From software programs that recommend antibiotics to passive note-taking technology, and even ChatGPT — the chatbot that has helped ignite the global AI fervor — Louisiana hospitals are leaning on AI to help providers make critical health care decisions.
Hospital leaders said the new tools are not intended to replace any physicians, nurses or other health care providers. If anything, the technologies are being implemented to help clinicians shift their focus from trudging through tedious tasks to listening to their patients.
"Our clinical teams are doing so many non-value-added tasks, like so many things that are just below their pay grade," said Dr. Denise Basow, Ochsner Health's chief digital officer. "All of these things are designed to just automate as much of that as possible and let them do the things, the high-level clinical work, that they're really good at. That's true whether we're talking about nurses or physicians or advanced practice providers."
A ChatGPT trial run
Basow said Ochsner has used AI models for years to identify patients at high risk of conditions such as sepsis and pressure ulcers.
However, more cutting-edge AI technologies are on the horizon. Ochsner is prepping for a limited ChatGPT launch next month, primarily to answer the tidal wave of emails that physicians receive daily. The program can also be used for operational tasks on the business side, such as patient billing management, Basow said.
Basow said a recent study in California of ChatGPT's ability to answer medical questions showed the chatbot had "a little more empathy, mostly because it had time to write more."
However, that doesn't mean ChatGPT will be the first line of defense any time soon. The software "still makes things up," she said, so its answers must be monitored closely.
"We would never send out a message that was not reviewed by a clinician," Basow said. "It's not taking the task away. It's making it a little bit easier. Right now, for clinical applications, you can't leave it on its own."
Baton Rouge General, through its partnership with the Mayo Clinic, is hoping to explore Google's Med-PaLM 2, an AI model that analyzes research to provide answers to medical questions, said Bennett Cheramie, the health system's vice president of information systems.
"Mayo, they're just starting to pilot it, and we're going to be on the cusp of them watching how the trials go and hopefully be an early adopter if they go well," Cheramie said.
One of Baton Rouge General's biggest AI investments, he said, has been TheraDoc, a software program that scours patient histories and medical records — sometimes from other facilities — to provide antibiotic recommendations.
"It has helped out a lot in making sure that our patients get the right doses at the right times in the right amounts, and offering the physicians assistance," Cheramie said. "Most of the time, TheraDoc is right on. It looks at all of their lab values, all of their vital signs, and even stuff that might go a little bit further back, and it helps the physician make a decision quicker than it takes time to review all of that information."
Cheramie said the point of the new technologies isn't to replace decision-making by providers. Instead, the tools help reassure providers that they're making the best decisions for their patients.
"We really got our legs under us when we said, 'OK, let's start looking at technologies that can augment efficiency, safety and care, and I think that's where we live right now," he said.
Listening in the background
Ochsner, Baton Rouge General and Franciscan Missionaries of Our Lady Health System are all in various stages of using ambient recording software to help providers take notes while visiting a patient. The software programs listen passively in the background while a provider talks to a patient, then creates a draft of notes for the provider to review.
Franciscan Missionaries has partnered with Suki, a California-based health care AI company, to roll out the ambient software to its provider group, said Dr. James Craven, president of Franciscan Health Physicians, the system's provider network.
A pilot program started in early 2022 with about 20 providers, said Josh Margulies, Suki's vice president of strategic customer engagement. It has since spread to about 80 Franciscan providers with a goal of spreading it to more clinicians in the near future.
Margulies said FMOL providers have helped shape Suki's development. For example, providers can now start notes in either Suki or Epic, a commonly used medical records software, and then finish the notes in Epic. That wasn't possible before FMOL began using Suki.
The ambient technology isn't for everyone, Craven said. Some providers don't like it, and they won't be forced to use it. However, younger providers have taken to it, particularly FMOL's residents, who just began their own pilot program with Suki in the last two months.
"A lot of our younger providers have grown up in a digital world," Craven said. "They're very savvy with technology. This is just something else we're able to put in their hands that hopefully improves their day, improves their workflow, but at the same time kind of feeds that inner drive to be on cutting-edge technology."
For the providers who do use it, the new tools help improve the work experience, which in turn makes talent recruitment and retention easier, he said.
"Being a provider, it is by far the greatest job ever. It's caring for others," Craven said. "But in caring for others, you have to be present for others. In being present, you have to be able to listen and focus your attention on not only them but their family and the needs being discussed. This technology allows our providers to be there and be more present in that encounter, to be able to listen more than working on a computer."
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