but the issue remains unresolved. The problem is exacerbated by the fact that many of the health system's physicians deliver care at different locations equipped with different EHR technology, meaning these providers must learn how to operate different platforms to complete the same tasks.

"You have a very powerful EHR that's getting more and more complex and it's more and more difficult to navigate, especially when you have … providers bouncing between institutions and having to retain usage efficiency within several EHRs," he said. "We've been looking for solutions to this. We think virtual assistants, and computing in general, is sort of a holy grail for this."

The EHR has become an essential component of patient care and reliance on the technology is likely to increase in the future. As physicians rely more heavily on digital record keeping and patient health data to deliver quality care and a positive experience, AI-powered virtual assistants and advanced voice-recognition technology could prove useful for reducing clinical documentation burden, as voice technology becomes a universal interface that can bridge the gap in EHR differences.

3. Hands-free documentation capabilities during medical procedures will be a gamechanger, according to the CMIO of an academic health system in the Northeast. The CMIO said being able to verbally request patient-specific information or information on a procedure itself while performing it could help boost surgeon performance. The CMIO also practices as an emergency medicine physician and said he could imagine such technology being particularly helpful in that specialty.

"Think of a surgeon in an operative suite, looking for information," he said. "[What if they] were able to call out with their voice [and get answers]?"

Mr. Harper shared the CMIOs excitement about such a possibility, adding that it would also allow physicians to perform real-time clinical documentation.

"Maybe you want to add something to a note on the fly, but you're not able because you're actually performing a procedure," Mr. Harper said. "I think this hands-free aspect of the virtual assistant is going to be the next wave, and that ties back to ambient [clinical intelligence], having a device in the room that's able to listen and respond in a hands-free way."

To learn more about Nuance's virtual assistant offerings, click here.

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