Epic, Nuance broaden GPT4-powered ambient documentation

By expanding DAX Express, hosted in Microsoft's Azure OpenAI, into EHR workflows, the goal is to reduce "what used to be hours of time for clinical documentation to mere seconds," says one CIO.
By Mike Miliard
11:17 AM

Photo: Lacheev/Getty Images

Nuance Communications and Epic on Tuesday announced wider availability of Nuance's Dragon Ambient eXperience Express technology to Epic customers.

WHY IT MATTERS
The expanded integration of DAX Express into Epic workflows will help existing Dragon Medical better manage the burdensome documentation and administrative workloads that so often lead to clinician burnout, the companies and their clients say.

"DAX Express for Epic will spark a transformational shift in how we all approach healthcare," said Josh Wilda, chief digital and information officer at the University of Michigan Health-West, in an Epic statement.

"We've already seen first-hand how ambient AI from Nuance has transformed the provider-patient experience using the DAX ambient solution, but now with the augmentation of generative AI, we're going to give our providers more options to use technology in a way that delivers even greater outcomes to them and their patients.

"DAX is already reducing what used to be hours of time for clinical documentation to mere seconds – while improving the quality of patient care and provider experiences," he added. (Watch our 2022 CIO Spotlight interview with Wilda on HIMSS TV.)

DAX Express is billed as the first clinical documentation application to combine Nuance's conversational and ambient AI with the powerful AI model, GPT4. Hosted in Microsoft's Azure OpenAI Service, the tool will enable providers using Epic to create draft notes automatically and securely from the exam room – or via telehealth – for quick clinical review and completion after each patient visit, the companies say.

By broadening the Dragon Medical portfolio and building on the DAX ambient technology first introduced in 2020, DAX Express represents the newest effort to harness AI to streamline charting, reduce administrative burden and enable clinicians to spend more time caring for patients. 

THE LARGER TREND
Nuance and Epic have worked together for many years to add AI-enabled clinical documentation improvement into clinicians' workflows.

And, as has been shown in some Healthcare IT News case studies, customers have reported tangible gains in efficiency, reduced after-hours charting time and general reductions in burnout after rolling out ambient documentation tools for their physicians and nurses.

"We've worked closely with Epic for well over a decade," said Peter Durlach, chief strategy officer at Nuance. "As Nuance and Epic continue to work toward a shared vision to create more efficient and intelligence-infused healthcare experiences for providers and patients at scale, DAX Express will act as a clinical workflow copilot for Dragon Medical One and Dragon Ambient eXperience users working within Epic's EHR."

DAX today is used by hundreds of hospitals and health systems using Epic. Nuance cites statistics showing that clinicians who use it say it has improved work-life balance (79%), job satisfaction (67%) and feelings of burnout and fatigue (70%).

Epic demoed some of its initial GPT3-based integrations at HIMSS23 in April, where it also announced integration of the Azure OpenAI Service with Epic's EHR platform.

While the GPT and generative AI tools hold huge potential for healthcare, and could be valuable "copilots" for clinicians, many still advise healthcare organizations to move ahead with caution with AI in clinical settings.

ON THE RECORD
"This collaboration will allow our physicians to focus more completely on the care and treatment of their patients while the AI works behind the scenes to document the encounter, allowing people and technology to each do what they do best without delays," said Dr. Hal Baker, CDIO at WellSpan Health, in an Epic statement about the new DAX expansion.

"For both patients and providers, quality care experiences start with meaningful conversations and mutual understanding," added Sean Bina, VP of patient experience at Epic. "For the first time, we can see how conversational understanding, generative AI, and clinical context can together generate high-quality documentation."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com

Healthcare IT News is a HIMSS publication.

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