Ambient Artificial Intelligence Technology to Assist Stanford Medicine Clinicians with Taking Notes
Abstract
Clinicians at Stanford Health Care have gained access to an AI-powered app that can securely listen to interactions with patients and automatically generate draft clinical notes. The app, which was recently tested in a pilot program at Stanford Health Care, harnesses ambient voice recognition technology to create a written summary that captures essential clinical details. The ambient listening technology, DAX Copilot, developed by Nuance Communications, a Microsoft company, is expected to help shoulder much of the clinical documentation workload. Starting in the fall of 2023, 48 physicians in a variety of specialties - including primary care, cardiology, orthopedic surgery, rheumatology and neurology - tested the technology. Through a preliminary survey, about 96% of physicians reported that the technology was easy to use, and 78% reported that it expedited clinical note taking. About two-thirds reported that it saved time. To use the app, the clinician first obtains consent from the patient to securely record the conversation through an app on their smartphone, then continues with the appointment. Once the recording stops, an algorithm processes the data and, seconds later, generates a draft clinical note. The technology is able to discern friendly chit-chat from discussions of pertinent health information, effectively becoming an invisible assistant that selectively prioritizes the relevant pieces of the patient's history and details of their appointment. Throughout the process, all conversations and data remain secure and HIPAA-compliant. Stanford Medicine clinical and technology leaders plan to roll out the app to all care providers at Stanford Health Care, including physicians, nurse practitioners, physician assistants, resident physicians and medical students. Advances to the technology - such as the ability to customize note style, suggest orders or edit drafts using natural language - are on the horizon.
Clinical implications
News article reporting on Stanford Health Care pilot program (fall 2023) with 48 physicians across multiple specialties including primary care, cardiology, orthopedic surgery, rheumatology, and neurology testing DAX Copilot ambient AI technology. Preliminary survey results highly favorable: 96% of physicians reported technology was easy to use, 78% reported it expedited clinical note taking, approximately two-thirds (66%) reported time savings. Technology uses smartphone app to securely record patient conversations with consent, then generates draft clinical notes in seconds. System able to distinguish relevant health information from casual conversation, functioning as 'invisible assistant' that prioritizes pertinent clinical details. Clinicians can review, edit, and approve notes before adding to electronic health record. All conversations and data remain HIPAA-compliant and secure. Notable physician feedback: Christopher Sharp, MD (chief medical information officer) reported ability to turn away from keyboard, face patient, and truly listen while documentation captured automatically. Gary Fritz (chief of applications) emphasized time savings help rebalance provider workload and cognitive load. Stanford Medicine planned enterprise-wide rollout to all care providers including physicians, nurse practitioners, physician assistants, residents, and medical students. Article references peer-reviewed study published December 5, 2024 in Journal of Medical Informatics Association (Shah et al., DOI: 10.1093/jamia/ocae295).