Augmented intelligence: Pros and cons of AI in health care and clinical workflow optimization

. 13 MIN READ

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.

How can AI improve health care? In this episode: successful implementation of telehealth, improving medical office workflow and the future of health care technology. Our guest is the AMA's new vice president of Digital Health Innovations, Margaret Lozovatsky, MD, who also discusses why physicians must be involved in the development of the tools they use and how the AMA is working to make technology an asset to physicians and not a burden. AMA Chief Experience Officer Todd Unger hosts.

Speaker

  • Margaret Lozovatsky, MD, vice president, Digital Health Innovations, AMA 

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Unger: Hello and welcome to the AMA Update video and podcast. Today my guest is the AMA's new Vice President of Digital Health Innovations, Dr. Margaret Lozovatsky, who is with us today from Charlotte, North Carolina. We'll be discussing a new AMA survey on how physicians feel about AI and how the AMA is fighting to make sure technology is an asset to physicians, not a burden.

I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Lozovatsky, welcome, and welcome to the AMA.

Dr. Lozovatsky: Thank you. Thank you for having me.

Unger: Well, we're so glad to have you join us. Technology is on everyone's mind right now. Before we dive into the discussion, tell us a little bit about your background and what brought you to the AMA.

Dr. Lozovatsky: Absolutely. So my name is Margaret Lozovatsky. I am a general pediatrician. I practice as a pediatric hospitalist and will continue to practice because it's very important to me to see patients and experience what the physicians out there are experiencing.

And my background really is that, as I went through medical training, I realized that technology is becoming more and more important to everything that we do. And I have a computer science degree, and so I quickly found myself as the go-to person through medical school and residency when people understood that I knew how to talk to the technology teams and to my colleagues, the clinicians.

And so that's how it all started. Over the years, I've worked at multiple institutions in various CMIO and CHIO roles, where my experience evolved from helping folks at the elbow understand how to use technology to really seeing it as a strategic asset, where I was able to sit at the executive table and help to develop the strategy for how clinical technology can be used so that we are taking care of our patients in the most effective way possible.

Unger: Well, I love that combination, practicing physician with a computer science degree. And then something you said is a great segue into the next question, which is about you being at the table when those kind of decisions get made because that, obviously, has been an issue for technology over the past decade or so with the objective, really, of making sure technology works for physicians and patients rather than the other way around.

So tell us a little bit more about how we're going to go about making sure that physicians are involved in the development and implementation of new technology. What's the AMA doing to make sure that's a reality?

Dr. Lozovatsky: Well, I am thrilled to have the opportunity to talk a little bit more about what the AMA is doing in this space because the AMA has been instrumental in supporting the development design of technology and the entire life cycle. And so one of the things that the team has done is create a program for physician innovators called PIN, Physician Innovation Network.

And that allows clinicians to have a voice in the very early stages of development. So any physician can sign up for this network, and what they can do is they can partner with various companies and help them develop, design products that will help them when they're taking care of patients. From that initial stage, there is many other phases to getting technology out into the clinical spaces.

And so the AMA has been instrumental in creating tools to help our physicians be able to implement and optimize that technology as it evolves. One of the tools that they've developed is a playbook for telehealth. Now, of course, telehealth has evolved to really move into the entire digital health spectrum, and so we're working to continue to create those tools to help physicians implement the technologies they need to meet the patients where they are so that they can take care of them in various settings.

We have a new AI report that is going to be coming out that really talks about the tools that are coming into the clinical spaces to ensure that they're helping physicians care for their patients in the most effective way possible. All of it, all the tools that the AMA comes up with, they incorporate the input from our physicians in as many ways as we can, from research to direct interviews to engaging them in the process of the development and design of the tools.

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Unger: That's great, and we'll make sure to include a link to the Physician Innovation Network, or PIN, as you mentioned, in the description of this episode. Now I love, again, that you're listening. This work is so important, especially given high levels of physician burnout, some of which is related to this issue of not having had physicians at the table. When you talk to physicians about technology, what is in most in need of their perspective right now?

Dr. Lozovatsky: That's a really great question, and I've talked to a lot of physicians over the years in multiple roles across the organizations that they work at. And if I had to choose just one thing that is most in need of a physician input, I would say it's workflow.

Technology is absolutely instrumental in our ability to care for patients. It's everywhere. We're using it all day. People think of the as EHR the main technology, but really, in a health care setting, there is 400, 500 other systems that are usually bolted on to that EHR. And we're interacting with them regularly.

But really, the goal is to help us care for our patients. And so having that physician voice in how the technology is implemented is absolutely critical. The AMA has surveyed physicians over the years and what we've learned is that there are four main questions that the physicians are asking themselves.

Is the technology going to work? Is it effective? Am I going to be liable if I'm using it? Will I get paid with the technologies that I'm using? And will it work in my practice?

And I think that one's probably the most critical one of all the questions because, again, it needs to enable us to care for patients. And so helping our physicians have a voice in the workflow, how it's implemented is really critical. And when it is implemented, a lot of times, it may not be as effective as we may have liked, and so having a voice in the optimization of the technologies that exist today and redesigning that workflow to fit the needs of each specialty.

I always say I'm a pediatrician. I'm not a cardiologist. The cardiologist knows what they need much better than what I might know. But what my level of expertise is as a clinical informatician is to help them implement, meet their needs, understand their problems and design the technology to solve the problem that they're trying to solve, and then bring that through all the processes at their institution for it to be implemented in the way that they envisioned to solve the problem that they started with. And so that's what I would say is probably at the forefront of most physicians' minds today.

Unger: That's great. It was not the answer that I was expecting you to give, but I love that the answer was workflow because we know from our other research around physician well-being and burnout that 80% of burnout really derives from system-level problems. And I think you're really zeroing in on the practical reality that is workflow and how that just affects every piece of the day.

Now, let's talk about the thing that I thought you were going to say because it's so much in the news, which is this world of AI. New AMA survey showed that 41% of physicians are equally excited and concerned about AI. One of their top concerns was the impact AI could have on the patient-physician relationship. Tell us more about that.

Dr. Lozovatsky: You make a very good point, Todd. AI is at the forefront of all of our minds. And while workflow may not be the exciting thing that we do in the background, AI is the exciting new tool that we're all thinking about. And I agree that many physicians have mixed feelings.

I think we all recognize that there is the decrease in administrative burden that we could experience, and that I think is where the excitement comes from. We recognize that automation—and that's what the survey showed is that automation could be incredibly valuable in a lot of those areas. And there is a fear when physicians think about why they went into medicine. We usually think of the patients.

We think about the fact that the relationships with those patients are very special to us. And that's what brings me joy when I practice medicine is the interactions I have with my patients. And so, the fear is that technology will be an extra layer between us and the patient. And so, I think a lot of the fears that I hear about come from that concern that the technology is going to take some of the work that we were doing traditionally, and step in between us and the patient, and perhaps not do it as accurately or as well and as diligently as a clinician can do.

And I think what's really important to consider—and the AMA has done a great job in taking a stance on this—that, really, we are looking at augmentation, not having artificial technology in that space. And really, we talk about augmented intelligence versus artificial intelligence. It's very important for physicians to hear because what we need to understand is that the technology is not going to diagnose the patient. The technology is going to help us in our day-to-day work to be able to do what we love, which is practice medicine.

Unger: Again, great vision for this. It's not about doctor bot at all. This is about a future in which AI and other technologies augmenting physician capabilities. If you—you're starting from scratch and you're kind of designing what the future of augmented intelligence looks like, what does that patient-physician relationship—how does it change in a world where we really have thought about how to make this an asset to physicians?

Dr. Lozovatsky: In my perfect world, I envision that AI technology is going to decrease what I like to call the cognitive burden. I think about my days at the hospital, where I'm managing sometimes upwards of 20 patients at the same time and constantly thinking about all of the different aspects of their care that I need to keep in my mind and stay on top of. Well, the way that I envision AI being most instrumental in the care of patients is to be a synthesizer of data to help bring that to the physician, the automation that we discussed that will decrease some of the cognitive burden that physicians are experiencing every day and the administrative burden that we're experiencing.

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Prior auth comes to mind as a perfect utilization of technology. And what that will lead to is actually the ability to spend more time with those patients, to spend the time that we had had in the past to get to know them, to really have that face-to-face interaction so we're not always staring at the computer because we're not having to spend all of that time to put that information together to dig for what we need. That is the power of technology, to really understand what data is most useful to us and bring it to the forefront in the right time, right place and have that decision support available to us that we don't have to dig for, and don't have to waste that time and can focus on the patient.

Unger: What a great objective. We know from our other research at AMA just how much time physicians are spending behind a computer screen relative to what they can do in that face-to-face interaction. And that's everyone's goal is more of that face-to-face patient care. Is there anything that stands out about one way the AMA is working to make a future like that a reality?

Dr. Lozovatsky: The AMA recognizes that physicians went into medicine to care for patients. And so we would like to change the narrative to have technology be the enabler so that we can make sure we're supporting our clinicians and caring for their patients. And the way we do that is to really consider the entire life cycle of the technology.

And so from the time of innovation, looking at the PIN network, to the time of implementation, and optimization, all the playbooks that we're developing, to a time when clinicians really need their voices in their institutions, building out that governance that they need in their organization to enable their clinical informatics colleagues to help them get to what they need, the AMA has a place in all of those phases of the technology life cycle.

Unger: Dr. Lozovatsky, what an exciting time to join the AMA and bring your expertise to the table on such an important objective. If making sure that technology is an asset, not a burden, making sure physicians are at the table for technology planning, if those are important to you, you can support it and more programming like this by becoming an AMA member at ama-assn.org/join.

Join 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. Please take care.


Disclaimer: The viewpoints expressed in this video are those of the participants and/or do not necessarily reflect the views and policies of the AMA.

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