In an effort to reduce provider burnout, improve work efficiency, and enhance the patient experience, CRH launched an ambient listening pilot in July using DAX Copilot, an AI-powered clinical documentation tool developed by Microsoft and Nuance that captures clinical conversations between providers and patients and transcribes them into progress notes and care plans.
The DAX tool was used initially to replace physical scribes in the Emergency Department and among providers with a high burden of note writing. The pilot was a success: 90% of providers who used DAX reported reduced burnout and better work-life balance, and 100% reported reduced cognitive burden and productivity gains. These results have led CRH to continue and expand the use of DAX in other care settings.
CRH providers have found AI enables them to have more face-to-face time with their patients, while reducing the amount of time they typically spend writing visit summaries. The provider uses an iPad that has Epic’s mobile platform Canto loaded on it. After receiving consent from the patient to record the conversation, the provider then activates the listening feature.
Emergency Department physician Ben Chastain, MD, said DAX has improved his interactions with patients and overall work efficiency. After completing a patient’s initial history and physical, knowing that DAX has captured and summarized the conversation, he is able to leave the room and go see another patient, rather than go to his desk to complete an initial summary. Within a minute of completing the encounter, he has a draft of an ED note started. He completes the same process whenever he returns to the patient’s room. DAX will then capture any updates, such as patient disposition, recommendations, and test results. “It does a really great job of capturing my discussion with patients and outlines the plan that I have put in place. I have been really impressed with how it can summarize a complex/challenging history, and it helps document my thought process,” said Dr. Chastain.
Prior to using DAX, Dr. Chastain and other ED providers would use a physical scribe to capture the conversation. Using DAX eliminates the distraction of having another person in the room. “I can focus all of my energy towards the patient with less concern for documentation,” he said. “Using an ambient scribe makes the physician verbalize their thought process, which I think allows the patient to have a better understanding of the physician’s plan.”
In the outpatient practice setting, physicians have found similar benefits using DAX. In addition to allowing for more face-to-face time with her patients, Family and Internal Medicine physician Mary Beth Hensley, MD, said it has improved her patient chart closure times (the time to complete and sign all required documentation for a patient encounter) from 50% closed in two days to nearly 90%. “This feature allows patients to have access to their instructions and chart notes more quickly,” she said. Her patients have been very receptive to the addition of DAX AI ambient note writing, and she includes them in the process and has them review their visit notes for any errors. “My patients have been extremely receptive to the addition of DAX AI ambient note writing,” she said.