Attendees of HIMSS in Orlando, FL 2024.
Courtesy of HIMSS
The hottest new technology for doctors promises to bring back an age-old health care practice: face-to-face conversations with patients.
As more than 30,000 health and technology professionals gathered among the palm trees at the HIMSS conference in Orlando, Florida, this week, ambient clinical documentation was the talk of the show floor.
This technology allows doctors to record their patient visits consensually. Conversations are automatically converted into clinical notes and summaries using AI. Companies like Microsoft's Nuance Communications, Abridge, and Suki have developed solutions with these capabilities, which they say will help reduce doctors' administrative workloads and prioritize meaningful communications with patients.
“After I see a patient, I have to write notes, I have to give orders, and I have to think about the patient's summary,” Dr. Shiv Rao, founder and CEO of Abridge, told CNBC at HIMSS. “So what our technology does is it allows me to focus on the person in front of me — the most important person, the patient — because when I press start, have a conversation, and then press stop, I can rotate my chair and within seconds, the note is there.”
Administrative workloads represent a significant problem for physicians throughout the U.S. health care system. A survey published by Athenahealth in February found that more than 90% of doctors reported feeling burned out on a “regular basis,” largely due to the paperwork they are expected to complete.
More than 60% of doctors said they feel overwhelmed by clerical demands and work an average of 15 hours a week outside of their regular work hours to keep up. Many in the industry call this working at home “pajama time.”
Because administrative work is mostly bureaucratic and does not directly impact doctors' decisions about diagnosis or patient care, it served as one of the first areas in which health systems began seriously exploring applications of generative AI. As a result, ambient clinical documentation solutions are having a real moment in the sun.
“There's no better place to be,” Kenneth Harper, general manager of DAX Copilot at Microsoft, told CNBC in an interview.
Microsoft Nuance announced its Dragon Ambient eXperience (DAX) Express clinical documentation tool in a preview capacity last March. By September, the solution, now called DAX Copilot, was generally available. Harper said there are now more than 200 organizations using this technology.
Microsoft acquired Nuance for about $16 billion in 2021. The company had a two-story exhibition booth in the expo hall that was often packed with attendees.
The technology saves doctors several minutes per encounter, though the exact numbers vary by specialty, Harper said. He said his team gets feedback about the service almost daily from doctors who claim it has helped them take better care of themselves — and even saved their marriage.
Harper recounted a conversation with a doctor who was considering retirement after practicing for more than three decades. He said the doctor was feeling burned out from years of stress, but was inspired to keep working after learning about DAX Copilot.
“He said, ‘I literally think I’m going to coach for another 10 years because I really enjoy what I do,’” Harper said. “This is just a personal anecdote of what kind of impact this has on our care teams.”
At HIMSS, Stanford Health Care announced that it is deploying DAX Copilot across its entire organization.
Gary Fritz, head of applications at Stanford Health Care, said the organization initially began testing the tool within its own exam rooms. Stanford University recently surveyed doctors about their use of DAX Copilot and 96% found it easy to use, he said.
“I don't know that I've ever seen that many before,” Fritz told CNBC in an interview. “It's a big deal.”
Its use is “remarkably smooth,” said Dr. Christopher Sharp, chief medical information officer at Stanford Health Care and one of the doctors who tested DAX Copilot. He said the speed and reliability of the tool is accurate and robust but could improve in picking up a patient's tone.
Sharp said he believes the tool saves him documentation time and has changed the way he spends that time. He said he often reads and edits notes rather than composing them, for example, so it's not as if the work has completely disappeared.
In the near term, Sharp said he would like to see more customization capabilities within DAX Copilot, both at the individual and specialty level. However, he said it's easy to see the value from the start.
“The moment that first document comes back to you, and you see your own words and the patient's own words reflected directly back to you in a usable way, I would say that from that moment on, you're hooked,” Sharp told CNBC. In an interview.
It's still early in the product's life cycle, and Stanford Health Care is still working out what the exact rollout will look like, Fritz said. DAX Copilot is likely to be rolled out to specific niche segments, he said.
Attendees of HIMSS in Orlando, FL 2024.
Courtesy of HIMSS
In January, Nuance announced general availability of DAX Copilot within Epic Systems' electronic health record (EHR). Most doctors create and manage patient medical records using electronic health records, and Epic is the largest vendor by hospital market share in the U.S., according to a May report from KLAS Research.
Integrating a tool like DAX Copilot directly into doctors' EHR workflow means they won't need to switch applications to access it, helping to save time and further reduce the clerical burden, Harper said.
Seth Hein, Epic's senior vice president of research and development, told CNBC that more than 150,000 notes have been crafted into the company's software by ambient technologies since last year's HIMSS conference. Technology is expanding rapidly. More notes have already been formulated in 2024 than in 2023, Hein said.
“We're seeing health systems that have worked through a deliberate process of acclimating their end users to this type of technology are now starting to deploy that quickly,” he said.
A company called Abridge also integrates its surrounding clinical documentation technology directly within Epic. Abridge declined to share the exact number of health organizations using its technology. California-based UCI Health is rolling out the company's solution system-wide, it announced at HIMSS.
Rao, CEO of Abridge, said the rate at which the healthcare industry has adopted ambient clinical documentation appears “historic.”
Abridge announced a $30 million Series B funding round in October, led by Spark Capital, and four months later, the company closed a $150 million Series C funding round, according to a February release. Rao said tailwinds such as physician burnout have turned into a “hurricane” for Abridge, and it will use that money to continue investing in the science behind the technology and explore where it can go next.
The company saves some doctors up to three hours a day and automates more than 92% of the clerical work it focuses on, Rao said. He added that Abridge's technology is available across 55 disciplines and 14 languages.
Abridge has a Slack channel called “Love Stories,” which CNBC saw, where the team will share the positive feedback they receive about their technology. One message this week was from a doctor who said Abridge had helped them take their least favorite part of their work and saved them about an hour and a half each day.
“This is the kind of feedback that inspires everyone in the company,” Rao said.
The market for ambient clinical documentation is “interesting,” said Puneet Soni, CEO of Suki. He expects rapid growth to continue over the next two years, although, like all hype cycles, he said he thinks the dust will settle.
Sony founded Suki more than six years ago after assuming there would be a need for a digital assistant to help doctors manage clinical documents. Suki is now used in more than 30 specialties in about 250 health organizations nationwide, Soni said. He added that six “large health systems” have begun working with Suki in the past two weeks.
“For four to five years I sat, basically with the store open, hoping that someone would show up. Now the whole mall is here, and there's a line out the door for people wanting to spread out,” Soni told CNBC at HIMSS. . “It's very exciting to be here.”
Suki's website says its technology can reduce the time a doctor spends on documentation by 72% on average. The company raised a $55 million funding round in 2021 led by March Capital. Sony said it would likely spark another round in the latter half of the year.
Sony said Suki is focused on deploying its technology more widely and exploring additional applications, such as how ambient documentation can be used to help nurses. Spanish is coming to Sooke soon, he said, and customers should expect most major languages to follow.
“There's a lot that needs to happen,” he said. “In the next decade, all healthcare technology will look very different.”
