AAFP teams up with startup Suki to use AI to combat docs' EHR pain points

The American Academy of Family Physicians believes emerging technologies could be the key to addressing doctors' biggest administrative headaches.

The physicians' group is looking to recruit 100 doctors to test out startup Suki's voice-enabled, artificial intelligence-powered clinical digital assistant that helps with tedious documentation tasks when using electronic health record (EHR) systems.

According to AAFP, many family physicians see EHRs as an impediment to patient care, putting a computer in that sacred space between them and their patients.

“The family medicine experience is based on a deep patient-physician interaction that requires support from technology. Today’s EHRs have greatly eroded the experience rather than enhancing it,” Steven Waldren, M.D., AAFP vice president and chief medical informatics officer, said in a statement.

“The vision is to help family physicians care for patients while using health IT that works for them, not against them.”

The AAFP launched an Innovation Laboratory last year to test emerging artificial intelligence and machine learning tools that can address family physicians’ top challenges.

As part of its first pilot project, AAFP's Innovation Lab has been working with health technology company Suki to test whether its clinical voice assistant tool can help reduce doctors' documentation burdens and alleviate physician burnout.

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A proof of concept with 10 family physicians using the same Athenahealth EHR system in a variety of practices that also used Suki's voice assistant tool showed promising results.

All the physician users saw time savings and a dramatic increase in satisfaction with notes completion, efficiency and EHR use for other administrative tasks, according to the AAFP.

Family physicians reported that using Suki decreased documentation time per patient by 62% and they saw a 70% drop in after-hours charting in the EHR. 

Suki works like an Alexa for physicians. It uses AI, machine learning and natural language processing to complete administrative workflows, such as creating clinically accurate notes and retrieving patient information from the EHR.

Suki launched in 2017 has raised at least $40 million to date, with investors including Flare Capital Partners, Breyer Capital, Epsilon Health, First Round Capital and Venrock. 

The company's team includes technologists from Apple, Google, IBM Watson and McKinsey, and physicians from the University of California, San Francisco and Stanford.

Suki recently announced an update to its technology called Suki Speech Service that better understands the speaker's intent when giving a command, allowing for more language flexibility, according to the company.

This allows doctors to speak more naturally, the way they would with a colleague and not have to remember rote commands.

"If a clinician says, 'What does my day look like?' Suki understands to pull up the clinician's schedule," Suki founder and CEO Punit Singh Soni told Fierce Healthcare.

The digital assistant recognizes commands at 99.5% accuracy, according to the company, and is 54% faster than its previous version.

Soni said health systems are showing an increased interest in Suki's AI-based digital assistant during the COVID-19 pandemic.

"It's driven by a need to reduce burnout on doctors which has only grown worse. They are looking to bring in more optimization to their processes," he said.

"We have a role to play here. The world we are going into will increasingly require low-touch and no-touch solutions," Soni said, noting that Suki wants to build the most intelligent and responsive voice platform in health care.

The AAFP Innovation Lab is now expanding the pilot with Suki to a larger group of physicians while also opening participation to doctors who use Epic and PowerChart EHR systems in addition to Athenahealth.

In stage two of the Suki pilot, physicians will use the tool for up to 30 days and participate in an interview about their experiences afterward.

Physicians involved in the proof of concept described how the digital assistant allowed them to see their patients and complete their documentation without feeling rushed or having to work after hours, according to the AAFP. Several physicians described this impact as a “breakthrough” in their practices.

Suki was chosen for the first pilot for several reasons, Waldren said.

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"The company was founded with the goal of helping physicians spend more time caring for patients and less time on administrative tasks. Increasing physician job satisfaction is the ultimate goal of our Innovation Lab," he said. "The company is actively and successfully marketing to primary care and family medicine, and the solution didn’t require any new hardware for the physicians who tested it in practice.”

AAFP's Innovation Lab is part of a 42-month project to address issues related to EHRs. The project focuses on driving innovations utilizing the latest health IT, addressed from a family medicine perspective, the organization said.

“Digital assistants like Suki show great promise as an essential technology to optimize the family medicine experience,” said Waldren. 

Suki is not the only company in the voice technology space. Amazon announced back in April 2019 that its voice assistant technology Alexa now has medical skills that are HIPAA-compliant, paving the way for developers to build voice skills that can securely transmit private patient health information.

In December, Amazon Web Services announced the launch of Amazon Transcribe Medical to convert clinician and patient speech to text. It's one of many areas in which Amazon is competing with Microsoft and Google.

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Microsoft is collaborating with Nuance Communications to develop technology to "listen" to physician-patient conversations and automatically document in an electronic health record. Stanford University is working with Google on a digital scribe pilot project to use voice assistants during patient encounters.

Communications IT vendor Vocera developed ambient voice capabilities that enable clinicians to wake up its Smartbadge wearable by saying "OK Vocera."

Startup Saykara's AI physician assistant tool serves 18 disparate healthcare specialty and is used by Providence Saint Joseph Hospital, Swedish Medical Group, Providence Kadlec, MultiCare Health System and OrthoIndy Hospital. The company says it offers the first ambient and autonomous voice assistant technology for healthcare that listens to any physician-patient conversation without voice commands.

EHR giants Epic and Cerner also are getting into this space. Cerner rolled out an AI-powered voice technology called Virtual Scribe which it developed with AWS as part of its expanded relationship.

Epic also developed an ambient voice technology voice assistant called "Hey, Epic!" The tool gives clinicians a new way to look up information about a patient and document care in the EHR, the company said.