How AI is lastly fixing the digital well being report [PODCAST]

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Doctor government Laura Kohlhagen discusses her article, “Right here’s what suppliers actually need in a contemporary EHR.” She argues that since digital well being data have been initially designed for billing and compliance, they’ve created disjointed workflows, cognitive fatigue, and clinician burnout. Laura explains how fashionable AI applied sciences are lastly reworking EHRs into the scientific instruments they have been at all times meant to be. She particulars how ambient listening know-how automates documentation, permitting physicians to concentrate on sufferers as an alternative of computer systems, whereas predictive analytics enhance operational effectivity and assist establish at-risk sufferers. AI can also be fixing long-standing interoperability challenges by normalizing and summarizing information from completely different sources. For sufferers, AI-powered platforms can provide proactive engagement and personalised schooling based mostly on social determinants of well being. The important thing takeaway is that whereas AI presents a path away from burnout and towards higher care, it should be carried out responsibly, with scientific usability and affected person security as the best priorities.

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Transcript

Kevin Pho: Hello, and welcome to the present. Subscribe at KevinMD.com/podcast. At present we welcome Laura Kohlhagen. She’s a doctor government, and immediately’s KevinMD article is, “Right here’s what suppliers actually need in a contemporary EHR.” Laura, welcome to the present.

Laura Kohlhagen: Thanks, Kevin, a lot. Comfortable to be right here.

Kevin Pho: All proper. So let’s begin by briefly sharing your story after which speak in regards to the KevinMD article that you just wrote.

Laura Kohlhagen: Positive. Comfortable to try this. So I’m an OB-GYN by background. Beginning out, that was an ideal specialty for me: an awesome mixture of main care in addition to the surgical aspect and delivering infants and being a part of that have for folk. It was simply actually thrilling. I began observe in Atlanta, Georgia—personal observe, very busy—and was rapidly overwhelmed by all the administrative necessities on physicians and, , one thing that we hear about simply continuously immediately. And I actually didn’t have the enterprise coaching to essentially deal with that as effectively as I wanted to.

We additionally had a number of billing challenges within the observe. You already know, being a really busy observe and having your income and your compensation measured by what number of sufferers that you just’re seeing. Not seeing these two metrics line up—the variety of sufferers I used to be seeing and the income that that was bringing in—I knew I wanted to study extra in regards to the enterprise aspect of medication. At that time, I used to be solely two years out of residency, so it was a giant choice, , going again. And I selected to return for a well being care-focused MBA and study that enterprise aspect. Whereas I used to be there, I actually acquired passionate in regards to the problem-solving, the method enchancment schooling that I obtained in that program: actually, Lean Six Sigma, idea of constraints, and the way that applies to well being care. In order that began me desirous about how I can broaden my profession past the scientific drugs aspect.

So I actually began to become involved in that and enthusiastic about that, and that’s the place my profession actually took a left flip into well being IT. And that’s the place I’ve been for the previous 14 years. So, a whole lot of my colleagues ask me, “Do you assume you wasted all that coaching?” Completely not. All the burdens that I felt as a brand new clinician beginning personal observe, these are issues that I now will help clinicians and assist drive the best way we, the merchandise that we create, the options that we create, and ensuring to make sure that scientific observe is less complicated for these clinicians to reduce that burden.

So, I’m actually excited to have the chance to try this. I now work for an EHR vendor as their CMO, so I’ve a really heavy affect on the course we take with our options and merchandise and talk with our shoppers to guarantee that the issues that we’re creating align with their wants.

Kevin Pho: So, after all, the digital well being report is without doubt one of the greatest well being IT challenges that each one physicians face, and you’ve got that distinctive perspective of each the scientific aspect and the aspect of the well being IT firm. So let’s speak about your KevinMD article. What’s it about?

Laura Kohlhagen: Proper. So I actually needed to write down this text to provide clinicians hope. So, what we’ve heard over the previous a number of many years is simply the rising burden and burnout brought on and positioned on clinicians by the EHR. So a whole lot of this know-how that’s quickly creating immediately can have rapid impression on that burden and people challenges. So I needed to begin by simply highlighting the historic challenges that I felt as a clinician that once I speak to clinicians on daily basis, these are the challenges that they’re feeling when it comes to disconnected workflows.

The EHR, like I stated within the article, it wasn’t designed for physicians. Initially, it was designed for billing, for regulatory compliance, and that DNA remains to be very a lot there, so clinicians have to switch their pure scientific workflow to suit throughout the confines of the EHR. In order that’s been a giant problem.

One other big problem that we see on daily basis is an absence of knowledge interoperability. So traditionally, EHRs, all of us developed our personal proprietary software program and actually weren’t incentivized to share that information. Organizations, hospitals, and well being care organizations additionally weren’t incentivized to share that information. So you actually get siloed footage of what’s occurring with these sufferers, and that is without doubt one of the greatest challenges that we hear from clinicians immediately. So the mixture of lack of knowledge and poor usability, these are issues that basically contribute to clinician burnout.

And what I see on the tech aspect is we actually have a whole lot of hope. We’re seeing a whole lot of enhancements which were promised for years and years and years which can be beginning to come to fruition that may have vital impacts on clinician workflow, clinician effectivity, and clinician satisfaction. In order that’s the place I get into speaking about AI. Proper? Everyone seems to be speaking about AI and the use instances in well being care.

So, what we’ve seen over the previous few years is an actual explosion of use instances for this know-how. So it began with ambient voice, and actually, ambient voice has been round for some time; it simply hasn’t been to the purpose of usability for the clinician on daily basis but when it comes to accuracy of these transcripts, price. You already know, there have been a whole lot of obstacles to adoption, and we’re lastly on the tipping level the place clinicians can benefit from a few of that know-how to ease the documentation burden.

Different issues which can be occurring within the AI area now are chart summarization. So finishing discharge summaries, giving me a fast snapshot of what’s been occurring with the affected person over the previous day, or, if I’m within the ambulatory clinic, over the previous, because the final time I’ve seen the affected person. How we’re modifying alerts to make them extra context-aware.

So lessening the usual pop-up alerts that plague us on daily basis and simply surfacing info that’s pertinent to what the clinician is doing with that affected person at that second, in addition to predictive analytics. So up to now, once I’ve needed a report created, I’ve needed to go to IT and ask for the report and wait a month or two for the report back to get created. Now we’re beginning to see on-demand dashboards that may be created by finish customers that don’t have expertise and experience in IT.

So it’s actually an thrilling time, and it’s now not “sometime.” You already know, we’ve talked about AI for years and years and years, nevertheless it’s by no means been actual, significantly for well being care, which traditionally has been slower to undertake know-how than different industries, nevertheless it actually immediately is making a big impression for clinicians in addition to sufferers.

So I didn’t even contact on the implications for sufferers when it comes to rising engagement by, let’s say, tailoring schooling to the precise wants of that affected person based mostly on their well being situation, their social determinant wants, et cetera, surfacing neighborhood assets that may assist that affected person, and permitting them to work together with the well being care group in a manner that is smart for them.

In order that’s why it’s such an thrilling time to be in well being care proper now, and we are able to actually see some actual options coming to fruition within the quick time period for each clinicians and sufferers and well being care organizations.

Kevin Pho: So, after all, on my web site and on this podcast, we’ve talked about that intersection between AI and well being care lots, and it’s so attention-grabbing to get views from folks throughout the well being care spectrum.

So that you talked about a number of improvements that AI may give throughout the context of the EHR. Now, carry that to life with a narrative. In an excellent state of affairs, inform us the distinction it makes to, say, any doctor in an workplace setting, a few of these AI instruments that you just’ve talked about. What would that appear like in actual life?

Laura Kohlhagen: Completely. So all of those handbook duties that I would like to finish immediately, resembling documentation, prescription writing, prior authorizations, orders, and referrals, a whole lot of this stuff will be automated and simply an automated byproduct of the interplay that I’ve with the affected person. So in particular, we take a look at functions for each generative AI and agentic AI.

So with generative AI, an awesome instance of that’s the ambient voice options that you just’re seeing immediately that may seize a dialog and generate a scientific notice based mostly on that dialog. So I see so many functions for that and saving physicians’ time and relieving that documentation burden. From an agentic AI perspective, that takes it one step additional.

Perhaps I’m having a dialog with the affected person and the AI resolution takes a take a look at the affected person’s chart and says, “Hey, like possibly you wish to place an order for this check based mostly on the affected person’s situation.” Effectively, the agentic AI is not going to solely place the order, however it will possibly additionally full the prior authorization wanted so it will possibly attain out to that payer API, perceive what information must be accomplished for that prior authorization, and full that prior authorization.

In order that takes a whole lot of time and handbook psychological power that’s immediately spent by the physicians and it places it the place it must be, permitting the physicians to have rather more concentrate on the affected person. So I do know a giant concern that suppliers have with AI is, “Is that this going to interchange me?” And completely not. AI is a instrument. It’s a instrument that may ease the handbook burdens that you must cope with immediately to permit you to actually concentrate on what’s occurring with the affected person. And that’s how I see it.

Kevin Pho: Now, when it comes to physicians being changed, I’ve heard opinion items as a result of to ensure that generative AI instruments to work, after all, they’re gathering a whole lot of information when it comes to how physicians communicate and the way they order. And naturally, now with these agentic brokers, it’s doing extra of the doctor duties. So, to take a opposite opinion, now with rising quantities of knowledge that these AI corporations have, what’s there to say that finally they will create an expertise much like going to a doctor?

Laura Kohlhagen: There isn’t any substitute for that non-public connection that physicians have with the affected person, that bedside method, that help that suppliers and physicians give to their sufferers. That’s why I see AI. Positive, it has the info, it has the data, however when a affected person’s going via a tough analysis, a tough state of affairs, AI is just not going to be their companion via that, via that point, via that analysis and that remedy. And that’s the place the doctor is available in.

In order that’s the place I see that AI isn’t going to interchange a doctor in that respect. It truly is a instrument to permit physicians to concentrate on sufferers. It provides them the complete affected person image, whereas immediately it’s very fragmented, and relieves them of all the handbook duties and rising burden that they’ve immediately and permits them actually to focus regardless of the psychological power that they’ve on the affected person and never on combating with the EHR or combating with the insurance coverage corporations—all the issues that physicians have to do immediately.

Kevin Pho: Have you ever heard a number of the suggestions from physicians as AI takes up extra of those duties? Do you’ve any metrics, any goal measures that these AI instruments do, in actual fact, save time and scale back doctor burnout?

Laura Kohlhagen: Yeah, we’re nonetheless pretty early in adoption, however we do have some early outcomes that do counsel time financial savings, significantly round ambient voice, and I talked about readjusting the main target of physicians away from the EHR and again to the affected person.

So some early research have proven that there’s a 20 p.c improve of targeted affected person time with ambient AI scribes versus conventional documentation. So, that’s only one instance. What I’ve really been stunned by lately is the elevated demand and how briskly that has occurred within the doctor neighborhood for a majority of these instruments.

Traditionally, well being care has been slower to undertake new know-how. And we’ve actually gone from, I might say, actually up to now six months, significantly in your neighborhood markets and your smaller well being care markets, from a stage of curiosity to a requirement for these instruments as a result of they’re actually beginning to see that in a real-world state of affairs, in on a regular basis observe, they’re making a distinction.

Kevin Pho: Is there something we have to be cautious of with regards to rising AI in that intersection with well being care? Any guardrails or simply something to watch out of?

Laura Kohlhagen: Completely. There’s lots to watch out of, so I’m glad you introduced that up. It’s simple to get very enthusiastic about AI and all the prospects, however we actually have to be cautious when it comes to what we level AI to do.

So desirous about, , is that this actually use case for AI? I don’t wish to throw AI at every part. We’ve got to be very thoughtful about how we practice these AI fashions, significantly round problems with well being fairness, to guarantee that the info that we put in is producing cheap output that we are able to use, that we are able to depend on.

So belief goes to be a giant situation. So now we have to put that groundwork in order that physicians are capable of belief the fashions that we create and deploy. In any other case, they’re not going to undertake it. So you have to at all times have clinicians closely concerned everytime you’re desirous about an AI mission, deploying instruments, significantly round patient-facing AI.

So brokers, chatbots that talk immediately with the affected person, there at all times must be a human within the center, so somebody who’s reviewing that and ensuring that that interplay is suitable and that the fashions usually are not offering info that’s inaccurate. That’s why it’s so necessary that we take this stepwise and we don’t rush into deploying all these AI instruments with out due diligence and thought.

So anyone who says they’re going to revolutionize well being care tomorrow or immediately with all these AI instruments, that’s simply not the case. We have to be targeted on incremental enchancment and concentrate on use instances the place it actually is smart and it’s going to make a huge impact for the top customers.

Kevin Pho: I discussed earlier that, after all, you’ve that twin perspective working for an EHR firm and likewise understanding the clinician aspect. So with regards to partnering with a well being care know-how firm, proper, there are simply going to be so many guarantees, particularly with the appearance of AI. From the clinician standpoint or from a hospital standpoint, what are some issues that they should look out for when partnering long-term with a well being care know-how firm?

Laura Kohlhagen: So, , don’t get caught up within the AI hype. You actually need to grasp what that companion is doing round growth from an moral perspective, a safety perspective, how they’re coaching their information fashions to guarantee that the fashions they’re creating are protected for affected person use.

Guarantee that they’re specializing in the correct issues. It’s necessary that your companions have in mind clinician enter. That’s one of the crucial necessary issues. And traditionally, that hasn’t occurred with EHRs. You already know, that’s why clinicians, we combat with EHRs on daily basis. They weren’t designed for us.

So that should change. So going ahead, searching for any companion, it’s what’s their definition of partnership? Are they going to work with you on creating instruments that you just want, that make actual variations on your group, on your affected person? And actually perceive what their roadmap is, like the place they’re going, and does it align along with your strategic targets.

Kevin Pho: We’re speaking to Laura Kohlhagen. She’s a doctor government, and immediately’s KevinMD article is, “Right here’s what suppliers actually need in a contemporary EHR.” Laura, let’s finish with some take-home messages that you just wish to go away with the KevinMD viewers.

Laura Kohlhagen: Nice. Thanks a lot, Kevin. So like I stated, the EHR, it wasn’t designed for clinicians. There are challenges we perceive with disparate, disjointed workflows, information silos, and all of that is altering. And it’s not tomorrow. It’s not, “Hey, it’s on the roadmap.” These are issues which can be occurring immediately. So there may be a whole lot of motive for hope from a clinician perspective and that we’re actually on the level the place now we have know-how obtainable to us to make a huge impact on enhancing documentation, enhancing information sharing, decreasing the handbook workflows that simply plague clinicians on daily basis, and permitting them to refocus on the affected person, which is what all of us went to medical college to do.

However in creating these instruments and this know-how, there’s a whole lot of pleasure, however we additionally should be cautious. So incremental enchancment is absolutely going to be the important thing to creating long-term impacts on well being care supply, clinician effectivity, satisfaction, and affected person engagement.

Kevin Pho: Laura, thanks a lot for sharing your perspective and perception, and thanks once more for approaching the present.

Laura Kohlhagen: Thanks, Kevin.