Defined by emotional exhaustion, depersonalization, and a reduced sense of accomplishment for clinicians, physician burnout has been a long-standing issue in
healthcare for well over a decade and by all accounts, it’s getting worse. Now nearly half of all physicians report feeling burned out.
“There was an explosion in healthcare of documentation and bureaucratic tasks—a lot of which was led by the 2009 HITECH Act and the push for meaningful use introduced through Electronic Health Records (EHR),” explains Dr. Eric Malamud, VP of Healthcare Al at Thinkhat. “Unfortunately, that has required clinicians to do tedious data entry and complete an endless checklist of tasks, leading to a lot of frustration.”
Luckily, as Dr. Malamud explains, the artificial intelligence (AI) revolution is providing solutions to physician burnout. The key is to make sure that proper adoption and training are implemented to ensure long-term success.
How Al can help
“How can we use Al as a transformative solution?” Dr. Malamud asks. “It’s really a powerful ally in alleviating burnout and streamlining clinical workflows. One of the places that we’re seeing extremely rapid rates of adoption is ambient documentation or Al-powered medical scribes.”
And indeed, these Al medical companions and scribe platforms are poised to flood the market in the coming years (some having already hit). Time will tell which of these platforms will find success.
As Dr. Malamud explains, these Al systems can leverage speech recognition and natural language processing (NLP) to automatically capture and document clinical encounters. The ambient Al listens to the doctor-patient conversation and then generates a draft clinical note in seconds for the physician to review.
“This is really transformative compared to how human scribes or manual data entry works,” Dr. Malamud notes. “And by handling documentation in the background, ambient Al scribes dramatically cut down the time doctors spend charting. Physicians can focus on the patient during the visit instead of the computer, and reduce what has now so eloquently been dubbed pajama time. The result of these tools is less cognitive load associated with writing notes and after-hours documentation. And we’ve seen that when doctors are reporting using Al scribes, they finally feel heard by the EHR, rather than hounded by it.”
And Dr. Malamud would know. As the VP Healthcare Al at Thinkhat he is working firsthand to develop and implement the Al companions of tomorrow, today.
Enter Noki
Dr. Malamud and his team at Thinkhat have been developing Noki, the voice-first healthcare platform designed to reimagine patient care and reduce administrative burden for doctors—and the platform is finally ready for the big league.
What does Noki do for physicians? The answer is as complex as the issue itself, but the foundational skill of the platform, as Dr. Malamud explains, is its ability to ambiently document a variety of pre-, in-, and post-clinical encounters, as well as assist with patient management.
While the entry point for many physicians will be Noki’s ability to ambiently document the in-clinic patient encounter, Noki offers a variety of tools and skillsets for doctors to automate everything from patient intake to follow-up, from scheduling to referral, and can even help doctors take care of insurance claims.
“Noki’s patient-intake automation is a new feature we have just announced, and it’s something we are really excited about,” says Dr. Malamud. “Noki’s Al can streamline the onboarding of patients and collection of information before the clinician even enters the exam room.”
Think of the tedious paper forms or basic history questions patients are required to answer-Noki’s Al-driven digital intake systems can handle that automatically. For instance, patients can interact with Noki’s secure, conversational Al via an online form prior to the visit. Using that platform, they can enter their medical history, symptoms, and medications.
“The Al system then summarizes and integrates this into the EHR,” Dr. Malamud explains. “This saves the front desk staff and nurses time, but it also saves physicians from re-asking routine questions. And again, we’ve seen that some of these digital intake tools can reduce documentation work for medical staff by up to 45%, saving about 30 minutes per day per nurse or medical assistant.”
With those kinds of time savings, the care team’s focus can redirect back on care delivery, which is the primary goal of Noki—but the platform doesn’t stop there.
“Another area that Noki can help is in terms of referral management, so Al can automate and optimize the referral process,” says Dr. Malamud.
Imagine a primary care doctor who needs to refer a complex patient to multiple specialists. Normally, this involves paperwork, finding the right specialist, ensuring the referral contains all pertinent info, and following up to make sure that the patient actually went to that visit. With an ever-more complex medical system, it is no wonder that doctors and their staff are having a harder time keeping pace, and are feeling more burnout as a result.
“Noki can parse through referral orders and automatically match patients to the appropriate in-network specialists,” says Dr. Malamud. “It can also autogenerate a referral letter with all needed clinical context using NLP on the patient’s record.”
This Noki skillset aims to address one of the biggest pain points that healthcare has seen in recent years. “Currently, about 63% of referrals lack sufficient information for the next provider, and 30% are sent to the wrong kind of specialist,” notes Dr. Malamud. “This causes delays and frustration, obviously, both for the care team and for the patient themselves.”
Another area that Noki can help is in the realm of coding and billing. Dr. Malamud explains: “Unfortunately, coding and billing are necessary evils that take up a considerable amount of physician and coder time. Every procedure and diagnosis needs an accurate code for billing, and physicians often have to ensure their documentation justifies those codes.”
Noki, for its part, can automate the coding process with a high degree of accuracy using NLP.
“Noki can read a doctor’s note or operative report and suggest the appropriate ICD-10 diagnosis codes and CPT procedure codes,” says Malamud. “This reduces some of the reliance on manual administrative tasks, as well as the back and forth queries for coding clarifications to physicians. Fewer errors mean fewer claim denials, and faster reimbursements.”
But it doesn’t just help doctors, Noki also helps reduce the mental burden on coders who face complex guidelines and ever-changing codes. With this reduced burden, Noki then allows them to operate at the top of their expertise, identifying the most complex codes and allowing Al to automate some of the low-hanging fruit.
“Each of these Al applications, from scribing to coding to referral management, attacks a different facet of the burnout problem,” Dr. Malamud says. “Noki can give clinicians time and sanity back, letting humans do what they do best, providing empathetic and complex care, and allowing Al to handle the rest.”
Even though Noki offers a solution to the varying issues contributing to doctor burnout, Dr. Malamud notes that there are still barriers to entry that the industry is working to overcome-chief of which is adoption of these new technologies.
Implementation and adoption of Al tools
“What can an organization, at this point, do in terms of implementation?” Dr. Malamud asks. “I want to clarify that implementing Al solutions is not a plug-and-play type proposition. It requires a clear strategy for healthcare executives looking to introduce Al into their
organization, and having a roadmap is really going to be crucial to ensure long-term success and sustainability.”
The trick, as Dr. Malamud points out, is being clear about what a clinic’s most pressing needs are and tackling them first. “I think it’s about identifying the priority pain points,” he says. “Start by pinpointing where your organization’s clinicians are feeling the most burnout, or where inefficiencies are greatest: is it documentation overload in clinics? Is a backlog of messages in the patient portal lengthy referral processes or billing errors?”
Dr. Malamud implores doctors and healthcare systems to engage with frontline staff through surveys or listening sessions and focus groups to find the low-hanging fruit where Al could help.
“Focus on a clear use case. Set a defined goal for Noki to achieve, and this clarity will guide the vendor selection,” states Dr. Malamud. The sweet spot of Noki implementation is choosing the package that meets at the intersection of physician and staff needs and the broader organizational goals.
Then the next trick to implementation is cooperation. “Al implementation has to really be a team sport,” says Dr. Malamud. “Assemble all the key stakeholders early. This should include professionals, clinicians, operations, and leaders. If your organization has a Chief Medical Innovations Officer, involve them to help bridge the clinical and tech perspective.”
Early clinician involvement in the training and adoption of Al tools is critical, Dr. Malamud notes. Their input will ensure that the Al solution actually fits into clinical workflow and addresses real needs. It also helps create buy-in for the organization as a whole.
Ultimately, with the proper training and adoption, Al tools like Noki are poised to radically transform the healthcare system for the better.
“Overall, I think we’re really on the cusp of a new era in healthcare,” concludes Dr. Malamud, “one where Al empowers a people-first care environment. Physicians should spend their day fully engaged in problem solving and connecting with patients, not wrestling with screens or bureaucracy, and at the end of the day, they should be able to head home on time, feeling satisfied with the care they delivered.”
