Inside HCA + Google's generative AI project

A leader from Nashville, Tenn.-based HCA Healthcare said physicians' reactions have been "generally pretty positive" to a new generative artificial intelligence project with Google.

HCA, the nation's largest health system, rolled out the pilot program with the tech giant in 2023, using AI to recap patient encounters in the emergency room.

Of 126 ER physicians at four HCA hospitals who were offered the technology, 79 signed up, according to Vikesh Tahiliani, MD, HCA's vice president of care transformation and innovation, speaking at a panel at last week's HIMSS 2024 conference in Orlando, Fla.

"They're definitely getting time back in their day, some of them more than an hour as a net positive," Dr. Tahiliani said. "What it's really afforded them is more time with the patient, at the bedside, and less time at the computer."

The platform employs an application from Augmedix to document the encounter and a Google large language model to summarize it.

The participating physicians have fallen into three groups, Dr. Tahiliani said: early adopters who now don't want the tool taken away, clinicians who are helping advance the platform but don't feel the technology is there yet, and physicians who say, "Come back to me when it's ready."

A big focus has been on change management, Dr. Tahiliani said. Where in the past, an ER physician would take mental notes on a patient — about, say, how their heart and lungs sound — before typing them out on a computer, now the clinicians have to say those things out loud so the iPhone with the Augmedix app can capture it.

"You talk to a provider who's been practicing the same way for 40 years and you're saying, 'Now you have to verbalize the physical exam,' you'll get there, but it's not going to happen on day one," Dr. Tahiliani said.

Still, the technology has been even more intuitive than expected. HCA scheduled an hour and a half to train each provider on the tool but it only ended up taking five to seven minutes per clinician, Dr. Tahiliani said.

Aashima Gupta, global director of healthcare solutions for Google Cloud, said many organizations don't have an executive sponsor for these projects and suffer from what she called "pilotitis": too many pilot projects that are not scalable and don't end up going into production.

"That's what I love about working with HCA. They have a clear strategy of where they're going," Ms. Gupta said at the panel. "It is not to test an interesting idea. This is not a science project."

Dr. Tahiliani said his ultimate wish is for healthcare to undergo a "paradigm shift," where providers spend about 90% of their time working with patients and the rest on administrative work, roughly the opposite of what it is now. Ambient listening and generative AI are good first steps to get there, he said: "We're just at the beginning."

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