by John Wernert, MD
As Norton Healthcare has grown exponentially over the past decade, age-old issues around documentation burden, chart timeliness and adequate record keeping added more stress to our providers and hospitals. As paper records melted into the past,“ note bloat” became a ubiquitous outcome from computerized notes, just importing the last visit and ballooning the unnecessary information that a provider needed to review for a patient encounter. Though documentation and billing requirements continue to strain our workforce, one helpful solution has been the implementation of Dragon CoPilot within our EPIC EMR. A similar program known as DAX Copilot is integrated into our Microsoft suite. While both tools aim to reduce clinician workload and improve documentation quality, DAX Copilot is more focused on ambient AI for real-time note creation, whereas Dragon Copilot offers a broader suite of tools, combining dictation, ambient listening and advanced AI capabilities into a single solution.
Norton began an initial pilot roll out to limited providers around two years ago, and due to early successes, has now expanded to any provider willing to go through the training. There were the usual speed bumps with early adoption, especially with older providers( in practice 20 + years) learning to integrate DAX into their usual clinical workflows. Early on, some docs spent too much time editing the AI generated documentation or were slow to close their charts; they were worried about accuracy.“ I just didn’ t trust DAX would get it right!” However, in time, reliance on the accuracy of the documentation improved, especially with signed patient consents and disclaimers of possible errors in the generated notes.
Now, more than two years into expanded adoption, Norton providers have seen a decrease in after-hours charting and can close charts more quickly, improving timeliness of billing. Another outcome has been opening more appointment slots, thus improving patient access.
by Tom James, MD
OK, so I am a“ senior physician” whose only advantage in the newer technology is having a son who works for an AI start-up in Brooklyn. I have let Artificial Intelligence( aka Augmented Intelligence) just slowly infiltrate my life. In my part-time practice, I use it to generate patient information sheets for conditions not addressed in the EHR library. Not completely trusting the information, I do review those before printing for my patient. A number of my patients do not speak or read English as a native language. Now there is Google Translate or iTranslate to convert my information sheets to the language preferred by my patient.
I have been beta testing Doximity’ s DoxGPT, which allows me to help personalize patient treatments such as with complex diabetes. It was great for that and made medical sense. But for a talk on the nuances of measuring quality in health care, it just didn’ t have the capabilities to go beyond elementary papers on quality.
But then there is the fun side. My friend and I wanted to take a river cruise in Europe later this year. CoPilot took all of our preferences for cost, time of year, riverboat amenities, countries and activities, and we came up with a cruise that will be spectacular for us. See you in Brussels!
Dr. James is an internist / pediatrician seeing patients at Family Health Center.
As advertised, Dragon and DAX AI programs continue to learn and refine note creation and more efficient documentation. Our
administration is satisfied that Dragon is worth the sizable investment. Next phases will be focused on in-basket management, test reporting and automating certain administrative tasks. With
the ultimate objective of enhancing health care workflows and outcomes, medical AI assistants are here to stay.
Dr. Wernert is an Executive Medical Director and practices with Norton Behavioral Medicine.
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