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Joaquim Cardoso MSc
Chief Researcher & Editor of the Site
March 31, 2023
EXECUTIVE SUMMARY
Microsoft is working on a solution to address one of the biggest challenges faced by physicians — clinical documentation.
- According to a study, 92% of physicians reported that documentation obligations are excessive and 73% said clinical documentation often has a negative impact on patient care.
- Microsoft’s subsidiary, Nuance Communications, is developing Dragon Ambient eXperience (DAX) Express, a clinical documentation application that uses a unique combination of conversational, ambient, and generative AI to automatically create draft clinical notes.
- DAX Express will integrate with Nuance’s Dragon Medical One and will be tightly integrated into electronic medical records, reducing cognitive burdens and helping increase the joy of practicing medicine.
- The application has the potential to reduce the time spent on documentation, empowering physicians to spend more time taking care of patients.
If successful, this technology has the potential to significantly improve healthcare delivery in a meaningful way.
DEEP DIVE
Microsoft Plans To Use AI To Solve A Huge Pain Point For Doctors
Forbes
Sai Balasubramanian, M.D., J.D.
Among the many challenges that physicians face, one of the most cumbersome is clinical documentation. In a study published by the Journal of Graduate Medical Education, it was found that nearly 92% of physicians surveyed reported that “documentation obligations are excessive,” and 73% reported that clinical documentation often has a negative impact on patient care.
The goal behind detailed clinical documentation is to ultimately ensure great record keeping: in an ideal world, a comprehensive patient chart enables any treating provider to see a patient’s entire medical and treatment history. Furthermore, the healthcare system has been built in such a way that documentation plays a critical administrative role. Healthcare organizations use patient charts to code and bill for services provided. Documentation also acts as a record of the patient journey, which has become especially important in the growing landscape of healthcare litigation.
However, for many providers, this is one of the most challenging aspects of the job, reporting that they spend far more time documenting a patient’s visit rather than with the patient itself.
This is a key pain point that technology companies are vigilant about, and now, Microsoft is working on a dynamic solution. Nuance Communications, which is owned by Microsoft, is the leader behind Dragon, one the healthcare industry’s most popular note dictation tools. The Dragon product is already well known as one of the best in class, boasting “voice recognition that’s 3x faster than typing with up to 99% accuracy,” in addition to flexibility of use, with easy synchronization across devices and systems.
Microsoft wants to leverage its work with AI and Chat-GPT to take this tool to the next level. In a press release earlier this week, Nuance expressed its commitment to increasing AI driven innovation, announcing “Dragon Ambient eXperience (DAX) Express, a workflow-integrated, fully automated clinical documentation application that is the first to combine proven conversational and ambient AI with OpenAI’s newest and most capable model, GPT-4…[as a means to] reduce administrative burden and empower clinicians to spend more time taking care of patients and less time on paperwork.”
The company explains that by employing “a unique combination of conversational, ambient, and generative AI, DAX Express automatically and securely creates draft clinical notes in seconds for immediate clinical review and completion after each patient visit in the exam room or via telehealth patient conversations. Clinicians will benefit from the seamless capabilities of Dragon Medical One, DAX, and DAX Express, which are tightly integrated into the electronic medical record, beginning from pre-visit through post-encounter, reducing cognitive burdens and helping increase the joy of practicing medicine.”
The value for this product will be determined by how accurately and seamlessly these draft clinical notes can be created, in an effort to ease physician workflows. The reality is that generative AI is actually quite accurate in a technical and objective sense; however, the key unlock in this space will be to ensure that the generated product is adaptive and easily modifiable by the provider for specific patient needs.
Scott Guthrie, Executive Vice President of the Cloud and AI Group at Microsoft, explained that “Microsoft and Nuance have been ahead of the curve in innovating AI solutions, and organizations large and small have long trusted our responsible, secure applications and infrastructure…With DAX Express, we are leveraging the revolutionary capabilities of large model AI to deliver outcomes-focused healthcare applications at scale.”
Indeed, if done correctly, Nuance and Microsoft have a lot to gain. More than just capturing market share, the companies have the potential to win the hearts and loyalty of millions of physicians that have to dedicate a significant portion of their day solely to cumbersome documentation practices.
Pundits are vivaciously expressing that with the introduction of generative AI, the next era of healthcare innovation is just around the corner. Undoubtedly, Microsoft has a massive opportunity with this technology, and has the potential to significantly improve healthcare delivery in a meaningful and tangible way.
Originally published at https://www.forbes.com.
Related Publication
Paperwork Versus Patient Care: A Nationwide Survey of Residents’ Perceptions of Clinical Documentation Requirements and Patient Care
Journal of Graduate Medical Education
Melissa A. Christino, MD Andrew P. Matson, MD Staci A. Fischer, MD Steven E. Reinert, MS Christopher W. DiGiovanni, MD Paul D. Fadale, MD
December 2013
Background
- The current health care system requires a substantial amount of documentation by physicians, potentially limiting time spent on patient care.
Objective
- We sought to explore trainees’ perceptions of their clinical documentation requirements and the relationship between time spent on clinical documentation versus time available for patient care.
Methods
- An anonymous, online survey was sent to trainees in all postgraduate years of training and specialties in Accreditation Council for Graduate Medical Education–accredited programs.
Results
- Over a 2-month time frame, 1515 trainees in 24 specialties completed the survey.
- Most (92%) reported that documentation obligations are excessive, that time spent with patients has been compromised by this (90%),
- and that the amount of clinical documentation has had a negative effect on patient care (73%).
- Most residents and fellows reported feeling rushed and frustrated because of these documentation demands.
- They also reported that time spent on these tasks decreased their time available for teaching others and reduced the quality of their education.
- Respondents reported spending more time on clinical documentation than on direct patient care (P , .001).
Respondents reported spending more time on clinical documentation than on direct patient care (P , .001).
Conclusions
- Trainees’ current clinical documentation workload may be a barrier to optimal patient care and to resident and fellow education.
- Residents and fellows report that clinical documentation duties are onerous, and there is a perceived negative effect on time spent with patients, overall quality of patient care, physician well-being, time available for teaching, and quality of resident education.
