Can Computer-Assisted Physician Documentation Alleviate Administrative Burden?

Artificial intelligence (AI) has been dominating headlines recently — largely for the ethics of its use in various industries. But in healthcare, AI has been around for quite a while, in the form of computer-assisted physician documentation (CAPD). With its promise of efficiency, can AI make strides in such a people-first field?

Whether you love it, hate it or are skeptical about the advances in CAPD, it’s something to consider when searching for a new job. Namely, how could CAPD affect your day-to-day work? And how do the healthcare organizations you’re considering invest in and train for this technology?

According to Elsevier Health’s Clinician of the Future 2023 guide, 73% of clinicians believe that physicians should be experts in the use of digital health technology, yet only 40% of U.S. physicians want to use AI tools to help make clinical decisions.

As a healthcare recruiting company working for more than 40 practices, medical groups and health systems across the country, Provider Solutions & Development (PS&D) is committed to finding a long-term fit for the providers we recruit. We intentionally work with partners who we know have a supportive culture, because culture is such an integral part of long-term job happiness.

The right technology is one important piece of a great work culture. The latest tech, if implemented with strong change management, is one of the most effective ways health systems can support your team and help with provider retention. And it’s something to look for in your current role or your next.

Providence, our founder, was an early adopter of ambient technology (electronic environments that are sensitive and responsive to the presence of people) and CAPD, and they’ve recently enacted updates that remove roadblocks to real-time visit documentation.

We spoke with Dr. Scott Smitherman, Chief Medical Information Officer (CMIO) of the Providence Clinical Network, a PS&D partner, about best practices and insights around health systems using or considering AI in clinical documentation. He is both helping implement this new tech and using it himself in the clinical setting with patients on a weekly basis.

“CAPD certainly has its challenges,” says Dr. Smitherman. “But with our inboxes flooded and the EHR being a constant struggle, this tech has the opportunity to improve the lives of our physicians and APCs — when brought in right.”

If you're searching for a new job, learn what to ask about during your interview process, including which technologies are important to you and the hiring organization. If you’re looking to grow your skillset around CAPD-enabled visits, learn about the latest advances, how it could help you in your practice and why AI will never replace the human side of medicine.

How Far Has Computer-Assisted Physician Documentation Come?

CAPD is software that leverages AI and machine learning to simplify clinical documentation. Many of these models also have natural language processing (NLP) to expedite patient intake and summarize large bodies of information.

The goal is efficiency through assistance. When you speak or type into the EHR — about symptoms, diagnoses, test results, etc. — CAPD analyzes the information and offers suggestions to improve your entries with accuracy, depth and compliance.

“Over the last year there’s been this explosion of interest in AI tools,” Dr. Smitherman says. “And we see many EHR vendors using the term AI to describe the technology that transcribes conversations and simplifies documentation, all to make providers’ days lighter.”

Providence, after a decade of investing and using a medical dictation platform, is building on their current CAPD models — Nuance’s Dragon Medical One and Dragon Ambient eXperience (DAX) — to deliver completed notes in real time, without wait times.

“In my personal experience, I used to leave my clinic about 90 minutes after my last patient walked out. In using more of these tools, it can now be as short as five minutes. I’m delivering the kind of care I want to and I have more of my off-the-job life back.”

~ Dr. Scott Smitherman, Chief Medical Information Officer (CMIO), Providence Clinical Network

Physicians and APCs who are already using this technology know this isn’t as simple as adding an app to your phone. CAPD requires training and change management for an organization to successfully embrace it.

And if you are a provider in the midst of a career change, knowing organizations like Providence are proactively seeking new methods to improve the workplace can help you modernize and refine your job search.

How Is CAPD Being Used Today?

Some physicians may ask, “What are the main benefits of computer-assisted physician documentation?”

Natural language processing software is a way to streamline patient intake information. With consent, providers can record their conversations, speaking to their patients without typing into the EHR. But there are other benefits as well.

“When you’re at the end of a busy day after seeing tons of patients and you’re documenting someone you saw anywhere from three to eight hours ago, it’s not easy to recall all the details,” Dr. Smitherman says. “For people who do their charts later in the day, CAPD remembers so you don’t have to. Whether it was the right or left leg or something more serious — it’s all there, it’s already in the note. All you have to do is make minor edits.”

NLP is already familiar to most providers — and so is the delay time. These programs used to require internal reviewers, which can tack on extra hours, Dr. Smitherman says. If a physician sees someone at the end of the day, the physician may not get that note until the next day.

“But with all the years put into clinical documentation tools, programs like DAX are getting ready to move past internal reviewers so providers can take care of their notes on the same day, which is really exciting,” he says.

Good CAPD not only has the potential to help with daily tasks, but it can act like a third person in the room, a researcher and expert on the patient’s medical history, bringing the EHR to life.

“By generating the note in real time, you also get a world where CAPD can put up guidance on a disease that you’re talking about or pull something from that patient’s history,” Dr. Smitherman says. “It opens incredible possibilities.”

AI is also streamlining the inbox. According to a recent study, physicians spend an average of 52 minutes on inbox management during the week, including 19 minutes (37%) outside their work hours. With inbox management, AI can read messages as they come in and prioritize them accordingly, to foster more timely patient care.

“If it’s a referral, it gets sent to the referral team. If it’s a symptom question, we can lift those to the top,” Dr. Smitherman says. “People can see us the same day instead of waiting for busy teams to sift through their inboxes.

“The best part is, we’re not just exploring, we’re actively using. We have over 500 users within Providence working with CAPD and seeing the gains, both from inbox management and natural language processing software, to make physicians’ and APCs’ lives better.”

How Does CAPD Alleviate Administrative Burden?

In a quantitative sense, CAPD is meant to optimize documentation and EHR processes by reducing cognitive load and time spent at a computer. And that goes a long way in reducing after-hours work, Dr. Smitherman says. Providers are all too familiar with sacrificing personal or family time. CAPD can help them get that much closer to work-life balance.

“In my personal experience, I used to leave my clinic about 90 minutes after my last patient walked out,” Dr. Smitherman says. “In using more of these tools, it can now be as short as five minutes. So, if I see the last patient at 4:40, I’m leaving at 5:05, and that’s incredible. I’m delivering the kind of care I want to and I have more of my off-the-job life back.”

By leveraging this technology to give their providers more time to focus on care, Providence also benefits from less physician dissatisfaction and moral injury.

“Providence is constantly looking for ways to get the computer out of the way,” says Dr. Smitherman. “A little ironic that we’re doing that with more tech, but we look at the technologies that are focused on taking more tasks off physicians’ plates.”

There are many places like Providence that prioritize provider wellness, and PS&D can help you find the organizations that have the tech you’re seeking.

Are There Any Concerns with CAPD?

There is a range of feelings associated with AI trickling into our working lives. When advanced technology comes into play with such sensitive information as healthcare, it’s important to consider the potential downsides.

One of which is that while CAPD can help with diagnoses and clinical knowledge, some people are concerned providers may begin to depend too heavily on the technology. Instead of using or improving their medical intuition and knowledge, providers may choose technological convenience over their own critical thinking.

Data breaches are another potential concern. Medical Economics points out that as healthcare providers create, store and transmit large quantities of sensitive data, the AI pipeline becomes a target for cyber attacks.

Adding new software is another point of access and, in response, the security to fortify an organization’s networks and data could be costly. While immense benefits exist, these are also vulnerabilities that need to be accounted for and addressed.

Another concern is the cost of this technology and who is footing the bill. Some organizations invest in CAPD to better support their physicians, while others require providers to pay a monthly or annual fee to use the service. (And that makes it a great question to ask when you’re seeking a new job.)

One barrier to adoption is skepticism. Change is hard, and providers might be hesitant to raise their hands for something that requires relearning another system. Or they could be critical of AI’s role in healthcare. But if both providers and organizations can come to terms with the investment it takes, the potential benefit it brings might outweigh those concerns.

It can be natural, as AI becomes more prevalent in many industries, to wonder, “Will doctors lose their jobs to AI?”

Dr. Smitherman says, unequivocally, no. This emerging technology will never replace physicians and APCs. After all, an AI platform can’t conduct an exam by itself, or know what a doctor is thinking. Unless a doctor says something out loud, it won’t be captured.

“CAPD will never replace the human element,” Dr. Smitherman says. “And in fact it can create more space and time for providers to concentrate on that human care, not administrative tasks.

“The challenge is the change in practice. For health systems thinking of adopting CAPD, you have to think about change management. You have to be patient with people, to respect their learning and adoption styles. The data is there, and you need to work with them to see the benefits in their practices and for health systems as a whole.”

When we take the time to learn more about how improvements in CAPD can enable our providers to creatively adopt a modern approach to care, we can embrace these advancements in a meaningful way.

How Can CAPD Improve Patient Care?

While there are clearly risks, the benefits of CAPD go beyond time management to promote better patient care and experiences.

Nuance’s internal surveys and studies on DAX, its ambient listening and documentation tool, show great benefits to care:

• 7 minutes saved per encounter, cutting documentation time in half
• 70% reduction in reported feelings of burnout and fatigue
• 75% of physicians state DAX improves documentation quality
• 85% of patients say their physician is more personable and conversational

While it might seem like adding more technology to physician-patient interactions could be a blocker, Dr. Smitherman says CAPD actually frees up providers at the point of care, improving eye contact and making space for a more human interaction. Providers can spend more time face-to-face, looking at their patients instead of at the EHR and their screen.

“All of us went into medicine to help people, not peck away at the computer. I’m excited to see CAPD actually take a piece of the burden off providers and allow them to focus on being a human caregiver,” he says.

The Future of CAPD: Restoring a Mission of Care

While it’s not a magic bullet, CAPD has the capacity to create industry-wide change for patients, organizations and providers, helping them rediscover fulfillment in their work.

“It’s hard for me to believe that in the next five years, physicians and APCs won’t be using CAPD for at least part of their clinical documentation. This technology is transformative, and the benefits we’re seeing are incredible,” Dr. Smitherman says. “And it’s available across the country. There are opportunities to seek this out. I’d advise health systems to get on board.”

If providers want access to computer-assisted physician documentation or other cutting-edge AI, PS&D can help you find a culture that prioritizes it.

Through matching top-tier talent with more than 40 practices and health systems across the country, PS&D understands the trending issues the healthcare industry is facing. We can help you find a job that suits your needs and find satisfaction in your medical career.

And not just any job — our recruiters work with our candidates to understand their needs in job roles, work cultures and communities. Our goal is to find the right long-term fit, for every provider we meet and every organization we serve.

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