MGMA Business Solutions: Alleviating Provider Burnout with AI and Automation
Download MP3Well, hi, everyone. I'm Daniel Williams, senior editor at MGMA and host of the MGMA Podcast Network. We are back today with another MGMA business solutions podcast, and we have a repeat guest, someone who's been on our show numerous times. That's doctor Michael Blackman. He's chief medical officer at Greenway Health, and doctor Blackman is a primary care physician and a health care technology leader.
Daniel Williams:Doctor Blackman, welcome back to the show.
Dr. Michael Blackman:Thanks. Pleasure to be here.
Daniel Williams:I'm just so glad that we we enjoyed each other's company enough, so you're back on the show with us. And for this episode, we're gonna talk a lot about AI automation, how it's helping provider burnout, and helping alleviate some of those pain points in that regard. We're also gonna be talking about Greenway Clinical Assist. We'll probably define some of the topics and terms that we're gonna be talking about. But first, even though you've been on the show numerous times, what I wanted to do was just have you share a little bit about your background just in case someone's never heard the shows that you've been on.
Daniel Williams:So if you don't mind just giving us a little bit about that background.
Dr. Michael Blackman:Yeah. So, obviously, as you mentioned, I'm I'm the chief medical officer at Greenway Health. I'm a primary chair physician by training, trained in both internal medicine and pediatrics. So that sort of gives you, you know, my my view of the world a little bit. And despite working now on the technology side for, dare I say, you know, fifteen plus years, first as the Chief Medical Information Officer at a health system and then moving over to the vendor side, I'm not the technology guy.
Dr. Michael Blackman:I'm one who looks at it says, Okay, what can these tools do for us? How can they make people's lives better? What the technology is? Yes. It can be exciting and fun and all of that, but that's traditionally not where my focus is.
Daniel Williams:Okay. And then for anybody who's listening, these are our medical practice leaders. Most will know Greenway Health for anybody who doesn't. Just share a little bit about Greenway Health and what your role is there.
Dr. Michael Blackman:Yeah. So Greenway Health focuses on the ambulatory space. We are strictly in the ambulatory space looking at providing, you know, a full set of solutions to ambulatory practices to help them succeed.
Daniel Williams:You and I and your team shared some information back and forth so we would really be able to zero in on a particular topic to talk about. So even though, as you said, you're not maybe, writing code or anything of that nature, that's not your background. But what I have learned from talking to your team, Greenway really takes a team approach to health care technology. Talk a little bit because you are a leader. So you might not be a, you know, quote, tech guy, but you are a leader.
Daniel Williams:And so you understand how important it is to have that team based approach. Talk about that and how Greenway can help medical practices really kind of embrace that team approach.
Dr. Michael Blackman:Yeah. No. And so we take a team approach, not only in the work we do within Greenway, it takes a village. We also want to support the team that it takes to run a practice. There is no person, whether that be the person at the front desk, a medical assistant, a nurse, a physician, an administrator, anyone else, can run a medical practice on their own and provide good care on their It requires that team approach and so as we build solutions, we wanna be certain that we're supporting that entire team, that we're giving people the ability to do the work they do best, to do the most important thing, which is support patients.
Daniel Williams:Right. Well, thank you for sharing that. So that topic that we're really gonna zero in on today is about AI and burnout. I'm just I'm sitting with that for a second because that is the topic that we we hear out there. Wow.
Daniel Williams:We've got AI going on. We've got burnout, but we're really trying to look at how we can mesh those together, how AI can alleviate some of those incredible pain points that our clinicians and their support team is going through. Talk about that a little bit.
Dr. Michael Blackman:We've talked about burnout for a a long time. Yeah. And we people have done different things and different approach to say, how can you eliminate burnout? You often hear about, you know, call it different things, but pajama time. People taking work home home with them in the evening.
Dr. Michael Blackman:Certainly, when I was in full time practice, I don't think we called it pajama time then, but I certainly did. Didn't call it that, but certainly brought stuff home. Sure. You know, you know, after I put my kids to bed, you can often find me sitting on the couch calling patients, and patients often be surprised. They get a call from me at, you know, eight or 09:00 at night.
Dr. Michael Blackman:But that's when I had the time to do it, and it was important to catch up with them. You know, AI and and people use the term very broadly, it can mean a lot of different things.
Daniel Williams:Right.
Dr. Michael Blackman:But I think it comes down to what are the available tools that can really help? Think about it as an assistant. It's not a replacement, but an assistant. And there are some things that can replace in some tasks. Some tasks, it's an additional speed.
Dr. Michael Blackman:I use AI tools a lot myself for doing different things. Even for something as simple as if I'm thinking about creating a presentation, I could sit and write an initial draft and it might take me a while. I can equally take AI and say, hey, what are the seven things or 10 things you would talk about on this topic?
Daniel Williams:Right.
Dr. Michael Blackman:And then edit it from there. I think the point of it being an assistant is critical, especially if we get to other pieces like using AI for clinical decision support. Notice I said that support and not decision making, this still requires human oversight and paying attention to what you're looking at. You know? AI can still hallucinate in certain situations, so you gotta make sure what's what's being presented is real and makes sense.
Daniel Williams:You make great points there, and we've talked about that before on this show. And, obviously, anyone who's interacted with, the different AI tools that are out there, they'll be humming along, and then all of a sudden, there's something just, as you said, the hallucination, the just getting things completely wrong. Or if you are looking at, as you were saying, making a presentation, it's not the right tone. You know? It's not really hitting the way you wanna address it.
Daniel Williams:So I think what's so important, and this is the point we make a lot here, at least in this day and age, We're not replacing jobs per se, but what we're doing is really giving us, whether it's you, me, physicians, clinicians, anybody else out there, some really important tools. And then we have to use our wisdom, our knowledge, our education base. And it sounds like you've really dealt with that as well.
Dr. Michael Blackman:Yeah. You know, it often comes up. People say, well, is it gonna replace people? It's gonna cause people to do different things. And I don't know where this quote originated.
Dr. Michael Blackman:It it's not mine, but I'm gonna share it. You know, people talk, oh, will AI replace doctors? And the short answer to that is no. But likely, doctors who use AI may replace those who don't.
Daniel Williams:I love that quote. I mean, not not for what it means for Vivo's job, but that that's the reality that we're in. And I think the people who really are making that adoption to using the tools and using them wisely are gonna be ahead of the ones who aren't. I mean, that's just the clear way to say it. So let's talk about a very specific AI tool.
Daniel Williams:That's the one that Greenway is working with. It's Greenway Clinical Assist. Talk about that because in the name itself, it's not Greenway Clinical Replace. It's Greenway Clinical Assist. Talk about a little bit about what you see in its usage as a tool and the way that you're seeing administrators and practice leaders using it?
Dr. Michael Blackman:So our vision for Greenway Clinical Assist is just that. It's an assistant that helps you, you know, across the board as you're working your way through any variety of tasks in the practice. The place that it's starting is assisting with documentation. At its core, it starts with being an ambient documentation solution. So as you're having a conversation with the patient, this system listens to the conversation and then writes a note based on that conversation, leaving in, you know, the the pertinent medical parts and stripping out other pieces that it doesn't deem are pertinent.
Dr. Michael Blackman:Now going back to the comment I made before, you still need to read your note. Right. You know? So you read it. You say, okay.
Dr. Michael Blackman:Yep. That makes sense. Or wait. It didn't it left out something I think is important, and you can then just tell it to put it back in. It's really very, very simple in that regard.
Dr. Michael Blackman:But what it does do at its core though, is it turns documentation from being what has traditionally been an after event. Do all of the work and now write down everything you did, to being a byproduct of the work you're already doing. So that in itself saves time. And at least, you know, we've seen with this, you know, both in the literature and in direct conversations with its providers, is it also creates in a lot of cases, a more accurate note. Obviously in the course of a medical visit, you're talking to the patient, thinking about things, and the patient may say something you miss.
Dr. Michael Blackman:It's just part of a conversation. Well, I've had conversations with physicians and others when they say, Well, wait a minute, this showed up in the note. I don't remember that coming up. We go back, we look at the transcript, and sure enough, it's there. And they feel like, wow, I I missed that.
Dr. Michael Blackman:You know, missed that comment. So I think that's important. One one provider in particular said to me, he said, I'm getting to spend more focus on my patient. It's taking me less time, and it's generating a better note. Truthfully, I take any one of those three outcomes, let alone all three.
Daniel Williams:I would too. I wish I spent twenty five years as a reporter, like, jotting down notes or recording it and having to go back and transcribe it myself. I'd spend the whole afternoon just typing up the interview, and now you can just get the audio, drop it into one of the different platforms, whatever it might be. And then in a minute or five minutes or so, you have the transcription. Now you can really use your
Dr. Michael Blackman:Yeah.
Daniel Williams:Analytical skills to, decipher what's right, what's wrong in there. So I do wanna follow-up with you one more question about the product itself. How does it work in practice? Is it within embedded in an app, or what what is where is it located, and how is it used?
Dr. Michael Blackman:Yeah. So the way really, it's embedded in an app. Walk in, start start the app, and then just ignore it.
Daniel Williams:Okay.
Dr. Michael Blackman:Have a have a conversation. It would be usual conversation, usual interaction with the patient. And then when you're done, you simply hit the stop button, it generates the note, you have a chance to review it, and then you press another button and off it goes right into the electronic health record. Now I think, you know, one of the things that is different about this a little bit, is that this may sound sort of obvious, but it can only record things in the note that the system hears. So, you know, the way what one chooses to vocalize during the course of the visit has to change a little bit if you want that to show up in your note.
Dr. Michael Blackman:You know, for example, you know, typically, as you're doing the physical exam, you'll you don't necessarily vocalize all of those findings. Right. You would just eventually write them down. But if you want the system to capture it, you'd have to say things like, yep, what was your heart exam? What was your lung exam?
Dr. Michael Blackman:What are your other findings? Now, personally, I think there's some benefit from that just to conveying that information to the patient, but it's it's a, you know, necessary step if you wanted to do that. If you don't want it to and you wanna put it in later, that's totally up to the user.
Daniel Williams:And that's a great point that it actually hearing you say that, it really increases that patient engagement in the way that you're being very transparent. There are some things you might just jot down. Now you're verbally saying it. They're hearing it. They might even have a well, is that a good reading or a bad reading?
Daniel Williams:Tell me tell me more about that. So, I think that there's a real benefit in actually verbalizing what is being done. So Mhmm. Now with your team, y'all shared some metrics with me. I wanna make sure I get these right.
Daniel Williams:You shared metrics like 90% report less time pressure and 81% patient satisfaction. I know what the patient satisfaction is. That report less time what is time pressure? What are we talking about there?
Dr. Michael Blackman:Yeah. Time pressure sort of goes back to burnout and back to that pajama time. You know, If you think about the day of a typical primary care physician, you have a series of appointments back to back, morning session, afternoon session. And yes, it obviously varies by practice and other things. But typically we're talking about fifteen minute appointments, sometimes 30s for physicals, maybe a little less.
Dr. Michael Blackman:So you People want to stay on time. You know? Mhmm. People we've all been to the doctor's office, myself included, where you're sitting there waiting, going, you know, my appointment was an hour ago. Why am I still sitting here?
Daniel Williams:Right.
Dr. Michael Blackman:And, you know, so having people giving the ability to sort of move through their day a little more efficiently, that's that time pressure. Now Okay. Does that mean everybody's gonna be out of time all day long? No. You know?
Dr. Michael Blackman:And I'll speak speak strictly for myself. You know, always wanted to make sure I gave everyone the time they needed. And if that meant running a little behind and giving someone more time, that's what I always did. And people, you know, who were late when I was running late, if they, you know, were concerned about that, and I said, listen. I spent time with someone.
Dr. Michael Blackman:If you needed it or your family member needed, I'd spend time with you. That usually solved the conversation pretty quickly.
Daniel Williams:Right. The other statistic is eighty one percent patient satisfaction. It's understandable on the surface, but do you have any examples of what are what's the feedback you're getting? What specifically are the patients seeing, experiencing that they go, this is a better patient experience for me.
Dr. Michael Blackman:This is some of information we're getting back, you either anecdotally or from from surveys, you know, we we put that afterwards. And it goes back to some of the things we were talking about a second ago, that sort of greater awareness of the patient about what's going on and their involvement and a better chance to ask questions.
Daniel Williams:Okay. I'm looking at some other notes I have here. We talked a lot about that fear of AI and automation replacing jobs. We talked about it already, but what I would like to talk about now is how do how do you recommend practices reframe that to their staff so there's not that fear, oh my gosh. We've got this the machine coming in, and now I'm gonna not have a job anymore.
Daniel Williams:How are you reframing that? What is a guideline or best practice to use so it can be used as an upsell to the staff that, hey. This is gonna help us all do our jobs better.
Dr. Michael Blackman:I think my first question to people is pretty much, what are you not spending time on that you would like to?
Daniel Williams:Okay.
Dr. Michael Blackman:What are you not doing that you think would help, either help the practice or help patients, or were you, yo, you're rushed? To a person, everyone has an answer to that question. Oh yeah, no. Then the other piece is, what are you doing that you don't think adds value? So we start looking at those two pieces and okay, what are the things you're doing that are necessary, but you don't think adds value or where it's not value from you, it becomes more rogue?
Dr. Michael Blackman:Well, where can we automate those as best we can, And then therefore free you up to spend more time on things that matter. Everything matters, but an extra conversation with a patient, an extra two minutes, whatever it may be, you know, improving that human interaction Mhmm. And not taking away from it.
Daniel Williams:With that said, is there data? Do y'all have data yet either internally or there are other studies out there? You're already talking about, well, we're able to reduce some of that pajama time. What about the time spent in front of the patient? Have you noticed is there is it allowing for more time to be on that specifically on the patient visit, or is there any data on that yet?
Dr. Michael Blackman:You know, we don't have I haven't seen specific data on that yet, but I mean, it's but I do think it's a function of not only it's not just the amount of time
Daniel Williams:Right.
Dr. Michael Blackman:But it's the quality of the time. Yeah. You know, that if you can sit and have that conversation and, you know, really focus on the patient, and especially as we get, you know, further along, as we continue to use AI to help, you know, bring other information to the fore and present things to people, they'll spend less time digging, you know, quote, unquote, digging through the chart.
Daniel Williams:Right. As soon as that those words came out of my mouth, I went, you know, quantity may not be the best thing. It could be quality, and it may be when how do we define that quality then? Is it having the clinicians better informed? They're not having to dig through a lot of stuff, but it's been very because I know when I work with AI, I can have just a couple of bullet points that are summarized, and I now better understand this patient or whatever it is we're doing.
Daniel Williams:Is that how you're defining quality, or what are you looking at there?
Dr. Michael Blackman:I think that's a that's a big piece of it. The other is adding, you know, beyond the the summarization capabilities and, you know, search capabilities as well, to make it easy to find the information. Right. Certainly if you have a complicated patient who wanna see you for years, there's a tremendous amount of data there. The best sort of corollary I can use here is to think about the old days before electronic records.
Dr. Michael Blackman:So you had something like that, you might have five volumes of thick chart, You'd stack up on a desk. Well, you didn't read the whole thing. Nobody did. You had it for reference to find you know, go searching for something. Well, manually searching for something in five volumes of paper chart is hard, and that assumes it was filed correctly.
Dr. Michael Blackman:Yeah. But electronically, we start having greater capability of pulling things out or being able to sort of you asked about this, Perhaps you're interested in this and bring and just bring it to the fore without you asking for it.
Daniel Williams:Right. That's a really good point. Couple of final questions then before we sign off. I really wanna ask you. I know you're not, yeah, I'll put the quotes again, tech guy, but you are a leader in health care.
Daniel Williams:And so you're understanding the bigger picture of things. Are there some other trends or there's some other things happening in health IT, health care IT right now in addition to AI that you might wanna share with our listeners?
Dr. Michael Blackman:Yeah. I think there's a lot going on, as there always is. I think there are probably three things that I would sort of focus on. One is related to AI. And so how do we continue to improve clinical decision support?
Dr. Michael Blackman:Really leverage the information that's out there. You know, moving beyond, you know, simple algorithms, but more complex models to say, hey. Did you think about this? And, again, not decision making, but support. Because if you have a constellation of symptoms, maybe to me, I think of five things in the differential diagnosis or three things.
Dr. Michael Blackman:Well, maybe there should have been six or seven. And it, you know, hey, give me a fuller differential. I may then dismiss some of them or not, or say, No, so I should look into that further. Why did that show up there? Especially in complicated cases.
Dr. Michael Blackman:So I think that's one. Obviously there's risk in all of this. You gotta watch for bias in the algorithms and things like that. You wanna be sure that we're within regulatory compliance and all of those kinds of fun things. But I think there are real advantages.
Dr. Michael Blackman:Second, continued increases in virtual care, remote monitoring and things like that. Things that are real shift in our traditional healthcare model, is in The US traditionally we've had sick insurance, we treat people when they're ill. How do we shift more to keeping people healthy and doing things to keep them out of the hospital? That's better. Some hospital administrators might not agree with that statement from a financial point of view.
Dr. Michael Blackman:But from a health standpoint, we're much better off if we can do more of that. And then finally, again, somebody's been talked about for a long time is interoperability. How do we continue to share data and information across practices in different places and TEFCA and some of the other regulatory structures are really starting to come to the fore. We say that, you know, every year or so, but I think we may be finally getting close.
Daniel Williams:Yeah. All of those are some we could just break off and start talking about each one of those and have a full episode. But the one that really struck me was the virtual care and how much that is gonna be part of our future because you and I are in different parts of the country talking now. And we're gonna broadcast this, and it's gonna be published, and people are gonna see it and listen to it. And so when it's appropriate, should, you know, adopt that as well wherever it can.
Dr. Michael Blackman:Yeah. I I think one of the things that's important there is for people to keep in mind that there are plenty of things that can be done remotely. And there are plenty of things that can't. Right. And that, you know, an expectation of, well, they saw me remotely the last time I should be able to do this remotely true, may or may not be true.
Dr. Michael Blackman:And that, you know, we need to use in whether it's AI decision support, remote monitoring, telehealth, those two they're they're simply tools. Mhmm. And we and the users of those tools need to use them appropriately.
Daniel Williams:I think I I need to do some study and just see what the adoption rate is of medical practices, MGMA members who have used AI tools. Without having that information right in front of me, what I would wanna ask you here as a final question, we're here talking about Greenway Clinical Assist. There are other AI tools out there, and it could be overwhelming to someone to go, okay. We need to get on this ship now so we're not left behind. But at the same time, if they're trying to make decisions, what should they what are the questions they should be asking?
Daniel Williams:What should they be looking for in AI tools to assist them?
Dr. Michael Blackman:I think you sort of start back and say what problem you're trying to solve.
Daniel Williams:Okay.
Dr. Michael Blackman:You know, always a a great place to start. You know, what are the concerns you have for your practice? What are the things you would wanna do that you can't that you think you can't do today? And what outcomes are you looking for? The next piece is that, right, a hodgepodge of tools isn't necessarily helpful.
Dr. Michael Blackman:How do those tools potentially work together? How do you make sure it all works together as a core system? And then equally, look at what you currently have. It's quite possible that what you currently have has more capability than you realize, or than one realizes, and you wanna make sure you're getting good value from all of those things as you're doing it. I think about myself and use of something like Microsoft Word.
Dr. Michael Blackman:Don't know what percentage of features in Microsoft Word I actually use. All I can tell you is that it's small. It has far more capability than I take advantage of. And that's often true for the tools that people put into their practices. And they look for a point solution when their core solution already does it.
Daniel Williams:Great point. So before we before we leave then, are there if people wanna get in touch with you or the Greenway team, how would they do that? What are any resources that we can put in the episode show notes?
Dr. Michael Blackman:Yeah. So, obviously, you can you know, it was on my website, which is greenwayhealth.com. Okay. You know, always send me an email. It's very simple.
Dr. Michael Blackman:It's Michael.Blackman@GreenwayHealth.com. I'll respond or get it to the right place. And there are lots of we're thinking about resources about the advent of AI, the use of AI in healthcare. I think there are lots of great resources out there. A couple that I particularly like is one is the Stanford Center for Biomedical Informatics.
Dr. Michael Blackman:Duke Health also has Duke AI, which I think is pretty good. And then for those interested, sort of a a podcast, there's one on it's called creating new health care, which I'm very fond of, hosted by doctor Zev Newers, who's done a lot of work in in health care transformation over the years.
Daniel Williams:All right. Well, Doctor. Blackman, it is so much fun to have you on the show yet again, and just connect with you and hear what is going on at Greenway, and how you're interacting with those practices out there.
Dr. Michael Blackman:Now we're looking forward to continuing to make make them successful, to create healthier communities, by empowering the patients.
Daniel Williams:All right, well, everyone, we will put those links and Doctor. Blackmon's email address in our episode show notes. We're also gonna create an article from this conversation so you can access it in a lot of different ways either through YouTube, Spotify, and the other podcast platforms, or on the MGMA site to read that article. So until then, thank you all so much for being MGMA podcast listeners.
