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[00:00:00] Health IT leaders reduce clinician burnout and enhance efficiency with Ambience Healthcare. Their AI powered platform automates clinical documentation, coding, and administrative tasks, allowing clinicians to focus more on patient care.

Seamlessly integrating with EHR systems, Ambience improves workflows and patient outcomes. Ready to revolutionize your healthcare operations? Visit ThisWeekHealth. com slash Ambience today and discover the power of AI with Ambience Healthcare.

We want to help any health system, any provider get reimbursed, get recognized for the tremendous work that he or she does every day.

Welcome to This Week Health. My name is Bill Russell. I'm a former CIO for a 16 hospital system and creator of This Week Health, where we are dedicated to transforming healthcare, one connection at a time.

Now, onto our interview

(Interview 1) All right. Today, we're doing an executive interview and I'm joined by Will Morris, the chief medical [00:01:00] officer for Ambience Healthcare. Will, welcome to the show. Thanks, Bill. Pleasure to be here. I'm looking forward to this conversation. You have been in the space for a long time. You've worked for some interesting companies. Cleveland Clinic obviously, and then you move to Google and now you're with Ambience and Ambience is in a very exciting space right now.

Talk to me a little bit about the space.

This space is exciting, daunting. The power of the transformer, right? The T in GPT it's really taking the world by storm, but its ability not just to reason and create prose and do automated speech recognition as people play with is powerful, but its ability to reason.

And so when you looked at the space of kind of ambient documentation, so you and I are talking, you might have a solution that just records us and turns it into text, automated speech recognition. The next step is who said what? Ascribing this is Will Morris, this is Bill.

And then reasoning. What was the intent of that conversation? [00:02:00] And, obviously, in healthcare, one of the most vexing challenges is that of, patient care, where you're glued to the computer, right? Technology feels like it's done to you, but it's certainly not done with you. We've seen an explosion of companies in the space of ambient documentation, and while Ambience does that, it's really important to take a step back and recognize that it's not just primary care that you need to serve. You need to serve the pediatrician, you need to serve the rheumatologist, you need to serve the patient.

the complex environment of the emergency room or a trauma surgeon. And so what first struck me about the company was the intentionality and thoughtfulness of recognizing that you have to serve the entire spectrum of clinical care. You can't just be primary care and show that you can do one condition.

You have to represent Because that's what, as a physician, every day someone shows [00:03:00] up, they're not cookie cutter, they're unbelievably diverse, unique, and the ability to personalize that is important. First thing is, where we're different is, we tackle the edge case.

We tackle sub specialties in the environments that are oftentimes forgotten, like the emergency room trauma OR. The second piece, I think it's really important, is the documentation within the electronic medical records serves not just the purpose of documenting my clinical thoughts and memorializing it, but it's really got three other stakeholders.

First is the patient. Now what I document, you probably have an open note, there's lot of wonderful things in terms of real time access, which is really empowering for patients, but making sure that it is complete, accurate. But also, Reflex Healthcare Literacy Guidelines is really important. So that's one stakeholder.

The other are the downstream consumers of documentation. Your coders, your billers, prior authorization, right? Helping [00:04:00] adjudicate in making sure that patients get the right care immediately and without surprise payments. And the last is patient quality and safety. our approach has been really intentional making sure that you address all of the stakeholders and certainly the variety of clinical medicine.

So you touched on a couple of things. One is the ability to do all those specialties especially such specialties. That's a huge deal. I remember back in the day I interviewed Nuance and I was talking to those guys and they were essentially saying, it is really hard from a language standpoint.

It's really hard to go from one to the next. And I'm like, why is that? He goes, because it's a different language. It is exactly right. so you have to be able to grasp that language and interpret it and then put it back into the note correctly. And that's why they were not, prior to GPTs, they were not moving all that quickly down that path.

They were essentially saying, it might take us 15 years to get to all the specialties. I guess the LLM technology has transformed that a little bit in terms of getting there. The second [00:05:00] is, it seems to me like everybody and their brother today is oh, look, we can do dictation and we can turn it into a note.

But the thing I like about were just saying is, You're looking at the entire workflow and how it integrates to all those different areas within the workflow. And the nice thing about that as a CIO for me, cause I'm looking at it as you rattle off a handful of things that I can get an ROI on.

Exactly right. And. Technical debt, right? All of these point solutions are yet another thing that the CIO or the CISO has to manage, right? And they naturally have a tail. Hey, I need a special NLP engine that will take the notes on the back end and try to find, CPT codes or ICD 10.

Hey, I need a special extract that will, Fill a quality registry for stroke patients, I need one for a cardiology pinnacle registry, or, and it goes on and on, and you realize all of these things It's like a Rorschach. They're all interpreting a note, but if the note is not [00:06:00] fundamentally good in tune in a way, it's kind of garbage in, garbage out.

And our approach is let's get it right within the workflow. Your language is exactly right. It's not so much just speaking the language of medicine, but how a rheumatologist thinks. is fundamentally different than how an internist or an infectious disease doctor, and those patients present differently, and they have different complaints.

A patient who you just have a conversation about school may not be relevant for the rheumatology, But for a child, that's really important, right? How are you doing in school? Are you paying attention? Are you falling behind?

These are important things where the model has to recognize that's part of the language rubric that belongs in the note.

I hate to go down this path, but financial path is pretty interesting to me because theory was if the note was done correctly, , it would be easier for the coders.

But the reality is If the note's done correctly, it's easy for the technology to take a first pass at the coding and even find some things [00:07:00] in the conversation that should be in the coding.

Yeah we're partnering with AHIMA and American College of Professional Coding. Coding is another language in and of itself.

I see a lot of vendors saying, Hey, look at this. I can use an open source LLM and it can extract an ICD 10. There is complex rules around what you can and what you can't extract. The difference is you don't want to just do that because you get in the space of diagnosing, right?

It's figuring out, Hey, this looks like diabetes. That is, fDA regulated device, right? You want the physician to be deciding what is a diagnosis and what is treatment. So there's an entire lexicon or language that a coder has to take into account and they are unbelievably good at understanding what has been mentioned versus evaluated, managed, treated.

I want to be clear though, North Star is not to replace the human. These are technologies that are accountable to the human, and when we partner with our colleagues in professional coding and [00:08:00] extraction, this is about up leveling them, so they're not Spending their time doing, the DRG assurance, which is like the ping or the documentation integrity, where they're pinging the physician saying, Hey, can you clarify X, Y, and Z?

No one wins on that. The coders don't enjoy that. And the providers don't enjoy it. Last thing they want is another in basket message. And so the opportunity to get a really highly specified. Verified authentic record that clinically captures all of the nuances of the patient.

Is the north star and then all of those back systems all benefit.

I assume you're getting feedback from the clinicians who are using this. What are you hearing from a job satisfaction, from a accuracy, quality of the note and those kinds of things?

We love feedback and it's the biggest, joy in anything. And certainly for the clinicians, what they want is something that reflects what happened in the office or. On the wards and it enables them to do what they [00:09:00] are trained to do, which is take care of the patient.

And so what we see is, wow, it's bringing back joy. Hey, I was going to reduce my FTE to 0. 6. These are all things that, hey, I can actually see more patients and I love the practice of medicine. It's not a burden, but it's actually a boon. No. The physicians aren't going, Oh my gosh, you can capture HCC scores and my, case mix index, cause there's other stakeholders, there's the coder stakeholders that are really important.

And then the patients from a patient experience standpoint as well, the notes are actually highly reflective of what happened in the exam room. And so while we look at all, and we love addressing burnout and we work as a physician closely with our clinical colleagues, we have to There's so many interesting stakeholders in this opportunity that rising tide raises all boats.

So where's this space going to go? It's crowded, so I assume there's going to be consolidation or something to that effect, but then what's going to differentiate each one of the players in this space?

It's a great point. We feel strongly that the ambient [00:10:00] listening aspect is the fulcrum, is one key piece of kind of clinical workflow.

But as I already alluded, there's a lot of downstream pieces that you have to be good at too. You have to be able to create the code set, the embedding model of that documentation to drive downstream. So there is a platform approach where, we talked about it. How can this augment, if not replace a lot of the single bolt on solutions that are doing tons of back office.

Processes over these notes, whether it be trials, whether it be a registry, whether it be a quality and public reporting or professional and technical coding. I liken it to it thinking about the documentation. There's a lot of work that goes before we actually walk into the exam room. [00:11:00] And we're working intentionally on, helping the clinicians, workflow and thought process going into the room and how can I help a make finding information easier.

We know that health care information is doubling every 72 days. And it's a real challenge for clinicians before they even walk into the door. And we're looking at it at bookends, but it starts with kind of the documentation and then our concentric circles outside. And we think it's going to be a platform.

We think it's going to be something that is the system of engagement rather than just a system of record.

So we'll close on this. It's somebody doing an RFP, RFI, , however, they're evaluating this. And actually From what I'm hearing, people aren't really even doing RFP, RFIs, because it's not that hard to just, hey, try this one,

what needs to be there in order for it to be effective?

Yeah, number one is You want to make sure that your or your vendor choice is thinking, not just today with documentation and, hey, I got an API but really, how do they actually help service the CIO?

How do they help [00:12:00] service the CMO? How do they help think about the CFO? And so I would demand that, a vendor shows up and can sit across an executive team at a hospital or a health system or a practice and articulate to those stakeholders. So I think that's number one is, this is not just technology and not just clinical documentation, it's way more.

I think number two is when you test this table stakes is, yeah, it's got to be primary care and ambulatory, but I would implore folks to ask about subspecialty. We have a hundred plus fine tuned models for all subspecialties. And so I think that's really important because as a health system, You don't want one solution that's ambulatory, one solution that's inpatient, one solution that's ED.

As a CIO, that's a nightmare scenario. And encourage people , to not only task, but think about the edge case. And then lastly, I think the most important is I think your vendor has to articulate ROI. We hear burnout, and [00:13:00] burnout is really important, but it's a tough one. As a CIO, yes, that's important.

Every dollar that you introduce into technology, how does it actually offset with another dollar or two dollars? Because we all know that hospitals are under unbelievable financial pressures and in order for them to, continue with their mission, we have to be cognizant of an ROI.

And that's where we work really tightly with the CFO and the quality folks because those are hard dollars. And in fact, we want to help any health system, any provider get reimbursed, get recognized for the tremendous work that he or she does every day. Yeah,

that's fantastic.

we are cognizant and we are concerned about clinician burnout. It's just so hard to quantify. It's yeah, do we invest this much in it or this much in it? and sometimes when we throw technology at these things, we think we're going to address burnout and we, yeah, we add costs, but we sometimes do the opposite.

Now this technology. The more and more I'm talking to people, [00:14:00] clinicians are just clamoring for it now. And it's really gotten to a point where I'm seeing a significant growth in the number of seats they're actually getting it out there and getting it used. Yeah.

And Bill, you actually brought up the punchline for the closer, it's about workflow as well.

And it has to be integrated into the workflow. Clinicians, want this experience, but they don't want swivel chair integration, right? They don't want to have to pivot over here, click another tab. And making it invisible to the doc. So they're in the EHR doing their work.

Yeah. Is absolutely paramount we know just change management is a real barrier as much as burnout. And so making it easy, seamless, and integrated with them is top of mind as well.

Yeah, we have overused the human API. It's take it from this machine, take

it from this machine.

and it doesn't scale.

It does not scale. I want to thank you for your time and look forward to seeing you. Take care. Alright, cheers.

Thanks

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