What CEOs should know about ambient intelligence, physician wellness and the future of patient-centered care

Diana Nole | October 14, 2020

The COVID-19 pandemic profoundly disrupted health care and reinforced the need to improve physician and patient experiences, care quality and financial outcomes. But it also showed health care CEOs, CIOs and CMIOs how technology that augments and amplifies human capabilities can deliver transformative results when it prioritizes people over administrative processes through AI-powered and other advanced solutions.

The dramatic growth of telehealth is a high-profile example of taking a people-first approach. It illustrates how information exchange can be improved, as well as the speed at which solutions that support how physicians deliver care and how patients prefer to engage with health care services can be adopted. It has provided powerful validation of how technology can help us achieve better health outcomes and increased system efficiencies. It also sets the stage for an even bigger transformation using AI- and cloud-enabled ambient clinical intelligence (ACI) technology.

ACI solutions combine advanced deep learning, speech recognition, natural language understanding and diarization technologies to understand the specific content and context of physician-patient encounters in real-time, then generate structured, high-quality clinical notes for review and inclusion in the EHR.

ACI solutions can eliminate the distractions and extra process imposed by a computer keyboard or scribing services and allow the physician to stay focused on the patient during exam room or telehealth encounters. In other words, ACI solutions enable true patient-centered care while reducing physicians’ administrative workloads.

ACI solutions also directly address critical strategic and operational concerns including physician burnout, clinical documentation improvement, value-based reimbursements and improving care quality and health care access. They also dovetail with existing health system efforts to modernize IT infrastructure while satisfying patient expectations for personalized digital engagement in every health care setting. All of those factors are driving the deployment of ACI solutions at major U.S. health systems and regional medical practices, where CEOs, CIOs and CMIOs are seeing ACI solutions quickly become physicians’ preferred way to interact with the EHR.

Physicians using ACI solutions report being able to spend more and better-quality time with patients, and less time on administrative tasks while improving documentation quality. Patients report feeling that they have their doctors’ undivided attention without a keyboard and computer present. Administrators say that the physician and patient satisfaction increases after deploying ACI solutions. That gives health systems a competitive advantage for attracting and retaining top clinical talent, as well as patients with rising expectations of personalized, consumer-facing care.

The adoption of ACI technology is a well-planned journey with progressive deployment of increasingly advanced capabilities aligned with practical use cases and integrated with existing IT infrastructures, clinical workflows and diverse health care environments. ACI solutions:

  • Are tightly integrated with EHRs.
  • Listen passively to live, multi-party interactions without the need for spoken commands or interruptions.
  • Capture the meaning and context of a conversation, and automatically convert the clinically relevant parts of natural conversation into high-quality documentation
  • Support a range of virtual assistant skills for automating tasks in the EHR and commonly used third-party applications.
  • Use an advanced AI engine trained and refined for years in multiple health care settings.
  • Support a wide array of medical specialties across in-person and telehealth encounters.
  • Generate clinical documentation that adheres to existing workflows and standards for coding and compliance.
  • Are secured with voice biometrics to authentic speakers, streamline workflows and improve accuracy.
  • Support both smartphones and purpose-built ambient sensing devices in exam rooms for maximum flexibility in deployment and use.

ACI solutions are cloud-based, providing security and reliability as well as the ability to easily deploy customized or enhanced workflow automation, virtual assistant, CDI and other capabilities over time. For example, the cloud makes it possible to integrate real-time clinical intelligence and diagnostic guidance at the point of care, tailored for radiology, surgical, emergency medicine, pediatrics and other specialties.

Health systems executives who’ve deployed ACI solutions began the journey to alleviate burnout, and improve physician and patient experiences, clinical documentation, and care and financial outcomes. For example:

  • Cooper University Health Care in New Jersey is adopting the Nuance® Dragon Ambient eXperience (DAX)an ACI solution at its Voorhees and Cherry Hill ambulatory centers for in-person patient visits. Cooper is building on its existing deployment of the cloud-based Dragon Medical One clinical speech platform for documenting care in their Epic EHR. It plans to use the Nuance DAX solution as the primary way for physicians to interact with the EMR, enhancing its competitive advantages in care quality, revenue cycle management and physician and patient engagement.
  • Monument Health in South Dakota is deploying the Nuance DAX system to reduce administrative workloads and empower physicians to focus on patient care. Monument had been a long-term user of voice-powered clinical documentation, mobile, radiology reporting and surgical documentation solutions for 4,500 physicians in 33 medical specialties in two states. ACI adoption was part of a continuous innovation process to improve care quality and restore the vital human connection between physicians and patients.
  • EmergeOrtho in North Carolina deployed the Nuance DAX ACI telehealth solution during the pandemic to transform its prior infrequent use of telehealth into the core to how its physicians in 49 orthopedic practices across the state deliver care. EmergeOrtho is adopting Nuance DAX integrated with Microsoft Teams calling the combined solution “a game-changer” that automatically documents patient-physician encounters and reduces the burden of clinical documentation.

Physicians using ACI solutions also relate other intangible benefits. They describe how it restores the deeply personal human elements of health care – the understanding eye contact and empathy that helps anxious patients, the relief in a parent’s face and the calm in their child’s eyes when both feel seen, understood and cared for in sometimes frightening circumstances. That is what ACI technology enables, truly patient-centered care.

To hear more about this important topic, register for “The Journey to Ambient Clinical Intelligence: A webcast with Nuance EVP Diana Nole” on October 29.

About the Author

Diana Nole, Author

Diana joined Nuance in June 2020 as the executive vice president and general manager of Nuance’s Healthcare division, which is focused on improving the overall physician-patient experience through cutting-edge AI technology applications.

She is responsible for all business operations, growth and innovation strategy, product development, and partner and customer relationships. Over the course of her career, Diana has held numerous executive and leadership roles, serving as the CEO of Wolter Kluwers’ Healthcare division, president of Carestream’s Digital Medical Solutions business, and vice president of strategy, product management, and marketing for Eastman Kodak’s Healthcare Information Technology Solutions business.

Diana has dual degrees in Computer Science and Math from the State University of New York at Potsdam and earned her MBA from the University of Rochester’s Simon School.