AI and ambient listening in healthcare.

Jeffrey Cleveland, MD, Ambulatory CMIO, Advocate Health

AI is becoming a transformative force in healthcare, particularly in addressing clinician burnout. At Advocate Health, Dr. Jeffrey Cleveland, Ambulatory CMIO, is at the forefront of integrating AI and ambient listening tools to enhance clinician efficiency and well-being. In a longitudinal study conducted in collaboration with Microsoft, Advocate Health tested the impact of AI-based clinical documentation on clinicians’ workflows. While the results revealed nuanced insights, the initiative underscores a commitment to improving the clinical experience through technology.

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AI-Powered Documentation: The Study Framework

Advocate Health, one of the largest nonprofit health systems in the U.S., set out to evaluate Nuance’s Dragon Ambient eXperience (DAX) Copilot—a tool designed to streamline documentation by automatically generating notes from patient encounters. Dr. Cleveland led the research, enrolling 125 primary care physicians and advanced practice providers (APPs) in the Southeast region. The study ran from June to December 2023, focusing on metrics such as time spent in the EHR and potential revenue generation.

Dr. Cleveland explained the motivation: “Our goal from the beginning was to address physician burnout by making their professional experience better. We want our clinicians to enjoy their work and return the joy to their practice.”

Key Findings

The study revealed mixed results. On average, clinicians saved 17 minutes per day using the AI-powered tool, but the control group also showed an 11-minute daily time savings, making the net difference modest. Additionally, the study did not find a significant increase in patient appointments or revenue attributable to the technology.

Despite these findings, a subset of users experienced profound benefits: “Almost 20% of users saved at least an hour a day. For some, it was life-changing—allowing them to spend more time with family, avoid burnout, and even reconsider retirement plans,” shared Dr. Cleveland.

This duality—incremental average gains versus transformative impact for specific users—highlighted the need for a more nuanced approach to evaluating AI tools.

Beyond the Metrics: Transforming Clinician Experience

While time savings were a primary focus, qualitative assessments revealed broader benefits. Clinicians reported improved patient interactions, as the tool allowed them to maintain eye contact and focus on conversations without the distraction of manual note-taking. This enhancement of patient engagement resonated strongly with both clinicians and patients.

Dr. Cleveland elaborated: “Even for clinicians who didn’t save time, the reduction in cognitive burden was significant. The tool captured details accurately, reduced friction in workflows, and made their professional lives more satisfying.”

This qualitative feedback led Advocate Health to expand the program, offering licenses across its enterprise.

Integration Matters

A key factor in the adoption and satisfaction with DAX Copilot was its integration with Epic, the health system’s EMR. While DAX is not an Epic-developed tool, its seamless interface with the EMR simplified workflows and minimized disruption.

Dr. Cleveland noted the importance of this alignment: “The tool’s integration with Epic meant that clinicians could focus on their patients, not technology. This ease of use drove higher adoption and sustained engagement.”

Lessons for Health IT Leaders

Health IT executives can glean several lessons from Advocate Health’s journey:

Start with a Clear Goal: Define the problem you want to solve. For Advocate Health, it was about alleviating clinician burnout and enhancing their professional experience.
Pilot and Iterate: Begin with small cohorts to evaluate adoption and identify challenges. Advocate’s phased rollout allowed for adjustments based on user feedback.
Focus on Integration: Choose tools that align with existing platforms to minimize workflow disruption.
Measure Beyond Metrics: Quantitative data is important, but qualitative insights often reveal the true value of a tool.
Communicate and Educate: Change management is crucial. Advocate Health used town halls, office hours, and targeted outreach to onboard users effectively.

Actionable Takeaways for Health IT Leaders

Prioritize Physician Engagement: Involve clinicians early in the tool evaluation process to ensure alignment with their needs.
Evaluate ROI Holistically: Consider both hard ROI (e.g., revenue generation) and soft ROI (e.g., clinician satisfaction and retention).
Invest in Training: Provide robust training and ongoing support to encourage adoption and maximize the tool’s potential.
Monitor and Adapt: Regularly assess both user feedback and system performance to refine implementation strategies.
Celebrate Success Stories: Highlight impactful user experiences to build momentum and justify further investment.

A Vision for the Future

As AI tools evolve, their potential to reshape healthcare delivery grows. Advocate Health’s experience with DAX Copilot illustrates that while technology may not always deliver dramatic immediate returns, its long-term impact on clinician well-being and patient care can be profound.

Dr. Cleveland concluded with a forward-looking perspective: “AI-powered documentation will be table stakes in the near future. By investing in these tools now, we’re not only improving today’s workflows but also shaping the future of care delivery for our patients and clinicians.”

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