Joshua Greenhoe has been practicing medicine for 25 years, and he remembers when he and other doctors began making notes about patients on a laptop.
“You’re looking at a computer screen, typing , not necessarily listening to the patient in the same way with direct eye contact, and so I think patients feel more isolated and not heard,” he recalls.
Complaints led some practices to hire transcribers, but that didn’t always sit well with patients.
“She might not want some stranger coming in and hearing me ask about sexual history or ‘how’s your mental health?’ And so you create this barrier," Greenhoe explains.
And Dr. Joe Evans, Chief Health Information Officer at Sentara, adds that physicians may have missed certain details because they weren’t looking at their patients.
“I think what is lost there is engagement with the patient, where you’re not able to look at the subtle signs – non-verbal cues of the interaction," he says. "They would maybe be saying something, but their eyes or their body would be telling us something different.”
Now, however, Greenhoe and other medical professionals at Sentara Health, the University of Virginia and other medical centers press an app on their cell phones, and, with permission from patients, begin recording their encounter. Minutes later, thanks to medical software developed by a division of Microsoft, they get a transcript of what was said.
"It saves at least an hour a day, and so I have a lot more energy than for the more meaningful things like lab results or how I’m going to communicate with the patient on a certain issue – that sort of thing."
He reviews each transcript, adding any details the software may have omitted.
"It will also filter out some things that it thinks are extraneous – like if the patient says, ‘I’m going to go to Greece next month.’ The computer probably won’t put that, but I want to remember that, and so there are some things like that that I will include."
And, he says, this record – created by artificial intelligence – adds a measure of consistency that patients and other doctors appreciate.
"For patients it’s having all of their information in one place + so that wherever they are a physician can open up the chart and see everything they need to know about a person."
It can also simplify billing, provide a reliable record for legal proceedings, and it reduces staffing needs for primary care practices which are – in many cases – the least profitable centers for healthcare systems like Sentara. Again, Dr. Evans:
"It’s an exciting solution to help us spend less time on the administrative functions that we do every day – helping us with coding, instructions, etc."
Sentara introduced the latest incarnation this program called DAX Co-Pilot in April with 41 doctors, nurse-practitioners and physicians’ assistants trying the new approach to medical records. By the end of July, the number had grown to more than 200.
