While future studies may further investigate the usefulness of Nuance’s generative artificial intelligence voice documentation tool for subgroups of clinicians and alternative clinical implementations, the researchers said that general availability Nuance’s co-pilot Dragon Ambient Experience in Atrium Health’s electronic health records did not reveal significant improvements in key metrics for the organization.
WHY IT IS IMPORTANT
Last year, Charlotte, North Carolina-based Atrium Health, which merged with and became Advocate Health in 2022, presents itself as the first US healthcare system to deploy AI-powered ambient 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 participating clinicians’ outcomes after the health system implemented Nuance’s DAX co-pilot.
They initially enrolled 238 clinicians specializing in family medicine, internal medicine and general pediatrics in outpatient clinics in North Carolina and Georgia in five waves, between June and August 2023.
Members of the group testing DAX received an hour of training and opened an account through their Epic EHR.
Researchers evaluated EHR-related outcomes over 180 days, including time spent in the EHR, time spent working outside of work, time spent in note, rate of appointments completed, rate closed same day and grade length, as well as financial measures, such as report to work. value units per visit.
The final analytic sample evaluated by the researchers included 112 clinicians in the software user group and 103 clinicians in the non-DAX user control group, they said.
They found that three-quarters of “active DAX users” (84/112) transferred more than 25% of their DAX ratings to Epic and that about 60% of “high DAX users” (67/112) transferred more than 60% of their grades. DAX notes on their EHRs.
After controlling for age, gender, provider type, years in practice and baseline results, the researchers said they found few “statistically significant differences” between DAX users and the control group – which saves time.
“High DAX users saw an overall decrease of approximately 7% in documentation hours compared to the control group,” they said in their report. report.
“Exploratory results suggest that modest reductions in note-taking time could result from using DAX at a high usage level or from deploying DAX to select subgroups of clinicians,” they added.
Wake Forest University Health Sciences, part of the university’s medical school that serves as the academic core of Advocate Health, funded the study.
THE BIGGEST TREND
Many organizations have expanded their use of DAX Copilot in the last year, including Intermountain Health, Pennsylvania-based WellSpan Health, and others.
EHR vendors have also formed partnerships to integrate the documentation pool with the goal of reducing clinician burnout. In January, Epic fully integrated Nuance AI Copilot and in March, Meditech Expanse EHR announced its integration.
Meanwhile, in October, Microsoft reported that after a year of availability, DAX was seeing momentum and highlighted that the AI tool was used in at least 50% of patient encounters at Northwestern Medicine in Chicago. The health system’s clinicians spent an average of 24% less time writing notes and increased the number of patients they were able to see by an average of 11.3, the tech giant said.
ON THE FILE
“Taken together, these results suggest that the effectiveness of AI-based documentation could translate into decreased markers of burnout for a subset of clinicians, and perhaps more broadly when implementing implementation of DAX will achieve a higher level of adoption,” the researchers said in their NEJM. AI Report.
“However, widespread implementation of DAX in its current form is unlikely to generate appreciable gains for health systems seeking to increase productivity.”
Andrea Fox is the editor-in-chief of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.