Ambient AI does not improve efficiency across the board, research shows

While future studies could further explore the usefulness of Nuance’s generative, voice-driven artificial intelligence documentation tool for physician subsets and alternative clinical implementations, researchers said the general availability of Nuance’s Dragon Ambient Experience copilot in Atrium Health’s electronic health records would not have a significant revealed improvements in the medical records. most important metrics for the organization.

WHY IT’S IMPORTANT

Last year, Charlotte, North Carolina-based Atrium Health, which merged with and became Advocate Health in 2022, touting itself as the first US healthcare system to deploy AI-driven clinical documentation to automate the creation of clinical documentation during patient visits.

For the post-DAX implementation study, published in the New England Journal of Medicine AI, researchers from Atrium and Wake Forest University School of Medicine evaluated outcomes for participating physicians after the health system implemented Nuance’s DAX Copilot.

They initially enrolled 238 physicians specializing in family medicine, internal medicine, and general pediatrics from outpatient clinics in North Carolina and Georgia in five waves, between June and August 2023.

Those in the group testing DAX received an hour-long training and were given an account through their Epic EHRs.

The researchers evaluated outcomes related to the EHRs over 180 days, including time in the EHR, time off work, time in notes, number of appointments completed, same-day close rate and length of notes, and financial data , such as working relationships. value units per visit.

The final analytic sample the researchers assessed consisted of 112 physicians in the software user group and 103 physicians in the control group, non-DAX users, they said.

They found that three-quarters of “active DAX users” (84/112) transferred more than 25% of their DAX notes to Epic and that about 60% of “high DAX users” (67/112) transferred more than 60 % of their DAX notes. DAX notes to their EPDs.

After controlling for age, gender, type of provider, years of practice and baseline outcome, the researchers said they found few “statistically significant differences” between DAX users and the control group – save your time.

“High DAX users had an overall decrease of approximately 7% in documentation hours compared to the control group,” they said in their report report.

“Exploratory results suggested that a modest reduction in note-taking time could result from using DAX at a high usage level or leveraging DAX to select subgroups of physicians,” she added.

Wake Forest University Health Sciences, part of the university’s medical school that serves as the academic core of Advocate Health, funded the research.

THE BIG TREND

Many organizations have expanded their use of DAX Copilot in the past year, including Intermountain Health, Pennsylvania-based WellSpan Health and others.

EHR vendors also formed partnerships to integrate the documentation pool in an effort to reduce physician burnout. In January, Epic fully integrated the Nuance AI copilot and in March, Meditech Expanse EHR announced the integration.

Meanwhile, Microsoft reported in October that DAX was seeing momentum after a year of availability, highlighting that the AI ​​tool was used in at least 50% of patient encounters at Northwestern Medicine in Chicago. The health system’s doctors spent an average of 24% less time writing notes and increased the number of patients they could see by an average of 11.3, the tech giant said.

ON THE RECORD

“Overall, these findings suggest that the efficiency of AI-based documentation may translate into reduced markers of burnout for a subset of physicians, and perhaps more broadly when DAX implementation reaches higher levels of adoption,” the researchers said in their NEJM. AI report.

“However, widespread implementation of DAX in its current form is unlikely to deliver noticeable gains for healthcare systems looking to increase productivity.”

Andrea Fox is editor-in-chief of Healthcare IT News.
Email: afox@himss.org

Healthcare IT News is a HIMSS Media publication.