AMA Update covers a range of health care topics affecting the lives of physicians, residents, medical students and patients. From private practice and health system leaders to scientists and public health officials, hear from the experts in medicine on COVID-19, medical education, advocacy issues, burnout, vaccines and more.
Featured topic and speakers
AI patient summaries: Who writes after-visit summaries? How reliable is AI in health care? Can AI help write clinical notes? How is AI used in hospitals?
Our guest today is Veena Jones, MD, vice president and chief medical information officer at Sutter Health. In this episode, Dr. Jones talks about how Sutter Health is turning clinical notes from the care team into patient-friendly summaries using AI. AMA Chief Experience Officer Todd Unger hosts.
- Watch AMA Update for health care news for physicians, residents and medical students.
- Not a physician? Join the Patients Action Network.
- Learn more about the AMA Health System Program.
- The AMA is your powerful ally, focused on addressing the issues important to you, so you can focus on what matters most—patients. We will meet this challenge together. Join us.
- Learn more about our AMA advocacy priorities, including:
- Reforming Medicare payment
- Fighting scope creep
- Fixing prior authorization
- Reducing physician burnout
- Making technology work for physicians
Speaker
- Veena Jones, MD, vice president and chief medical information officer, Sutter Health
Transcript
Dr. Jones: One really stark difference with ambient AI is this is really powerful and really is alleviating a lot of the burden that our clinicians have felt when it has come to using the electronic medical record.
Unger: Hello and welcome to the AMA Update video and podcast. Today we're talking about how one health system is turning clinical notes from the care team into patient-friendly summaries using AI. Our guest today is Dr. Veena Jones, vice president and chief medical information officer at Sutter Health. And she's talking to us today from San Francisco.
I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Jones, welcome.
Dr. Jones: Thank you so much. Happy to be here.
Unger: Very curious to get into this use of AI. Of course, you can imagine, there's a lot of conversation about AI in medicine these days. But let's just start with where we were before this. What was it about these kind of summaries that inspired you to want to take another whack at how they were being produced?
Dr. Jones: Yeah, so historically, the information that we share with our patients as clinicians is very heavily reliant on what the clinician, the physician or individual taking care of a patient, what they are able to remember from the conversation and then what they're able to write down or type into the electronic health record to share with the patient. So very much reliant on clinician recall and their ability to type quickly.
Unger: It's interesting because, as I was looking at the discussion guide, I glanced down, and I have one of these patient summaries that was generated through the EHR on my desk from my recent visit to my primary care physician. What does that tell me? What is that going to look like in a future where you're using AI to create the summary?
Dr. Jones: Yeah, so to tell you a little bit about what we've launched in our system, so we've partnered with an ambient AI vendor called Abridge. And essentially what their technology allows our clinicians to do is simply record the conversation as it's happening with patient consent, and at the end of the visit, clinician just types 'Create Note.'
And after clicking that button, not only is a full clinical note generated for the medical record, so a note that describes the discussion that the physician had with the patient, including their physical exam and ultimately their assessment and plan. But it also generates, in patient-friendly language, the corresponding or the analogous summary of the visit that can be shared directly with the patient.
So that I think is really what is incredibly unique about this partnership that we have and about this technology that we've launched is that it's not just generating a note for the clinician and for clinical purposes. It's also generating a summary in less medical speak but patient-friendly language that really empowers the patient to have the information they need.
Unger: You really covered two important advancements in that one conversation, which is ambient listening to begin with, which is freeing up the physician to remove themselves from typing in front of a computer to talking to the patient and then having a patient-friendly summary generated out of that.
Is this something that the physician needs to go in and look at before they do it? How reliable are these summaries?
Dr. Jones: Yeah. So yes, ultimately all of the output from these generative AI platforms as we've implemented them, they require clinician review. And so our clinicians review both the note content before they hit 'Sign' and the summarized patient content before they send it to the patient.
In terms of reliability, we've heard anecdotally that our clinicians are overall quite impressed with the output. I think there is variability, depending on the clinical specialty and how nuanced that clinical visit is. But we've also heard a lot of feedback from patients who have been really impressed about the level of detail that's been captured in the summary that they receive from their visit.
Unger: Tell me a little bit more about that patient reaction. What are they seeing in there? What is noticeable to them about the difference?
Dr. Jones: Yeah, I can tell you, one example that stands out is actually a patient that had a visit with their clinician and shared their perspectives on, this has been bothering me. I've been having pain here, and here's the story of why and how it happened.
And historically or traditionally, our clinicians who are very busy listening to patients, trying to type as they listen, that's challenging to do to. Be able to just sit back and have the AI capture this, the patient was very impressed at the level of detail and really left saying, wow, they really listened to me. They really heard me and heard what I was concerned about and documented that.
Unger: Was the number one thing, as you were talking about that, that struck me, is that word "listening" because I was just thinking back, again, the traditional patients note, it was mostly like action steps. Let's just call it that.
There's not a lot summary of what we talked about, per se. And certainly that sense of having been listened to, as you tell your story to the physician, that must be very gratifying, I imagine, to both patient and physician.
Dr. Jones: Yeah, I really think it is because at the heart of what we do as clinicians, it's our patients and their well-being. And yet the cognitive burden of practicing medicine is so high that I think some of these details often get lost. So having a platform, having technology that can really help capture that and bring us back to that part of medicine, that patient-provider interaction, I think is incredibly valuable. And I think that really is the power of what ambient AI is allowing.
Unger: Now, we talked a little bit about patient reactions to this. Obviously, there are benefits to the physician as well in a situation like this. But talk to us a little bit about the workflow. Obviously, with any new technology that is so critical, how are your physicians actually using this tool? And what's their experience been so far?
Dr. Jones: Yeah, so Abridge is being pretty widely used across our organization, but you make some really good comments on workflow. And fitting something new into a practice is not without its own challenges. And so when we embarked on our journey to first launch this technology, we started with a small group of pilot clinicians from across our organization, different specialties, primary care, specialty care, surgeons, and really tested it out, tested our training materials out, understood the best workflows based on their experiences.
And then it was from there that we started expanding and further scaling the technology. So currently, this platform is being used by over 2,000 clinicians across our system.
Unger: That's great. And one thing that has struck me, as I've talked with different physicians about the incorporation of AI into workflow, is that unlike, let's say, the development originally of EHRs, so much energy is being put into what you talk about, which is, how do I work this into the workflow so that it's an asset, not a burden? Do people notice that, the way that you're proceeding with this?
Dr. Jones: I think they do. And one thing I'll say, as a leader, scaling technology in a health system, so much of implementing EHRs and optimizing EHRs is sometimes painful for clinicians. Learning how to use a new technology is not easy.
I think one really stark difference with ambient AI is this is really powerful and really is alleviating a lot of the burden that our clinicians have felt when it has come to using the electronic medical record. And so the uptake has been pretty phenomenal. And this has very much felt like a pull rather than a push.
Our clinicians want this. They are pulling to get it. Whereas implementing an electronic health record, a little more of a push, a little more of, we need you to do this. This is the right thing to do.
And so I think that shift in dynamic with technology in the clinical space is also really profound. And our clinicians are in general really satisfied.
Unger: I love pull versus push analogy here. And that is a real win for everybody here. Obviously, there's a practical benefit of these types of summaries, and they do provide not only notes on what the actual conversations were but next steps in terms of medication or other treatment options. You're just at the very beginning of this. What do you think, longer term, that these types of summaries are going to have in terms of impact on patients?
Dr. Jones: Yeah, I think, if you're familiar with the OpenNotes movement, the movement around transparency with our patients, the obligation to share as much information as we can with our patients, the 21st Century Cures Act, the final act that was implemented several years ago, really mandated that all health systems, all clinicians share information with patients.
And I think at the heart of that is the fact that patients should be considered and really are a key member of their care team. Whether it's medication management, understanding their health, identifying potential errors in their health record, I think patients are really uniquely positioned to do those things. And it's also our obligation to give them information in a way that they can digest it to be those members of their care team. So I think that's really where the power of AI is in helping us provide easily digestible patient summaries that can then help empower patients to be active members of their own health.
Unger: That makes a lot of sense. What's on your roadmap for the coming year?
Dr. Jones: Well, we're really looking to continue to scale our use and adoption of Abridge, of our ambient AI platform across our system. So the 2,000 users that I mentioned, we really started our journey with scaling the technology across our ambulatory clinical user base. And we're now in the process of bringing it to our inpatient, our hospital-based, clinicians, our emergency department clinicians.
So coming this year, we're going to be scaling that a lot more widely as we've learned about how the workflows differ in those clinical settings and what the needs are there as we scale. And then we're really excited about the development roadmap that Abridge has in terms of what they're bringing forth. Whether it's helping our clinicians with order entry or billing and coding, I think there's a lot more to come, and we are excited to be early adopters in that journey.
Unger: Well, I'm really impressed with your use of the technology and also the care with which you're scaling it across your organization. It's just been so fascinating to hear you talk about this, and I just want to say thank you for sharing your experiences with us today.
Dr. Jones: Absolutely. Thank you for having me.
Unger: And one of the AMA's top priorities is making sure that technology works for physicians, not the other way around. So if you found this discussion valuable, you can support more programming like it by becoming an AMA member at ama-assn.org/joinnow.
That wraps up today's episode. We'll be back soon with another AMA Update. Be sure to subscribe for new episodes and find all our videos and podcasts at ama-assn.org/podcasts. Thanks for joining us today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
Subscribe to AMA Update
Get videos with expert opinions from the AMA on the most important health care topics affecting physicians, residents, medical students and patients—delivered to your inbox.
