How an FQHC is using ambient AI to reduce clinician burden

IMPLEMENTING THE TOOL

Ambient AI technology, like Nabla's tool, targets clinical documentation burdens, one of the primary drivers of clinician burnout.

The ambient AI technology discreetly records clinician-patient conversations during medical visits and creates a clinical note automatically, essentially acting like an "invisible assistant," explained Delphine Groll, co-founder and COO at Nabla.

"Every part of the platform is designed to reduce the time and cognitive effort required to complete notes, without adding complexity to the clinician's day," she said. "The AI generates accurate, structured notes in less than 5 seconds and uses customization and multiple templates."

The templates are built for different kinds of visits, such as routine check-ups and mental health sessions. Clinicians review and sign their notes to ensure accuracy.

Additionally, the tool offers a real-time dictation feature for clinicians who prefer more control over their notes, Groll noted.

To implement the tool, the organizations worked together to identify a cohort of participating providers from different specialties. The next, and most crucial step, was gaining staff buy-in.

Though Neighborhood Healthcare had been using live medical scribes, the idea of technology taking over needed some getting used to. Reyna Reynaga-Vargas, a nurse practitioner at the FQHC, shared that training and getting experience using the tool were essential to gaining staff buy-in.

"At the beginning, it was a little challenging because I didn't have too much experience in using it," she said. "But once you start using it, it's pretty simple."

Nabla conducted live training sessions and hosted office hours where pilot participants could ask questions and receive guidance specific to their workflows. They also distributed pre- and post-pilot surveys to measure the pilot's impact.

For the expansion phase, the Nabla team spent several days onsite at Neighborhood's clinics to better understand the clinical environment. Following this, they began a phased rollout that included live, one-hour training sessions tailored to new users.

Aside from some providers who needed to adjust to an AI tool after having a live scribe, the FQHC's staff appear to have embraced it. Reynaga-Vargas noted that patients also seem comfortable with the technology, with only a handful of patients expressing concerns about data safety. To allay these fears, clinicians explain that the data stays in the cloud for a short period of time before disappearing.

BENEFITS OF AMBIENT AI

Neighborhood Healthcare faces many of the challenges that FQHCs across the country face, including caring for high-need and vulnerable populations with limited resources.

It facilitates over 500,000 medical, dental, and behavioral health visits across 30 facilities. However, keeping up with the administrative burden of all those visits often requires clinicians to work after hours. And research shows that ambient AI technology can reduce the cognitive burden of clinical documentation and after-hours work time.

Reynaga-Vargas' experience aligns with the research. She shared that she typically worked for an hour or two at home to finish clinical documentation prior to the tool's implementation. But now, she sees "approximately 16 to 20 patients a day, and I'm able to finish my notes most likely on the same day."

Not only that, but the tool's AI-generated notes are largely accurate. Of the 34,000 notes generated during and after the pilot, 76% received a rating of 4 or higher out of 5 from providers, and only 2% required editing.

Additionally, the tool supports 35 languages, which allows clinicians to document in the language they and their patients are most comfortable with. For example, Reynaga-Vargas usually speaks Spanish with her patients, and the tool records the conversation in Spanish and then translates it into an English note.

As a result, Neighborhood Healthcare has "seen a marked improvement in data capture and reduced administration time," said August.

Ambient AI's value proposition is becoming clearer. Even though questions remain regarding its cost impact, health systems are seeing the positive impact on clinician burnout, primarily as a result of reducing the clinical documentation burden. Thus, even for smaller and under-resourced facilities, investing in AI scribe technology may well be worth the cost, as it appears to have been for Neighborhood Healthcare.

"Invest now in making your organization a more effective and efficient care provider," August said. "It will be worth it."

Anuja Vaidya has covered the healthcare industry since 2012. She currently covers the virtual healthcare landscape, including telehealth, remote patient monitoring and digital therapeutics.