Health systems across the country face the same pressing problem — rising levels of burnout among physicians. It’s a challenge that’s reaching a crisis point.
Nearly all physicians in the U.S. said they feel regularly burned out and over half of them have considered either leaving the profession or adopting non-patient-facing roles, according to a recent athenahealth survey conducted by Harris Poll.
A growing number of hospitals and health systems are betting on advancements in AI as part of the cure for what ails physicians. Specifically, providers are investing in AI medical scribes and generative AI tools to help alleviate the drudgery of administrative work that takes up so much of clinicians’ time. Health systems also plug these technologies as a benefit for patients—doctors can spend more time talking face-to-face with their patients during the exam rather than typing into a computer.
Companies like Abridge, Suki, Nabla and Microsoft's Nuance use ambient voice tech and AI to convert a patient-clinician conversation into a structured clinical note draft and then integrate it into the patient's medical record.
Doctors also are optimistic about healthcare AI with 83% saying AI could help reduce administrative burdens and increase efficiencies, according to that same athenahealth survey.
Chicago-based Rush University System for Health is working with technology company Suki to trial its AI assistant. The trial will start with a "few hundred" physicians and then the technology deployment will expand to more physicians, according to Punit Soni, CEO and founder of voice AI tech company Suki. "The endgame is to roll this out to all of Rush end-to-end to make sure that all the clinicians across the health system can use the product," he said.
The nonprofit health system includes Rush University Medical Center, Rush University, Rush Copley Medical Center and Rush Oak Park Hospital, as well as an extensive provider network and numerous outpatient care facilities.
“After using other AI documentation solutions, Suki stood out to us for its depth of integration with Epic, ability to do more than documentation, and competitive cost," said Bina Desai, M.D., chief medical informatics officer of Rush in a statement. "We understand the profound impact that AI solutions can have on our clinicians as well as patient care and are excited to introduce Suki to our network. We are excited to see how the solution will boost engagement and reduce burnout."
Suki offers other capabilities beyond ambient note generation, according to Soni, such as Siri-like dictation features and coding, and the tool can answer questions through data retrieval.
The company says it can help clinicians complete notes 72% faster on average. It also claims other benefits for health systems such as a significant reduction in claim denials, with a 48% decrease in amended encounter rates, and opportunities to generate incremental revenue and improve efficiencies.
Soni, a former product manager at Google, founded Suki in 2017 to develop healthcare tech that's invisible and assistive to lift the administrative burden for clinicians. He believes using generative AI to automate clinical documentation is just the tip of the iceberg for how AI advancements can be used in healthcare.
"This is a snapshot in the evolution of AI and other things will soon follow up behind it. What you really need is an actual assistant that can do a lot more than just clinical documentation. And that thesis has borne out, because we do ambient notes summarization, but we also offer dictation and we offer coding and we offer Q&A. There's a host of other capabilities coming over the course of 2024, which will make this more like a true assistant at the doctor's shoulder rather than just a solution that does ambient note summarization,” he said in an interview.
Suki was interested in deploying its technology at Rush University System for Health for its reputation as a center of excellence and a frontrunner in using cutting-edge technology, Soni said.
"[Rush] is the tip of the spear when it comes to a lot of Epic innovation," he said. "It's a health system that's known throughout the country for its focus on improving the health of individuals and diverse communities. We were looking for a health system like that could help us trial out and highlight all the cutting-edge features we were building enabled for the Epic EHR. And, also be able to deploy them onto its users so that we can see and measure the actual impact of this at a system level."
He added, "It was pretty clear that Rush was looking for a partner, not a solution for a particular area."
The medical AI assistant market has exploded in the last few years as health systems are eager to test out tools that can help reduce physicians' administrative work, as research shows that these tasks are a big contributing factor to burnout.
Microsoft's Nuance is a dominant player in the market but newer startups are growing rapidly. Abridge continues to ink new partnerships with health systems to put its generative AI tools in front of more physicians. Sutter Health, UCI Health, Yale New Haven Health System, Emory Healthcare, The University of Kansas Health System, UPMC, and dozens of other health systems are now using Abridge's AI-based clinical documentation technology.
Around 5,000 doctors currently use the company's software, Abridge says, and its technology is available in more than 14 languages and over 50 specialties.
These generative AI companies working in healthcare are drawing interest from notable investors. Abridge has raised $212.5 million to date backed by Lightspeed Venture Partners, Redpoint Ventures, Union Square Ventures, Bessemer Venture Partners, Mass General Brigham Artificial Intelligence and Digital Innovation Fund (AIDIF), Kaiser Permanente Ventures and CVS Health Ventures.
Suki, in turn, has banked $95 million to date from investors like Philips Ventures, Venrock, Flare Capital, Breyer Capital and inHealth Ventures. The company is ramping up its partnerships with enterprise customers, Soni said. Suki works with 250 health systems, medical groups and clinics, and its Suki Assistant can be used across 100 medical specialties, he said.
Suki integrates with Epic, Oracle Cerner, Meditech and athenahealth EHR systems. The company also integrated its AI assistant with Amwell's Converge telehealth platform, which is used by more than 55 health plans.
"I think from a commercial momentum perspective, it's been, frankly, quite insane. I would say we are doubling our revenue every six months or so at this point in the past year and a half," Soni said. "The momentum is real. The market is clamoring for a solution. Suki is very well-positioned to be there. Having said that, the market is also very noisy."
Children’s Hospital Los Angeles (CHLA) is working with startup Nabla to roll out its ambient AI assistant, Nabla Copilot, to the hospital's pediatric specialists after a successful four-week pilot program with 30 physicians. Nabla says its Copilot produces AI-generated clinical notes in seconds and also enables AI-enabled medical coding identification.
CHLA performs more than 15,000 surgeries and conducts more than 700,000 patient visits annually. Children’s Hospital Los Angeles Medical Group is the largest pediatric multi-specialty medical group in the United States.
CHLA is investing in the tech to help address burnout issues plaguing pediatrics. Physicians report saving 1.5 hours a day by using Nabla Copilot, and less than 5% of the notes are modified by physicians before being integrated into patient records. Nabla Copilot integrates with Cerner, CHLA’s electronic health record, according to the companies.
CHLA is Nabla’s second contract with a significant health system. The Permanente Medical Group (TPMG) rolled out Nabla Copilot to 10,000 physicians last October.
The health system said it selected Nabla Copilot due to its high levels of confidentiality and rigorous compliance with privacy regulations. Nabla Copilot is a certified SOC 2 ambient AI assistant, where all transcripts and summaries are stored locally on the physician’s computer. Nabla does not store any customer data.
“Children’s Hospital Los Angeles is committed to fostering a culture of innovation in service of both our patients and team members,” said Dr. Matthew Keefer, chief medical informatics officer at Children’s Hospital Los Angeles in a statement. “We are thrilled to be rolling out this new application across our organization that will not only improve the patient-family experience but also serve as a time-saving tool for our clinicians so that they can more efficiently operate at the top of their license.”
Patient-doctor interactions are different in a pediatric hospital setting where parents frequently accompany patients in the exam room, so Nabla closely collaborated with CHLA’s clinical team to tailor specific capabilities. As one example, the startup adapted the note templates specifically for CHLA’s pediatric setting so that clinical notes better reflect if some facts were reported by the patient or their parents.
Nabla Copilot also can capture multiple people’s voices in the exam room, including the parent or guardian speaking on behalf of a child patient. Nabla Copilot also supports both English and Spanish languages.
The startup launched Nabla Copilot in March and in the past year it has been adopted by a growing list of providers and EHR companies, including the Mankato Clinic, Frontier Care, Opus EHR and NextGen EHR.
Health IT company Greenway Health also teamed up with Nabla to develop Greenway Clinical Assist to marry the company's ambient AI assistant technology with Greenway's EHR solutions.
Nabla is rapidly growing in the ambient AI assistant space, raising $43 million. The company says it went from $0 to $3 million annual recurring revenue (ARR) since Nabla Copilot’s launch and is projected to hit $15 million ARR by the end of 2024.
Abridge and Suki both got high-performance scores from provider customers, according to KLAS Research, a company that offers industry benchmark reports for healthcare technologies. A small subset of users, 15 from six organizations, gave Abridge an overall 95.3 score while 22 users from 15 organizations reported an overall score of 93.2 for Suki's technology.
Some health systems are investing in building their own internal AI assistants rather than bringing in third-party vendors.
CommonSpirit Health recently announced the launch of an AI-powered tool called Insightli. The tech is designed to streamline workflows and quickly create highly customized assets, according to the health system.
Insightli empowers CommonSpirit employees to create unique resources and solutions without sharing private information outside of the system, which has been a pitfall of using publicly available AI solutions, the health system said.
"CommonSpirit is committed to making our people’s work lives easier and their work more meaningful,” said Daniel Barchi, senior executive vice president and chief information officer at CommonSpirit Health. “Insightli gives us the ability to quickly and efficiently create highly relevant content specific to our organization, all while keeping the data safe and secure.”
By building its own AI assistant, CommonSpirit is providing its employees with a tool that enables the content that's created to be unique, immediately relevant and highly personalized, executives said.
"With more than 17,000 prompts processed just in a few months, our Insightli AI platform is poised to dramatically improve the way we work," Barchi said. "Our people will not only be able to get their work done faster, but because of Insightli, they will be able to even better prioritize their time so they can pursue the aspects of their work they find most satisfying. We are confident that Insightli will help us further empower and engage our entire workforce.”
While a growing list of health systems are testing out generative AI tools for doctors, the key to large-scale adoption will be integration with legacy EHR systems, Soni noted.
"The EHR integration that matters is the kind of integration that will guarantee a high adoption rate of users, and to be able to do that you have to accommodate all sorts of different workflows of doctors," he said. "The better you're integrated into the EHR, the less copy and paste the doctor has to do, the higher the chance the doctor will actually adopt it."
A recent survey from Wolters Kluwer Health found there has been a rapid shift in acceptance of the gen AI technology. Sixty-eight percent of doctors they have changed their views on generative AI over the past year, and 40% said they are ready to use it this year at the point of care.
But, transparency is critical to build trust, doctors said. The vast majority of docs (91%) said they need to know that the data used to train the tools were created by doctors and medical experts before using them in clinical decisions. Nearly the same percentage of physicians said they need vendors to be transparent about where information came from, who created it and how it was sourced.