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AI and healthcare: Indian medics see turnkey opportunity in US hospitals

Surbhi Gloria Singh/New Delhi 15 Apr 19 | 12:06 PM

Some doctors at Massachusetts General Physicians Organization have saved more than two hours per clinical session with virtual scribe technology. A physician listens in real-time from Mumbai or Hyderabad and other parts of the world, and transcribes relevant details directly into the patient’s electronic medical record (EMR).

The India-based ‘virtual scribe’, typically a doctor who is either fresh out of medical college or has a few years of work experience, is taking over from assistants who used to accompany the doctor physically on rounds, according to Indian Express. Augmedix, a San Francisco startup has partnered with Google and is taking back-end support from Indian physicians, wherein, doctors live-streaming their office visits to the virtual scribes in Bangalore, who look on and take detailed notes.

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IKS Health, a $6 billion US-based company that provides the documentation service based on digitally-recorded patient visits, has about 450 doctors on staff across Mumbai and Hyderabad extending support to patient visits in hospitals and clinics across the US. 

Through this new process, Google technology enables a second person to experience what the doctor sees and hears in another country and become the doctor’s real-time assistant. 

A survey conducted by Stanford Medicine and The Harris Poll of physicians and health organizations found that 46 per cent exhibited some degree of burnout. When asked what contributed to that burnout, they blamed the administrative burden added to the work of patient care.

The problem

Chief among those administrative burdens was documenting in the electronic health record. Many physicians were spending two hours or more after each clinical session documenting in the EHR.

A recent study published by the AMA and the University of Wisconsin School of Medicine and Public Health, and College of Engineering revealed that physicians spend nearly six hours of an 11-hour workday working with EHR; 44% of that time — about 2.6 hours a day — is spent on clerical tasks.

Nearly half of PCPs (44%) say the primary value of their EHR is digital storage, while less than one in 10 (8%) cite key clinically related items such as disease prevention/management (3%), clinical decision support (3%), and patient engagement (2%).

Half agree that using an EHR detracts from their clinical effectiveness

Solution through AI

Through ‘Virtual scribe’, physicians could be relieved of the burden of documenting ambulatory clinical encounters. Scribes help physicians navigate EHR, from documentation and coding to retrieving patient records and lab/radiology results.

What is Scribing

Scribes act as personal assistants to physicians. Dr David Y Ting, chief medical information officer and a practising physician at Massachusetts General Physicians Organization, said, "The workflow releases our physicians to focus on – and even enjoy – the patient-doctor interaction, rather than fret over how they would document complicated histories and detailed exams.

"And in contrast to live-scribe solutions that require placing an additional person in the exam room, the Scribble solution suffers neither from the need to expand the size of exam rooms nor the hassle of managing and scheduling hundreds of additional staff with the accompanied high rates of turnover."

Healthcare organisations that are investing in 'virtual scribes'

Massachusetts General Physicians Organization engaged IKS Health to implement its virtual scribe technology, dubbed Scribble. Scribble provides a hybrid technical-human system where a physician uses a secure device to obtain an encrypted audio recording of the patient encounter, with the patient's consent.

Apart from IKS, other scribe technology vendors in the US market such as iScribeMD, Physicians Angels, Scribe Technology Solutions and Skywriter MD are also betting on the virtual scribe business.

Augmedix has partnered with search-engine major Google to use the Google Glass technology for scribing, with back-end support from Indian physicans. Doctors wear these devices through the day, live-streaming their office visits to the virtual scribes in Bangalore, who look on and take detailed notes. Augmedix has raised over $35 million from venture capitalists and health systems.

Elements of scribing:

i. Doctors wear Google Glass and capture video and audio for their patients visits.

ii. Scribes work with the doctors in real-time.

iii. EHR: The doctor and scribe collaborate to build an electronic record of the patient visit.

Source: Augmedix, Francisco startup

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