A new AI tool at Denver Health means your doctor will see you now (and not their screen)

Dr. Daniel Kortsch is a pretty popular guy these days in the hallways of Denver Health, the hospital where he works in primary care.

Colleagues come up to him for spontaneous hugs. He’s received at least one box of chocolates.

The reason for this affection has to do with Kortsch’s other job at the hospital — as chief medical information officer, sort of a guru at the intersection of technology and patient care. After months of testing, Denver Health is now widely rolling out an artificial intelligence program that helps doctors transcribe conversations with patients and then convert them into notes that can be entered into the hospital’s electronic medical records system.

Sound simple enough? Well, for doctors overburdened with tedious documentation work long after their day at the clinic is over, it is life-changing.

“It’s transformational,” Kortsch said. “I think it is the most transformational technology I have seen in my medical practice, ever.”

Artificial intelligence has for years now been making its way into patient rooms and medical records in Colorado, whether that is to diagnose tricky conditions or to spot health risks before they emerge. But Denver Health’s use of AI highlights another front: The potential for AI programs to make doctors’ workflow a little less clunky and burdensome.

The program Denver Health uses comes from a company called Nabla, which now counts 50,000 doctors and other medical practitioners across the globe — but mostly in the United States — as adopters. The Nabla program supports 35 languages, and it integrates directly with a hospital’s medical record system.

Because Nabla was developed specifically for use in medicine, it is trained not to trip up on complex medical jargon or tongue-twister drug names, in the way that more generic AI transcription services might. If it does make a mistake, users send a note to Nabla informing the company of the goof.

“The point is really to focus on patients, not the clinical notes,” said Delphine Groll, a Nabla co-founder and the company’s chief operating officer. 

To use the program, doctors simply click a button and then talk with their patients naturally while the program works in the background. For privacy reasons, the program does not keep a recording of the conversation, and the transcript it creates is quickly deleted.

At the end, the program produces a summary of the visit for the doctor to review. If the doctor gives the OK, those notes get entered into the hospital’s records system — looking very much like the kinds of notes on visits that doctors have long entered into patient records.

But what used to several minutes per patient now takes a few seconds. The result, Kortsch said, is less time working in the clinic after hours to catch up on documentation and less “pajama time,” the term doctors use to describe the hours at home at night spent on digital paperwork.

“It makes everything slightly easier and slightly better,” Kortsch said.

At Denver Health’s Montbello Family Health Center, physician assistant Jessica Wallace said she typically sees 10 to 12 patients during every half-day shift. That comes out to about 15 minutes per patient.

“The demand in terms of what we’re expected to do within primary care have increased exponentially over time, and our patients have become a lot more complicated,” she said.

A patient may come into the clinic not just to address one issue — hypertension, say — but multiple issues at a time — hypertension and diabetes and knee pain. That’s a lot to cover in just a few minutes.

Before Nabla, Wallace would walk out of a patient’s room and think to herself whether she had enough time to crank out notes to enter into the patient’s record before racing to the next appointment. If she didn’t, it meant working late or at home at night.

But now, she said, she has enough time to enter the notes and then go to the bathroom or grab a drink of water.

“It doesn’t solve all that ails primary care,” she said. “It takes away the one stupid thing that nobody loved doing and finally makes it easier.”

Kortsch said Denver Health has mainly presented Nabla to its medical providers as a wellness initiative — a way to help ease burnout due to the digital paperwork of an electronic medical records system. And in that sense, it appears to be succeeding.

The hospital has a little over 500 medical providers using Nabla. In an earlier pilot project, Kortsch said the hospital saw a 42% reduction in manual typing by those using Nabla. A survey found that 83% of providers using Nabla said the program has increased their desire to continue seeing patients.

But there have been other benefits, as well. Kortsch said Nabla has been “budget neutral” for Denver Health — meaning it has allowed doctors to see more patients, which has offset the cost of the program. And patients, who are informed about the use of Nabla before each visit, also appear to like it.

Denver Health’s patient satisfaction scores have improved for providers using Nabla. One reason for that, Kortsch said, is that use of the program has appeared to increase eye contact between doctors and patients.

In other words, physicians are turning their eyes away from the computers where they had previously typed furiously during visits and turned them toward the people they are actually treating.

“The only difference you’ll notice,” Kortsch said, “is that your doctor looks at you more.”