Baton Rouge, La.-based FMOL Health was an early adopter of Epic’s new AI scribe after finding the application accurate and cost-effective and working with the EHR vendor to make improvements, a leader told Becker’s.
The nine-hospital system signed an enterprise license for the solution in early March after trialing it for about a month. Epic released AI Charting in the beginning of February after teasing the product at its User Group Meeting in August. The tool ambiently listens to patient encounters with the company’s Haiku app and generates a clinical note for providers to review in the EHR.
“The linkage with native Epic functionality is just hard to beat,” said Bobby Dupre, MD, ambulatory chief medical information officer of FMOL Health. “Then the other big thing, which I think differentiated them a lot from the others, was the way they decided to handle provider personalization.”
Clinicians can request that the application, through a voice assistant, customize their notes based on the way they write them (and by visit type: established patients, telehealth, etc.), Dr. Dupre said. With another scribe, that had to be done in a separate app. He said providers in the past would stop using ambient AI for clinical documentation because it didn’t feel personalized.
“Providers are very particular about the way their note looks, the way the content is presented,” he said. “And so in order to get some providers on board, you want to get that as close as possible to the way they like their notes.”
FMOL Health had individual licenses for two other AI scribes before deciding to scale Epic’s tool. Dr. Dupre said AI Charting hallucinated less right off the bat, and the company has quickly incorporated suggested fixes. He said there was an upfront fee, but maintenance costs in the coming years will be about half that of other companies.
Epic’s scribe is only for outpatient care now, so FMOL Health plans to continue to use a different solution in the emergency department.
The health system was also the first to integrate Epic’s Diagnosis-Aware Notes feature that ensures providers follow through on giving and documenting diagnoses. He said he recently had a patient who reported recurrent UTIs, but since he’s a rheumatologist, he didn’t put it in his visit diagnosis; the AI reminded him and, with the click of a button, added it to the note.
Dr. Dupre said he’s spending a little more time with Epic’s tool than with previous ones because he’s documenting issues and working with the EHR giant’s developers to fix them. But he expects that to only be temporary. He’s not being incentivized for this work, but said he’s doing it “for the good of the product, because the better the product is, the happier my physicians.”
“Over the last few weeks, we’ve had a couple of updates that have made it much more accurate, much clearer. Today, the only things I had were small glitches with Diagnosis-Aware Notes itself.”
AI Charting also has the ability to tee up orders, but Dr. Dupre said the feature is currently “confusing,” so he’s set up a meeting to discuss improvements.
Epic also recently rolled out speaker diarization, enabling the scribe to distinguish between different people in the room — say, family members in addition to the provider and patient.
Industry observers will be paying close attention to health systems’ reaction to Epic’s AI Charting, as it stands to upend the burgeoning AI scribe market. Dr. Dupre expects that Epic clients that don’t have an enterprise license with another company will go with Epic; others might stick with third parties that are farther along on things like coding assistance.
He compares it to what happened in the telehealth market, when a variety of companies were competing for health systems’ business before Epic released a native virtual visit solution that many healthcare organizations switched over to.
So those other players will need to evolve. Dr. Dupre said they might look to incorporate instant claims adjudication for payers, a tall task but a real opportunity for a third-party company.
“As Epic starts to add these features in, these other third-party vendors are going to have to stay ahead with something new, something better,” he said. “So the pressure is going to be on them to continue to innovate, while Epic continues to come in afterwards and do it well. It’s kind of like that effect where, ‘Hey, this great app was just created,’ and then a few months later, Apple does it, and they do it well, it’s integrated fully in their system and in the ecosystem.”
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