How physicians actually use AI: Jarrett Dodd, MD

Jarrett Dodd, MD

Dr. Jarrett Dodd’s medical group has seven primary care clinics. It uses a couple of AI-based tools, but the most significant one allows physicians to easily identify potential hierarchical condition category (HCC) codes in conjunction with the EHR. Before a patient appointment, the AI goes into the chart, looks for any potential HCC diagnosis codes, and then surfaces those to the clinician so that they can evaluate whether they are appropriate and, if so, include them in the claim. The software provides not only the code but also the rationale for why it is presenting it with direct links to relevant evidence in the chart.

“Before, we were coaching our clinicians to make sure when you open the chart that you look at the med list and find any of these particular types of medications that might indicate an HCC diagnosis, make sure you are looking at all the imaging studies, make sure you are looking at all the consult notes,” Dodd says. “Well, no clinician has time in a busy day when we’re slammed with patients — docs aren’t going to do that.”

But because the group relies on value-based care contracts, HCC coding is vital to success.

“This tool really helped us accomplish that without adding burden to the clinician,” Dodd says. “Now, the AI is looking for all those things in the chart and presenting it to them on a silver platter, saying, ‘You pick, you get to decide, is it appropriate or not?’“

Before committing to the tool three years ago, the group had physicians at each location pilot it. After overwhelmingly positive feedback, it was rolled out to the entire staff. Dodd says there wasn’t pushback in the form of AI-phobia, but more like asking someone to change their work flow and learn something new. In addition to the HCC coding, the program provides doctors with a patient summary to quickly review the diagnosis, medications and prior visits.

“We were able to promote it to our clinicians as ‘we want to do better HCC coding, but there are other parts of this that will make your life easier once you learn how to use it,’“ Dodd says. “We sort of promoted it as ‘we are trying to help you on several different fronts.’“

A dashboard allows the group to monitor who is using it and who isn’t. The expectation is that 80% of the codes the program suggests are reviewed and either rejected or approved by the doctor.

In addition, some doctors in the group use an AI-powered dictation tool that uses ambient listening to create notes. “The docs [who] are using it, it’s a real lifesaver for them,” Dodd says, adding that they have been using some version of it for about four years. “It gives them a very well-structured note. They can push the computer to the side, have a conversation with the patient, and the computer is listening. At the end of the visit, they generate the note, and they don’t have the computer between them and the patient, which is huge.”

Dodd says the accuracy has been excellent. “When it gets demoed to people who have never seen it, they’re shocked at how accurate it is and how good it is at really pulling out the clinically relevant parts of the visit and leaving out the chitchat that really doesn’t need to be there. Is it 100%? No, but I rarely have to edit much, if at all.”

Although time savings will vary, one doctor in the group reduced documenting a typical visit from 20 minutes to three, as measured through the EHR. Dodd says it didn’t save him much time because he was already good at using macros and shortcuts, but it did give him a more complete and personalized note.

Next up is finding inbox assistance to help with patient portal messages. Dodd says the best way to find the right program for you is to find practices like yours and ask them what they are using and what the pros and cons of it are.

“You don’t have to roll it out to everybody,” Dodd says. “Most of these companies will allow you to do a small pilot for a couple of your doctors. Don’t pick the technophiles to do it — pick the ones [who] are going to have the most trouble and let them use it. If you can get them on board, you’ll get everybody on board.”