You Guys. Listen Up. AI documentation. Yup, it was a game changer. I got the chance to pilot an AI dictation system in February 2024. One day after getting onboarded, I ripped the tendons (UCL) from my left thumb and severely sprained the ligaments on my right thumb in a skiing accident, making typing and any activities requiring an opposable thumbs nearly impossible. Several weeks later, I underwent surgery. 6 weeks later and I was barely out of a splint on my right hand (still very weak-couldn’t untwist most caps) and in a post-surgical splint on my left hand. And AI saved my life/career. I seriously don’t think I could have done my job without it. And now, when my hands are healed to the point that I can type? I still couldn’t survive without it. In fact, if they take AI away, I doubt I will continue working unless it is replaced with something just as good or better.
For context, I am a pediatric endocrinologist. I work in a rural area. My notes are long, detailed, and require compilation of tons of outside records and data. A dictation before AI (I timed it) would take me 7 minutes for an “easy” note, and about 15-25 minutes for a “hard” note. Even with smart phrases (pre-made generic content). Also, because I rarely could dictate on the same day, I would often forget tons of details by the time I dictated, requiring me to comb through my notes and the chart AGAIN for documentation purposes, and delayed notes (even by a day or two) pretty much universally took me 15-25 minutes each. On a full day, I see 12 patients (40 minute slots, no lunch so I can run home to get my kids). Many days I am overbooked. Then I would dictate on my day off (non-clinical day), Saturday, or after 8 pm when my kids went to bed. In general, for a day of patients, dictation would take me 2-4 hours. At four days a week, that is 8-16 hours of dictation time in addition to my patient contact hours (this is not counting all of the message centers, physician phone calls/curbside consults, inpatient visits/consultations, etc). My kids complained. My spouse complained. I complained. I burned out. In flames. I was on the brink of quitting all together (documentation was not the only component but…).
Then, I piloted DAX, our computer system’s complement AI system at the time (currently I am on Oracle). How it works is that I pre-populate my note with smart phrases I know I want to use (physical exam, negative review of systems, general information about the disease process I am seeing). Then I save the note. I put the recorder on in the room, and the computer fills in my note! Then I spent about 3-7 minutes per note at the end of the day editing. So, about an hour of dictation work for a day of patients. About 4 hours a week of additional dictation time in excess of my patient contact hours. A 50-75% cut in out of office time spent on dictating. A life changer. Now, I use Oracle, and that chart prep is minimally necessary, honestly, saving me even more time.
Also, with my hands injured, it actually allowed me a hands free way to write my notes! My painful hands were only used in a limited fashion, and I used Voice Dictation for most of my emails and messages, so I only took 2 days off for my surgery (probably a little overambitious, but oh well what’s done is done).
Are my notes in my “voice”? No. Are they exactly how I would have written it? No. Do they have the necessary information? Yes!!! As my partner said, “I have to be less precious about my notes”. Because do notes give me job satisfaction? Absolutely not. But extra time with my patients and my family DOES.
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