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Featured topic and speakers
What is the leading cause of physician burnout? What problems can AI solve in health care? Benefits of artificial intelligence in health care: How is AI used in EHR?
Our guest is AMA President Jesse Ehrenfeld, MD, MPH. AMA Chief Experience Officer Todd Unger hosts.
- The AMA is your powerful ally in patient care. Join now.
- AMA EHR burnout resources and efforts to reduce physician burnout.
- Free EHR toolkit and the AMA Inbox Reduction Checklist PDF available.
- Access AMA's Taming The EHR Playbook.
- How do doctors use AI? Find more AI in medical field examples.
- Regulations on artificial intelligence in health care (PDF).
- Digital health technologies examples.
Speaker
- Jesse Ehrenfeld, MD, MPH, president, AMA
Transcript
Unger: Hello and welcome to the AMA Update video and podcast. Today we're talking about making technology work for physicians, and not the other way around.
Our guest today is AMA President Dr. Jesse Ehrenfeld in Milwaukee. And I'm Todd Unger, AMA's chief experience officer in Chicago. Dr. Ehrenfeld, welcome back.
Dr. Ehrenfeld: Thanks for having me again.
Unger: Well, there's been more talk lately about the technology physicians are using, and the impact that it may have on their well-being—both positive and negative. Dr. Ehrenfeld, what's driving this conversation right now?
Dr. Ehrenfeld: Well, Todd, I do think we're seeing a confluence of trends at the moment. On the one hand, you've got this growing interest in AI. Which has got the potential to usher in a new era of digital health technology, and there's a lot of excitement about that.
On the other hand, you've got the ongoing concerns about physician burnout. People are starting to focus more on the system level issues that contribute to burnout. And we know that technology—poorly designed technology, poorly usable platforms—can be one of those drivers.
So as we discuss ways to use AI in medicine, the potential impact of these tools on physician well-being also has to be part of the conversation. And I think that's a positive development. Whenever a new digital health tool, whether it's AI-powered or not, is rolled out without considering the impact on physicians or other health care workers or workflows, that's when we see problems. That's when you have workflow inefficiencies, barriers to care and burnout.
Unger: A very different scenario, maybe, right now when you talk about that confluence than EHRs a decade ago. Let's talk a little bit more about the problems that you mentioned. What do they actually look like in practice?
Dr. Ehrenfeld: Well, actually, the electronic health record is a prime example. And people still have PTSD from poorly designed electronic health records that we were forced to use. And in many cases, EHRs were developed without the input of frontline clinicians. Then they were implemented without considering the impact they'd have on the workflows of physicians and other members of the health care teams. This created a massive administrative burden for physicians, and was the reason that electronic health records were the number one dis-satisfier of physicians for years running.
We're continuing to deal with some of the consequences of those early decisions about EHR adoption and design today. So we still spend too much of our time in the EHR. Every physician I know can attest to that. The time that I spend documenting steals time that I have to be with my patients, which is what brings me joy. And that means that you've got to work longer hours, and that drives this vicious cycle of burnout.
So a lot of organizations have improved the usability of their EHR systems over the years. But the ever-increasing documentation requirements, unfortunately, are undermining this progress. So with all the excitement around new AI tools, I think there's also a desire to implement them the right way and not repeat those same past mistakes that we did with electronic health records.
Unger: Well, let's talk a little bit more about that. Because as you point out, technology can have a positive impact on well-being when it's developed and it's implemented with physicians in mind. So tell us a little bit more about some of the examples that you're seeing.
Dr. Ehrenfeld: Well, there's a lot of exciting work that a lot of practices are engaged with involving use of the EHR and AI. The EHR inbox is one of the biggest administrative burdens right now. But practices are using automation and AI tools to make this process of triaging and responding to messages much, much more efficient. Of course, this leverages technology, but it involves a lot of collaboration between physicians, members of the care team, administrators and information technology experts.
They've got to work together to look at the current process, figure out what's going on, figure out how do we improve things, create the automation rules. But also regularly assess what's working, and what do we have to go back and iterate. And when this works, it can yield significant time savings. But if it's going to work, you have to make sure that the technology and the care team are all involved in collaborating.
And that's just one example. We're also starting to see practice experiment with AI scribes to cut down on the time physicians spend on documentation. This is really exciting, because it's using generative AI to address a long-standing problem.
And I will tell you, there's one physician I know who broke down in tears when she got access to one of these AI scribes. Because for the first time in months, she was able to get home to have dinner with her family. So these technologies will be used by physicians when they work. And the only way that they're going to work is if we are involved in their design, development and deployment every step of the way.
Unger: Well, that's such a great story. And we know and have heard these issues around pajama time being used for documentation. You mentioned it as stealing time away from patient care. We know that's what physicians are most interested in.
Anything that can alleviate the burden would help, obviously, improve well-being. What else do we need to do to ensure that future digital health tools are an asset, and again, like you said, not a burden to physicians?
Dr. Ehrenfeld: Well, in the examples that I mentioned, I focused on the collaboration that has to happen at the practice level. But ideally, this involvement from physicians, it goes much further upstream. We believe and have advocated at the AMA that physicians should be involved in the actual creation of all of these digital health tools.
So if there's a developer out there who's writing and creating software that is intended to be used by physicians, they ought to be consulting with physicians at the start of their development process. That is the way to alleviate a lot of the problems up front, because we need people who understand the workflows designing the systems. And so when a practice goes to implement a tool, then they can focus on optimizing how they use it, rather than creating workarounds because it didn't understand fundamentally what physician practices are like.
And we're starting to see this happen more and more often. Some physicians who have left practice because of burnout are now working at companies to help create tools to alleviate it. I was at South by Southwest this year and a physician in the audience stood up and said, "You know, I was too exhausted. I was too tired. I just couldn't practice anymore."
And now he's doing work on the technology development side. And a lot of people out there who are engaging with companies, we have a lot of tools to facilitate those interactions. The Physician Innovation Network, or PIN, is a free, online platform for physicians and trainees and anyone in health care to engage with companies to, again, make sure that these tools work for all of us.
Unger: Now, you've been in the forefront of discussions about technology, including AI, in regard to health care this past year. Any other kind of things that the AMA is working on to address this and make life better for physicians and patients?
Dr. Ehrenfeld: Well, I know that making sure that the technology works for all of us is going to continue to be an even bigger and bigger priority for the AMA going forward. Obviously, there's a lot of work that we've been engaged in. I mentioned the Physician Innovation Network which, again, is designed to connect these startups and entrepreneurs with physicians so they can get feedback that they need on the solutions that they're bringing to life.
During the pandemic, telehealth emerged as a really valuable tool in delivering and increasing access to care. It doesn't solve every problem. But it can be really important in certain settings, particularly if it's integrated well into the delivery process.
But what do we need to make these technologies work better for physicians? We need advocacy. We need to make sure that there's the regulatory flexibility that we've had throughout the pandemic around telehealth to allow these tools to actually work in sync for all of our practices.
And we also are just trying to continue to make sure that companies and regulators understand the need for physicians to be involved in the development of these digital tools, especially those that are using AI. And that's why I've been out at so many of the tech conferences over the last year—consumer electronics shows, South by Southwest, other places—to make sure that we have the physician voice at the forefront of the development cycle.
Unger: Actually, I love that. What a great way to make sure that physicians are a part of all of this development. Dr. Ehrenfeld, thank you so much for joining us today, and for all your insights and advocacy on this issue to support AMA's efforts to make technology work for physicians. Become an AMA member at ama-assn.org/join.
And 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 today. Please take care.
Disclaimer: The viewpoints expressed in this podcast are those of the participants and/or do not necessarily reflect the views and policies of the AMA.
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