Cleveland clinic and John Muir talking about their deployments and lessons.
Various scribe vendors. Elbow support really key for adoption. Some users waiting until an Epic champion on service before adopting.
IP: ability for second recording needed.
ED: needing time stamps at multiple moments in ED course. Also ‘where I am’ in the ED visit and summary on the fly. Re-generating the note at multiple points.
IP: in room note. Then after room added discussion and note regeneration.
IP: focused on Hospitalists first. Then expanded from there. Live sessions for training weekly. Medical directors present at every training session for operational detail (!smart). Slow rollout 6 month rollout.
IP: There is a sweet spot for AI early adopter tools. They gave it to 10 super users and only 2 champions continued at first. It was too green at first. Lots of feedback sessions then with tech and workflow improvements really took off. Up to 100 users now.
Pay attention to culture or style. Worst thing: try it once and will not try it again.
Barriers: ED docs worry that patient is too unfocused. Chronic illness vs reason for visit today. But worked well among early adopters.
IP: Diagnosis aware notes. A limiting factor is inability to write back to the problem list. ‘maybe on the first day doesn’t save you time. But it will continue to get better’
ED: a worry about trust in the tool due to hallucinations. But improving every month. Now main concern is ‘style’ and does it sound like me.
IP: must push hard at the beginning to get over the first hump. Then when early adopters like it, then it can take off.
John Muir in California: 2 party consent. Made it challenging. initial consent was about Recording but not about AI. Then prepare front office with FAQ to explain to avoid need for doc to do consent in ED exam room. Still written consent but only needed once a year. Scanned in. But ambulance arrival, maybe not consented. Also small # decline. Or can do instead: smart fixation after in room ambient. Also can put a flag on the chart visible for providers before they walk in.
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