Nearly all doctors feel burnout, but many are encouraged by potential of AI, survey says

Guardian Nigeria

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00:00 You know, when you go to your doctor's office,

00:01 you've probably noticed that your doctor spends a lot of time

00:04 during your visit typing into the computer,

00:06 documenting your symptoms

00:08 into your electronic health records.

00:10 Well, those EHRs are really the bane of doctors' lives.

00:14 A lot of them actually end up finishing those notes later,

00:17 often at home, in what's become known as

00:20 pajama time in the business.

00:23 Microsoft's Nuance Technology Unit

00:24 has an AI-enabled app called Dax Express

00:27 that just could put pajama time to bed.

00:30 To see how it works, I did a simulated doctor's appointment

00:33 with Nuance's Dr. Julie O'Connor,

00:35 and she didn't type at all during our visit.

00:39 - I'm actually on my phone, and I'm inside our Dax app,

00:41 is actually can record the conversation

00:45 and use that ambient AI to automatically create

00:48 a draft clinical document from our conversation.

00:51 So I'm with Bertha, who's a 50-year-old female

00:54 here today for foot pain.

00:55 So tell me, Bertha, what's going on?

00:57 - I love to run for last 15 years until about 2017.

01:02 - Okay. - It was great.

01:04 It was a great stress reliever.

01:06 I really enjoyed doing it.

01:07 And then around 2016, 2017, I developed plantar fasciitis.

01:12 - Okay. - So I had to

01:14 literally step back, and I wasn't running much anymore.

01:18 - But recently, it's become worse, is that correct?

01:21 - It's become worse, particularly in the morning,

01:23 regardless of whether I've run or,

01:26 well, if I've walked a lot,

01:28 so I like to go hiking as well.

01:29 - Okay. - So if I do that,

01:32 it, like the next day, I will feel some aches,

01:35 more aches in my feet. - Okay.

01:37 - It's like you're walking on marbles.

01:40 And now also my ankles sort of feel a little crunchy as well.

01:43 I don't know if it might be arthritis.

01:46 My grandmother had arthritis.

01:47 - I think the MA told me that you're going on a vacation,

01:50 you're hoping to hike.

01:51 - Yeah. - It's up in the Adirondacks.

01:52 My in-laws, they have a place in Lake Placid,

01:55 and so we usually go up in the wintertime.

01:57 - This year, the black flies and deer fly are really vicious.

02:02 Fourth of July, I was up there, I got bitten on,

02:04 I had everything covered, but got bitten on my finger,

02:06 got infected, and I wound up having to take antibiotics.

02:10 - So next, I would really like to do an exam,

02:13 if that's okay with you. - Okay.

02:14 - So when I press the outside of your ankle,

02:16 does that hurt at all? - No.

02:17 - There's no focal tenderness

02:19 over the medial or lateral malleoli.

02:22 Normal range of motion in both ankles.

02:24 Your exam is normal,

02:26 but your symptoms are consistent with platar fasciitis.

02:29 What I typically recommend patients do

02:32 is they actually stretch their foot out

02:34 before they even step out of bed in the morning.

02:36 I would actually wear shoes with orthotics.

02:39 I'm also gonna do x-rays of your ankles bilaterally,

02:42 so x-rays of both ankles

02:43 to evaluate for possible arthritis.

02:46 In addition, I would recommend you do ibuprofen,

02:49 600 milligrams, three times a day.

02:52 So I stopped the recording,

02:53 and so what happens is that audio file

02:56 of our conversation goes up to the Microsoft Azure Cloud,

02:59 gets run through the engine,

03:01 and we automatically receive a note back.

03:03 And as a clinician, I'd be able to reference this

03:06 on the phone, review it on the phone,

03:08 or review it from the computer.

03:09 I can make edits from either of those locations as well.

03:13 So this is the part of the medical documentation

03:15 that actually tells the patient's story

03:17 of what brought them in.

03:18 So you love to run, you've been doing it for 15 years,

03:21 until 2017, it was a stress reliever,

03:25 and you were developed plantar fasciitis.

03:27 You're running less, instead you're doing walking

03:31 or the elliptical, but it's not the same for you.

03:33 The bottom of your feet's hurt, your ankles feel crunchy,

03:37 and honestly, this part of the note

03:40 is really taking your own words,

03:42 and it included the walking on marbles as well.

03:44 You've done the therapy in the past,

03:46 you'd like to go hiking.

03:47 Supplemental information, you had an infection

03:51 from July on your hand that got treated with antibiotics,

03:56 which is important medical history.

03:58 Taking a medication like that can set you up

04:00 for other things down the road,

04:02 but it did take out the banter about me--

04:04 - And the Adirondacks. - And the Adirondacks,

04:06 me having family that lived in Lake Placid,

04:08 and so that's not medically relevant.

04:10 So with DAX Express, anything that I verbalize out loud

04:15 will be incorporated into the output.

04:18 I focused really on the foot exam,

04:21 and so looking at the left foot,

04:23 there's no focal tenderness.

04:25 Now coming down to the assessment and plan,

04:27 so this is where we document our diagnosis

04:31 and the medical decision-making.

04:32 So I recommend stretching, orthotics,

04:35 taking the ibuprofen, 600 milligrams three times a day.

04:38 I don't see the x-ray specifically,

04:40 so I would add that back in as I'm reviewing the note

04:43 before I sign off.

04:44 - When I've seen my doctor notes,

04:46 I never see a narrative like that.

04:48 I see basically bullet points.

04:50 - So they're trying to do the fastest thing they can do,

04:53 and this allows them to really just focus on you,

04:56 focus on the medicine of what's bringing you in.

04:59 - As a doctor yourself, where do you see this going?

05:03 - 40 to 60% of clinicians are, you know,

05:07 identifying with feeling burnt out,

05:10 and we are facing this huge shortage

05:13 in physicians in the US.

05:15 You know, by 2025, I think they estimate

05:17 90,000 physician shortage in the US alone.

05:21 And so we need to combat that administrative burden,

05:25 and these tools, this technology,

05:27 is really serving a huge pain point in the workflow.

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