Technologies for Reduccing EHR Usability Burden
Technology innovations have long promised to relieve burden by freeing physicians from manual EHR tasks. Today there is clear evidence that technologies and technology-enabled services can relieve some EHR usability burden by inserting technology or technology- assisted services into the EHR workflow and eliminating or streamlining tasks.
Below are five major technologies to help you reduce clinical documentation burden:
Medical scribes
Virtual scribes
Medical speech recognition
Ambient speech recognition
Artificial intelligence (AI) assistants
$2500–$4500 per month
Medical and virtual scribes are professionals who record information during clinical visits in real time and can perform other EHR tasks under physician supervision.
Pro:
• Delegating documentation and other administrative tasks to an in-person scribe takes burden off the physician
Con:
• Not broadly used in family medicine or primary care due to costs and investment required
Impact:
• Increased productivity
• 57% increase in patient face time
• 27% decrease in EHR time
$1000–$1200 per month
Virtual scribes reduce possible intrusiveness by removing the third party from the exam room and reduce costs by scaling and offshoring the scribe’s work.
Virtual scribe companies >> Augmedix, Aquity, Athreon, ScribeEMR, SkywriterMD
Pro:
• Cheaper than medical scribes and have no retention issues
Cons:
• Performs only patient charting
• Not real-time; up to 24-hour delay
• May incur added hardware costs
Impact:
• Up to 85% burnout reduction
• 1.1 hour/day EHR time reduction
• 1 hour/day documentation reduction
Enterprise: $25–$75 per month
Single physician: $200 per month
Medical speech recognition (MSR) can help by letting physicians use their voice to dictate into their EHRs more easily. Their accuracy and integration have evolved enough to provide many physicians relief from documentation burden. However, physicians still must navigate the EHR to enter and edit information.
Medical speech recognition companies >> Dragon Medical, MModal, KLAS Ranking
Pro:
• Established technology option with greatly improved accuracy
Con:
• Similar to dictation but physician must navigate EHR and edit
Impact:
• 79% of users were satisfied with MSR
• 77% reported improved efficiency
$150-$1,000+ per month
AI technology and services that “listen” to conversations between the clinician and the patient during the visit to create a note from their conversation. Ambient speech recognition is just emerging as an option and will evolve as AI becomes more powerful and accepted.
Pro:
• Shows promise in decreasing burden and enhancing care and visit documentation efficiency
Con:
• Ambient discussion in exam room is personal; MDM is purposeful and may not be done in the exam room
Impact:
• 79% of users reported better documentation quality
• 70% saw reduced burnout and fatigue
• 81% of patients saw greater physician focus
$150–$200 per month
AI assistants are emerging rapidly to perform EHR tasks on behalf of physicians, including documentation, chart review, order entry and inbox management. They replace human manual effort with software by allowing the physicians to interact much more efficiently through the AI assistant than via the EHR directly.
Pros:
• Mobile assistant allows physician to step away from EHR and let assistant interact
• Consumer-friendly features and cost
• Some AI assistants use a "human in the loop" to edit and correct the transcription while the AI assistant learns
Con:
• EHR integration is essential and vendors have been slow to support, but progress is being made
Impact:
• 72% reduction in documentation time
• 40% decrease in after-hours work, including weekend work
• 20% increase in practice satisfaction
