Penn Highlands Healthcare is a rural healthcare system with many very sick patients who do not have many resources. And the health care system’s resources, in terms of physicians, are very limited. The result is that burnout is extremely high.
THE PROBLEM
Penn Highlands was looking for a way to reduce physician burnout and make these jobs more enjoyable for professionals who might want to come to Penn to work.
“When I think about burnout and how it affects us, the most negative part of our day is just the administrative burden and the long working hours that we have,” says Dr. Renee Allenbaugh, medical director at Penn Highlands Healthcare. “There are many studies that show that physicians honestly need more than 24 hours a day to complete all their patient care and their documentation.
“When you have limited resources,” she added, “you simply don’t have the time to capture the full patient story, collaborate with a medical team, keep your patients and families informed, and then create a plan to formulate and implement in addition to documenting it. everything you need for the government, for the government regulations, for the different payers.”
Frustration with the The amount of documentation requirements and daily administrative burdens led Penn Highlands to look for change.
“The hospital staff worked after hours to get all their work done, sacrificing time for family, friends and their own self-care,” Allenbaugh noted. “We were looking for some kind of physician-centric solution. There are a lot of solutions out there, but many of them are more computer-centric. They have workflows that don’t match the real workflows that we have as physicians.
“We wanted to find something that was very physician-centric and that really helped us within the workflows that we have to improve our efficiency and improve the quality and timeliness of our documentation,” she added.
PROPOSAL
Penn Highlands went with a kind of AI-powered “copilot” technology from supplier Regard. The technology can be integrated into healthcare providers’ electronic medical records.
“They are very doctor-oriented and offered us such as an AI assistant that is quite accurate, because for example a resident basically works with healthcare providers, trying to give them information and details and reduce the workload, and at the same time learn what is important to you and learn what is important for medicine in overall,” Allenbaugh explained.
“And that’s what they pitched to us: You have this AI technology that’s fully integrated into our Cerner EHR,” she continued. “It goes through the entire EHR and selects clinically relevant information to upgrade a diagnosis you already have or recommend a diagnosis you didn’t have yet. It doesn’t just transcribe a note for you. It goes in and finds information that it would be so time consuming for us to go back and do it.”
Allenbaugh said health literacy in her service area is very low, making it sometimes difficult to get information from patients.
“If you can’t find everything in the medical record or you spend hours searching different systems and pulling information from different places, everything becomes very difficult,” she explained. “You’re going to miss something because you can’t go back and go through all that.
“So that’s the benefit: It’s like your assistant,” she continued. “It doesn’t take the place of your clinical thinking, but it mines the EHR and the data and brings out what’s clinically important.”
RESULTS
Penn Highlands began using the Regard AI software in September 2021.
“Let’s start with what really matters, which is the return on investment for the people who buy these products,” Allenbaugh said. “Regard went in and did a study on the product after nine months with 30 users in five hospitals, and they showed $3 million in improved revenue. We wouldn’t have made $3 million otherwise.
“We did a similar study internally because we didn’t want to base our results solely on what the company told us, and we saw an increase in revenue of $7 million,” she revealed. “And we achieved that through a 10% increase in the case-mix index that was sustained. The case-mix index is a measure of the resources and complexity of the patients in the hospital.”
The Center for Medicare and Medicaid Services is established the case mix index and reimbursement for specific diagnosis-related groups. Provider organizations are moving this on a scale based on how complex their patients are and how many resources those patients need.
“If you document well and get all the information in the documentation, you reflect the acuity and complexity of your patients,” Allenbaugh explains. “So that’s going to increase your compensation. And that’s really the main reason why we saw that increase in revenue.”
The $7 million in increased revenue was measured in a slightly different way than Regard. When calculating Regard, the percentage increase in the case mix index was considered, as well as the percentage increase in the number of cases of multiple chronic conditions. When calculating Penn Highlands, only the case mix index was considered. But it looked at two years prior to the implementation of the AI technology, and then at the twelve months after implementation.
ADVICE FOR OTHERS
“The most important thing organizations need to consider is thinking about their end user,” Allenbaugh advised. “With this type of technology, the physician is the end user, and they have to be very involved and committed when you’re thinking about adding the technology, because it not only improves documentation, but it also changes workflows – and that makes a difference for many doctors.
“In our case, it made our physicians’ workflows much more efficient, allowing us to reduce the amount of time we spent documenting by about two hours per day per provider, which is huge,” she continued. “But that came from really thinking about the product, how it fits into our workflows and then how we can use the product most effectively.”
Allenbaugh has seen this type of technology fail when leadership simply gives it to physicians without any real training other than how to use the technology themselves, rather than how to fit it into the workday and be as efficient as possible.
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