The use of augmented intelligence (AI)—also called artificial intelligence—and cutting-edge technologies are paving the way for a more efficient health care system. These innovations are easing administrative tasks, allowing physicians to devote more time to patient care and enhancing overall well-being.
By integrating smart solutions into daily operations, University of Iowa Health Care is not only streamlining workflows but also fostering a deeper connection between physicians and their patients, promising a healthier future for both caregivers and those they serve.
University of Iowa Health Care is a member of the AMA Health System Program, which provides enterprise solutions that equip leadership, physicians and care teams with resources to help drive the future of medicine.
Among physicians who participated in a recent AMA survey, 57% said that addressing administrative burdens through automation remains the biggest area of opportunity for AI to address key needs as workforce shortages continue to increase and as physician burnout continues to be a key concern.
The AMA survey (PDF) examines changes in physician sentiment toward health care AI from August 2023 to November 2024 and offers insight into physicians’ evolving perspectives on adopting and using health AI. Researchers surveyed nearly 1,200 physicians, including primary care physicians and an array of specialists, as well as a mix of physicians practicing across different settings.
In 2023, University of Iowa Health Care launched its own survey to identify pain points in the organization. That research led them to identify technology solutions to help physicians find burden relief through AI tools.
“The No. 1 problem that we had was external data integration, which I’m hoping that we move the needle on,” Jim Blum, MD, chief health information officer for University of Iowa Health Care, said in an interview.
These AI tools do not replace the judgment of physicians, but they do help improve physicians’ well-being—and the experience of patient care.
“Rarely do people get fan mail, but we have gotten fan mail regarding this,” said Dr. Blum, an anesthesiologist and critical care medicine physician. For example, physicians as a whole have said: “Thank you so much for bringing this to us. This has made my life better.”
“The other thing we have is we have gotten email from patients saying, ‘My doctor wasn’t consumed looking at the computer during my whole visit. They actually talked to me and made eye contact with me. It was really nice,’” he said.
Reducing documentation burden
The first resource launched was an ambient AI-documentation tool from Paris, France-based tech company Nabla, which was released to all physicians, nonphysician providers, nursing, house staff and trainees at University of Iowa Health Care.
“We’ve had very strong adoption amongst our attending staff, with about 50% of outpatient clinicians using it on a regular basis,” said Dr. Blum, adding that “we have surveyed them and looked at the folks who are using it very closely.”
“From our preliminary data, when we did a trial of this tool, we saw a reduction in burnout and we’ve seen that replicated in the data we’ve gotten so far,” he said. “In our small case series, we went from about 69% burnout in the trial group to about 42%. We’re seeing an equivalent drop, but the general population wasn’t 70% burnt out this time around.”
Additionally, “we know that physicians have dramatically reduced documentation pajama time by hours,” Dr. Blum said. “It’s time that they were spending at home in their nonclinical time catching up on documentation.”
While the Nabla tech is primarily used in the ambulatory environment, Dr. Blum has used it in the intensive care unit too.
At each visit, the physician will explain this new AI tool to help with documentation and will ask the patient to consent to the use of it. Once the patient agrees, “you set your phone down on the desk and you do your exam, you talk to the patient,” he said. “You can actually say what you’re doing during the exam and it will document all those things for you.”
“It will actually write everything for you and you can talk to the patient about whatever problem it might be,” Dr. Blum said. “And then the physician just reviews it, edits where necessary, and signs off on it.”
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Gathering patient health history
The other AI tool is from a Palo Alto, California, company called Evidently, and it is used for chart review. It combs through the EHR and generates an automated problem list and summary of the last 24 hours and the patient’s last clinical encounter with University of Iowa Health Care.
From a physician “perspective, it really helps paint a picture of a patient who would otherwise take hours to generate the level of detail that it does, and it presents it to you immediately with linkages to how it determined each of those diagnoses,” Dr. Blum said. “Given the marginal quality of EHR data as a whole, you still need to go back and verify the source record.”
“It’ll present that information to you, but then you have to manually select things and export it to your note or whatever you’re going to do with it,” he said, noting “you’ll open up the patient’s record in our EHR and you can go to the Evidently tab and what it will first start off with is the set of clinical summaries for you.
“Then it will generate a problem list for you of problems that this patient has documented in the past. It’s not just from things that were previously coded. It’s problems that were identified through reading every note that patient has ever had written,” Dr. Blum said. “It’s presenting more of a comprehensive view to people not necessarily saving them a ton of time. But we think it’s helping them make better decisions.”
For example, “I was in the ICU working and I noticed a patient didn’t look well … but it helped me identify this woman with really severe pulmonary hypertension that wasn’t clearly articulated in any note,” he said. “But it was on her echocardiogram and it identified that diagnosis and really changed the therapy that we provided her.”
“The problem with the EHR is not that we don’t have enough information. It’s that the information is so verbose that no one can possibly metabolize it,” Dr. Blum said. “The average medical chart now is 1,200 pages. It’s The Count of Monte Cristo and we’re asking people to read this in 10 minutes and not miss anything. It’s just nonsensical.”
“These technologies really help surface potentially concerning diagnoses that may fundamentally change the way people are managed,” he said.
From AI implementation to EHR adoption and usability, the AMA is fighting to make technology work for physicians, ensuring that it is an asset to doctors.
