As health systems look to adopt ambient AI to ease nursing documentation, it can be a challenge to get nurses to verbalize tasks they are used to doing in their heads.
Charlotte, N.C.-based Advocate Health thinks it may have found a solution.
The 69-hospital system received a $100,000 award Oct. 8 from the American Nurses Credentialing Center for a program that will leverage virtual reality to train nurses how to use ambient listening for EHR documentation.
“Nurses aren’t used to narrating their assessments and their care, so while they’re in workflow, they’re used to recording it on a computer, rather than talking through it and having it be recorded,” Betty Jo Rocchio, DNP, CRNA, executive vice president and chief nurse executive of the 69-hospital system, told Becker’s. “One of the things we wanted to try was a virtual reality teaching them how to speak their assessment and have it be recorded.”
Since April, Advocate Health has been a testing site for Microsoft’s Project Nursing tool that uses ambient listening and AI to record in-room patient assessments and automatically fill in information in EHRs. The technology is in “private preview” among 60 med-surg nurses at three Atrium Health (which is part of Advocate) hospitals in North Carolina.
“Whether it’s listening with the stethoscope or listening in other ways to patients or just talking with them about things during that assessment, we usually just do it, log it in our mind and then put it into the computer, or our mobile phone, but we’re used to punching it in,” Dr. Rocchio said. “We’re not used to talking about it while we’re doing it.”
With ambient listening, the notes are filled in automatically, saving nurses documentation time that can be transferred to the bedside. Nurses currently spend about two hours per shift documenting; Dr. Rocchio said she believes ambient technology can cut that by about two-thirds. More timely documentation will also improve care, she said.
“The impact of the change on a nursing process, this is one of the biggest that we’ve seen in a long time,” Dr. Rocchio said. “It’s one of the biggest change management lifts that I’ve seen in a long time.
“Nurses love the concept and love the technology. It’s just that learning to work it into workflows in front of patients was their key.”
Ambient AI for clinical documentation, like Microsoft’s DAX (aka Dragon) Copilot, has been a successful tool in reducing burnout among outpatient providers but is in the earlier stages of being deployed for nurses and in inpatient settings. Ambulatory physicians and advanced practice providers, however, typically focus on a single issue in conversation with patients, while inpatient nurses take head-to-toe assessments of every patient at the beginning of each shift.
“It’s a whole different ball of wax, and we have a lot more documentation on that inpatient side,” Dr. Rocchio said. “It’s a lot different. It’s not even the same product… which is why it’s taken Microsoft a little bit longer to roll this out than they did DAX.”
Advocate Health plans to offer the VR training to nurses at its Project Nursing pilot sites, beginning at Atrium Health Union hospital in Monroe, N.C.
Dr. Rocchio foresees ambient listening for documentation eventually becoming the norm for nurses, especially as the EHR moves onto mobile devices. She believes this type of VR training could eventually be done in nursing school.
“It really is the base technology for opening up even more ways and pathways for nurses to spend more time at the bedside and get more documentation done, or actually be able to look for information in the EHR by speaking and looking for things, rather than having to search on a computer,” she said. “It’s going to be one of the more significant change management things that we do in nursing.”
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