Thorough and accurate physician and practitioner documentation supports improvements to care quality and claims reimbursements, but capturing this information continues to impose significant administrative burdens on the physician and practitioner workforce. Over 60% of physicians report too many bureaucratic tasks (e.g., charting) as the top contributor to burnout. With healthcare organizations facing physician shortages and increased patient demand for services, they need a clinical documentation solution that supports the physician-patient experience, giving time back to the physician to really listen to each patient’s health concern, leading to better patient outcomes and greater physician satisfaction and engagement.
For Hudson Physicians, a multi-specialty clinic and urgent care provider offering services to communities in Western Wisconsin, the major challenge in clinical documentation and workflow efficiency stemmed from an inability to provide enough support staff for their physicians due to high demand and limited availability of such workers.
"We primarily used a scribe model where busy doctors had scribes, but even then, staffing challenges were so severe that we couldn't secure scribes for all who needed them," says Ryan McFarland, MD, a family medicine physician practicing obstetrics at Hudson Physicians.
"We needed a different solution to maximize efficiency and keep up with the increasing demand for our services," he continues. "Efficient processes are crucial for us — they enable us to provide better care, more effectively meet patient needs through better communication, and patient management."
Hudson Physicians joined Oracle Health's Clinical Digital Assistant beta program to help shape the development of a tool that meets their specific needs for efficient and effective care delivery and charting.
"Our primary motivation for participating in the digital assistant pilot was the lack of existing products that function as they should," McFarland explains. "We were eager to engage early in the development process to shape a solution that meets our needs effectively. Our only real concern was the time commitment required, as it meant extra work without slowing down our clinic operations. However, the potential benefits and the opportunity to innovate a functional product greatly outweighed this concern."
The digital assistant leverages speech, language, and generative AI to more accurately capture and interpret spoken dialogue during patient visits. This information is then seamlessly integrated into the electronic health record (EHR), automating the documentation process and allowing physicians to focus more on patient care rather than manual data entry. This integration speeds up workflow, improves the accuracy of medical records, and supports compliance with healthcare regulations.
"The underlying technology of our digital assistant is powered by cloud infrastructure, which allows us to deliver a system with high levels of security, privacy, and performance right from the start," says Jigar S. Patel, MD, Oracle Health senior director and executive medical director who is a member of the development of the digital assistant.
"This infrastructure supports the rapid development and deployment of applications, simplifying the process of creating tools that enhance physician-patient interactions," he adds. "The cloud's capabilities are fundamental in meeting the fast-paced demands of clinical environments and helps ensure the solution is effective and secure."
In the exam room, the digital assistant enables the physician to maintain direct and continuous engagement with the patient. The physician's smartphone acts as the recording device, often unnoticed by both the patient and the physician. The digital assistant seamlessly integrates with Hudson Physician's Oracle Health electronic health record (EHR) system, creating a preliminary note for physicians to update and sign.
"Initially, the digital assistant was quite clunky, slow, and imperfect, as you might expect from a new technology," McFarland reveals. "However, after actively participating in its development, I've been using it exclusively for the last two months. It has effectively replaced my scribe and is now performing exactly as intended, which has greatly simplified our processes and improved efficiency."
“Now I sit and face the patient the entire time to talk with them, and they feel heard because I'm not distracted doing something else. I'm responding to their questions or concerns because I have time to review with them. Oracle Health Clinical Digital Assistant allows you to just have your natural organic clinic interaction with patients.”
According to McFarland, the digital assistant has provided several benefits to Hudson Physicians:
Improved documentation accuracy: Physicians who previously struggled with sparse notes are now producing more detailed and accurate documentation, making it easier to understand their actions and decisions. This leads to improved patient care by helping ensure that patients receive follow up tests, prescriptions, and imaging studies as necessary.
Enhanced billing accuracy: The assistant helps ensure proper documentation, leading to more accurate billing and eliminating underbilling issues among providers.
Workflow Efficiency: The implementation has significantly improved workflow efficiency, reducing the time spent on documentation and allowing staff to focus on other tasks.
Time management: Physicians can stay on schedule more effectively, allowing them and their staff to take lunch breaks and reducing the need to catch up on documentation during off-hours.
Ease of use: All physicians, including those initially resistant to technology, have easily adopted the assistant, demonstrating its user-friendly design and practical benefits.
"Implementing and training for this technology involves minimal effort — it is one of the simplest systems I've supported in nearly two decades," Patel emphasizes. "We install the application on the physician's phone, perform a test conversation, and demonstrate just how easily they can record and send for processing. Essentially, if you can use a smartphone—to touch, type, swipe, or voice command—you can use this system with ease."
Building on this ease of use, Patel sees future opportunities where the integration of generative AI into the technology further enhances its capabilities. "Moving forward, we aim to transform how clinicians access and utilize information by incorporating generative AI into our technology, which will enhance data summarization and reduce the burden of chart review. This advancement will enable more efficient and effective use of data, streamlining processes that are currently cumbersome in EHR systems and ultimately revolutionizing clinical practice."
That will extend beyond the Oracle Health digital ecosystem, benefiting more physicians.
"The technology is API-enabled and hosted in the cloud, but it remains accessible in traditional settings for flexibility. Expanding compatibility with non-Oracle Health EHRs by adopting a system-agnostic approach will go a long way toward accommodating a broader range of healthcare IT environments."
The integration of advanced digital assistants into clinical workflows offers a promising solution, helping reduce physician burnout and enhancing their engagement, improving the patient/physician experience and patient satisfaction, improving operational efficiency, and producing better financial performance through accurate billing and optimized workflows.
To learn more about Oracle Health Clinical Digital Assistant, visit oracle.com/clinicaldigitalassistant.
