Latest / Becker’s Healthcare Podcast / Clinician Trust, Burnout and ROI: The Real Test for Ambient AI in Healthcare
Transcript
- 0:00- Hi, everyone. This is Brian Zimmerman with Becker's
- 0:02- Healthcare. Thank you so much for tuning into
- 0:04- the Becker's Healthcare podcast.
- 0:06- Today, we're gonna talk about clinician trust, burnout,
- 0:08- and ROI,
- 0:10- the real test for ambient AI in healthcare.
- 0:12- Joining me for this discussion is doctor Michael
- 0:14- Hahn, chief medical officer at Ambience Healthcare. Doctor
- 0:18- Hahn, thank you so much for being here
- 0:19- today. Thanks for having me, Brian. Pleasure to
- 0:21- be here.
- 0:23- Awesome to have you on. And just as
- 0:24- we get going here, maybe you can share
- 0:26- a little bit about yourself, your your your
- 0:28- professional journey, your work in healthcare, and and
- 0:30- what you're doing with with Ambiance today.
- 0:32- Sure. So my name is Baikhan. I am
- 0:35- a urologist
- 0:36- by background.
- 0:37- If you asked me,
- 0:39- twenty years ago if I would be in
- 0:40- medical informatics
- 0:42- and and and being part of a team
- 0:44- that's, building an AI,
- 0:47- ambient clinical documentation
- 0:48- tool, I I would have said, what's informatics?
- 0:50- And ambient clinical documentation, never heard of it.
- 0:53- Things have changed, certainly. Things have changed over
- 0:56- the last twenty years. I had the honor
- 0:58- of, of practicing with a very traditional
- 1:02- single specialty urology group, a multi specialty group,
- 1:06- that that focused on on value based care
- 1:08- delivery,
- 1:09- as well as a couple of very large,
- 1:11- integrated delivery networks,
- 1:13- here on the West Coast.
- 1:15- I I think that I am part of
- 1:16- the generation
- 1:17- of what I call accidental informaticists.
- 1:20- There's a a group of us that never
- 1:22- had the thought that they would be,
- 1:25- working, with the, the electronic health record and
- 1:28- its governance and implementation and maintenance.
- 1:31- But,
- 1:32- you know, we, I was involved in a
- 1:34- early implementation electronic health record.
- 1:37- It didn't go so well,
- 1:39- and my chief medical officer at the time
- 1:41- said, well, you seem like you're really good
- 1:43- at using the record. You're already part of
- 1:45- the leadership team.
- 1:47- I don't have to pay you anymore to
- 1:48- do this. Other duties are assigned to go
- 1:50- fix the electronic health record. And so, you
- 1:53- know, moving on to,
- 1:55- working for larger integrated delivery networks, certainly there
- 1:58- was more complexity
- 2:00- in trying to drive provider adoption and satisfaction
- 2:03- with the electronic health record.
- 2:05- And so I went on to get a
- 2:07- a a board certification in in clinical informatics,
- 2:11- which taught me some of the science behind,
- 2:14- change management and implementation,
- 2:16- and,
- 2:17- and a little bit of computer science. And
- 2:20- then I I found myself,
- 2:22- wondering if
- 2:24- if I should continue
- 2:25- along
- 2:26- the pathway,
- 2:27- on the provider side,
- 2:30- or,
- 2:31- whether I wanted
- 2:32- to give the venture backed startup space
- 2:35- a try. And I I guess timing is
- 2:38- everything. And,
- 2:39- and Nikhil Budama,
- 2:40- our CEO,
- 2:42- reached out to me earlier this year. And,
- 2:45- and I guess the rest is history.
- 2:47- And so now I have, the privilege of
- 2:50- of of working alongside who I believe is
- 2:52- the the best team in health care AI
- 2:54- in building,
- 2:55- an intelligence platform
- 2:57- to,
- 2:58- apply artificial intelligence
- 3:00- to improve the delivery of health,
- 3:03- in this country. And so as the chief
- 3:05- medical officer at
- 3:07- at at a health care technology company, I
- 3:09- I think that the the the role is
- 3:11- really,
- 3:12- threefold. I I think that there there is
- 3:15- a sales portion to the role.
- 3:17- There is certainly,
- 3:19- a support,
- 3:20- portion to the role. And finally, there is
- 3:22- product. So and and I'm happy to say
- 3:24- that I've been involved in all three,
- 3:26- in my first couple of months here and
- 3:28- seek. And, it's been an amazing journey.
- 3:31- Wonderful to have you on and to hear
- 3:33- about that journey. And, Nikhil, the CEO is
- 3:36- certainly a friend of the podcast, has been
- 3:38- on before.
- 3:39- I wanna go back though to something you
- 3:41- spoke on
- 3:43- early, which is that that those early days
- 3:44- with the EHR, you mentioned it was,
- 3:47- I'm paraphrasing here, but but pretty challenging.
- 3:50- And and I think that's that it's fair
- 3:52- to say that, anecdotally, that's been the experience
- 3:54- of a lot of clinicians with EHR.
- 3:57- But now we're starting to see things change
- 3:59- quite a bit. So there's a study Yale
- 4:02- led in 2025
- 4:04- from across six health systems that found that
- 4:06- Ambien AI reduced clinician burnout rates
- 4:09- roughly fifty two percent to thirty nine percent
- 4:11- in just thirty days. And, of course, the
- 4:13- EHR is some of that documentation burden is
- 4:16- closely tied to to to to burnout.
- 4:19- As a clinician, putting your clinician hat on,
- 4:22- how do you separate, I guess, what what
- 4:24- genuine progress like this,
- 4:26- with AI looks like from sort of AI
- 4:29- hype? You know, what does meaningful lasting relief
- 4:32- for clinicians look like? Because this this seems
- 4:35- real and tangible, but there's also a lot
- 4:37- out there in terms of a lot of
- 4:38- noise, a lot of promise. So putting your
- 4:40- clinician hat on, how do you separate the
- 4:42- two?
- 4:43- I I think that first and foremost
- 4:45- is leading with the data. I mean, I
- 4:47- I I you know, physicians,
- 4:49- providers,
- 4:50- clinicians in general,
- 4:52- they're they're taught to start with subjective data
- 4:54- and then move on to the objective data.
- 4:56- And and I think that that that is
- 4:58- super important to to to lead with data.
- 5:01- When when I was at MultiCare, which is
- 5:03- the the last, integrated delivery network that I
- 5:05- was a part of,
- 5:07- we looked at at at return on investment
- 5:10- from any clinical documentation in in three buckets.
- 5:13- The the first was time savings.
- 5:16- Are we actually seeing,
- 5:18- a savings in time for our physicians and
- 5:21- APPs?
- 5:22- So,
- 5:23- time in documentation,
- 5:25- time in chart,
- 5:27- time spent after scheduled hours in the electronic
- 5:29- health record.
- 5:30- We we also looked at revenue generation
- 5:33- and,
- 5:34- did we see an in an increase,
- 5:37- in productivity?
- 5:38- Did we see an increase in in risk
- 5:41- scoring? And then finally, you know, the the
- 5:43- the the the same the same data that
- 5:45- you mentioned from the Yale study,
- 5:47- we looked at burnout.
- 5:49- And and, you know, the the folks at
- 5:51- Ambiance hate it when I say this, but
- 5:52- agnostic of solution. Right? We looked at three,
- 5:56- competing solutions, Ambiance included.
- 5:58- Agnostic of solution,
- 6:00- in about six months, we went from
- 6:03- sixty percent of physicians and APPs
- 6:07- reporting any symptom of burnout. So that's six
- 6:09- zero percent
- 6:10- to sixteen, one six percent,
- 6:13- reporting any symptom of burnout. We went from
- 6:16- eleven percent of our physicians and APPs,
- 6:20- saying that they enjoyed their work
- 6:22- to, the end of the bake off, where
- 6:25- where 35%
- 6:26- of them, said that they were actually enjoying
- 6:28- their work. You know, in the fifteen years
- 6:30- that I've been doing informatics,
- 6:32- I've never seen anything move the needle like
- 6:35- that. And so, you know, kudos to to
- 6:38- institutions that are implementing this technology,
- 6:42- and and certainly to to to those who
- 6:44- are building it. Yeah. I mean, those those
- 6:46- numbers are so striking and this is not
- 6:49- it's not like this hasn't been a problem
- 6:50- people have been trying to solve for some
- 6:52- time. Right? Doctor Hahn, and and now suddenly,
- 6:55- it feels like there's a there's a special
- 6:57- tool that can really, really help get you
- 6:59- there. Is that is that a fair read?
- 7:01- Yeah. And I think it's only the start.
- 7:02- Right? I think that documentation,
- 7:05- is only the start.
- 7:07- I think that there are areas both upstream
- 7:10- and downstream of,
- 7:12- within,
- 7:13- position and APP workflow that we can continue
- 7:16- to tackle to to ease and automate,
- 7:19- as much as possible.
- 7:21- Yeah. Yeah. And and there are these wins
- 7:24- folks can point to and sometimes,
- 7:26- you know, certain organizations will experience similar wins
- 7:30- in in pilot modes. Right? In in in
- 7:33- they'll have an effective pilot, but they'll run
- 7:34- into barriers then when they try to scale
- 7:36- deployment.
- 7:37- So why does that happen? Doctor Han, can
- 7:39- you can you expand on that? Where where
- 7:41- does that disconnect happen, and
- 7:43- how can health system leaders sort of avoid
- 7:45- that, avoid sort of perhaps a a promising
- 7:48- pilot that doesn't turn into sort of enterprise
- 7:50- wide results?
- 7:52- I I think that that that the issue
- 7:54- here is fairly classic, you know, sort of
- 7:57- change management and and and looking at the
- 8:00- the looking at the adoption curve. Right? Because
- 8:03- for the most part, you know, I would
- 8:05- say that pilots are populated with with with
- 8:08- clinicians
- 8:10- who are pioneers and early adopters.
- 8:12- Right?
- 8:13- And and and so you are more than
- 8:16- likely,
- 8:17- going to get
- 8:19- fairly decent adoption
- 8:20- and fairly decent utilization
- 8:23- amongst those providers.
- 8:25- But as you move from your your pioneers
- 8:29- and early adopters up, you know, the early
- 8:31- majority part of the curve and and certainly
- 8:33- the late majority part of the curve, down
- 8:35- the late majority part of the curve. Now
- 8:37- you're talking about providers that are a little
- 8:38- bit more skeptical.
- 8:40- And so, you
- 8:42- you you need to do a couple of
- 8:44- things well here. Right? I I I think
- 8:47- that the first is is
- 8:49- is really looking at the people in the
- 8:50- process. Right? And
- 8:52- and and being able to convince people that
- 8:55- they wanna be able they wanna use this
- 8:56- tool
- 8:58- and and make sure that the tool fits
- 9:00- into their workflow.
- 9:02- You know, I know that, some of my
- 9:03- engineering friends are gonna cringe when I say
- 9:05- this, but but technology is really the easy
- 9:07- part.
- 9:08- Convincing the people and making sure it integrates
- 9:11- into the workflow, the process is the hard
- 9:13- part, and it's a step that, you know,
- 9:14- a lot of systems and vendors quickly forget,
- 9:18- after having a a a, you know, a
- 9:19- moderately successful pilot.
- 9:22- You know, you know, sort of double clicking
- 9:25- on on that move from pilot to
- 9:28- to production.
- 9:30- Here at Ambiance, we we we look at
- 9:32- a couple of different data points, because we
- 9:34- truly believe that the most expensive AI you're
- 9:36- ever gonna buy is the AI that's not
- 9:39- being used.
- 9:41- And so most of the vendors in this
- 9:43- space,
- 9:44- measure what they what they call utilization
- 9:46- based on, did the clinician
- 9:49- use the product
- 9:50- once or twice in a month?
- 9:54- But we think that that's the wrong question.
- 9:55- That's that's adoption. How many providers do you
- 9:58- have that are using this, on a monthly
- 10:01- basis?
- 10:02- We believe at Ambiance that encounter youth level
- 10:06- utilization
- 10:07- is a key metric.
- 10:08- What percentage of visits is the clinician actually
- 10:11- using the technology
- 10:13- over their total number of visits. And and
- 10:15- that's a much higher standard.
- 10:18- What we've seen is is that the industry
- 10:20- average for Ambient AI
- 10:22- is around 40%.
- 10:25- When we scaled Ambiance at MultiCare,
- 10:28- we we moved from 200 providers in the
- 10:31- pilot
- 10:31- to to over 1,200 providers in a period
- 10:35- of three months,
- 10:36- and we sustained 80%,
- 10:39- encounter level utilization for those providers.
- 10:43- And so, you know, the the
- 10:45- the the internal numbers
- 10:47- if you if you say that we're using
- 10:49- this if 40% of your providers have have
- 10:51- adopted the tool and they're using it for
- 10:53- 40% of their encounters,
- 10:55- then across the system, you're only using it
- 10:58- for 16%,
- 11:00- of your total encounters.
- 11:02- At MultiCare, I would say that we're already
- 11:04- at around 70 to 75%
- 11:07- of our eligible providers,
- 11:08- and we're running pretty close to 80%,
- 11:11- you know, which which tells me that we're
- 11:13- we're we're well above 50 to 60%,
- 11:17- of the total number of encounters. And and
- 11:19- I think that that's,
- 11:20- it it it's just more data to prove
- 11:23- that that the ambiance technology is being both
- 11:26- adopted
- 11:28- and utilized.
- 11:30- Yeah. Again, more more striking numbers there. I
- 11:33- wanna get to something. I do wanna get
- 11:35- to sort of,
- 11:36- perhaps, attention between clinical documentation and and and
- 11:40- revenue integrity. But first, I wanna get at
- 11:43- something at another barrier here that might be
- 11:46- the cause of why that number isn't,
- 11:48- and that that multi care success isn't seen
- 11:51- across other organizations
- 11:53- as well. Specialties are tough. Right?
- 11:56- When you're moving into different different specialties, that
- 11:59- could be a challenge. But ambiance, if I
- 12:00- if I'm reading this correctly, you and you
- 12:02- can correct me if I'm wrong,
- 12:03- 200 plus specialties into including complex areas like
- 12:07- oncology and psychiatry.
- 12:09- I wanna ask how important is that specialty
- 12:11- specific depth when health systems are really trying
- 12:13- to evaluate
- 12:14- ROI,
- 12:16- clinician adoption, and really driving that long term
- 12:18- enterprise value by having that clinician adoption at
- 12:21- at very high rates, well above that that
- 12:23- average 40%.
- 12:25- It's it's a nonnegotiable.
- 12:27- I mean, it it we we we started,
- 12:30- here at Ambiance,
- 12:31- creating specialty specific modules.
- 12:33- And the fact that we we treated each
- 12:36- specialty differently
- 12:37- is is one what won the hearts and
- 12:39- minds,
- 12:40- of of all of our physicians' APPs.
- 12:43- You know, I knew that I had a
- 12:44- winner when an oncologist, a cardiologist, and primary
- 12:48- care physician all came to me and asked
- 12:50- for Ambiance
- 12:52- by name. They said, this is what we
- 12:54- want.
- 12:55- And and it wasn't just that MultiCare,
- 12:57- asset specialist at the Cleveland Clinic, asset specialist
- 13:00- at the Mayo Clinic,
- 13:02- asset specialist at University of Pennsylvania.
- 13:05- This is why Ambiance is winning, and we're
- 13:08- gonna continue to focus on our ability to
- 13:10- provide specialty specific,
- 13:13- documentation.
- 13:15- Thank you so much, doctor Hahn. Can you
- 13:17- share a little bit to why it's so
- 13:19- difficult,
- 13:20- I guess, for for for solutions to work
- 13:21- in the specialty space and and what's any
- 13:24- more details you have about what makes Ambien
- 13:26- stand out in this regard?
- 13:27- Yeah. I mean, I I I I think
- 13:29- that the the biggest surprise that I had
- 13:32- when when I got here
- 13:34- was the number of physicians and nurses and
- 13:37- clinicians,
- 13:38- that I met who worked at Ambiance. And
- 13:40- and and and and the number of
- 13:43- of physicians and nurses,
- 13:45- we actually have
- 13:47- hands on keyboard coding the product. You know,
- 13:50- nowadays, it may be whispered a clod,
- 13:52- but I mean, literally, hands on keyboard creating
- 13:54- the product.
- 13:56- In fact, one in five of our employees,
- 13:59- have a clinical background.
- 14:01- And and so this product is is is
- 14:05- coded and built by clinicians
- 14:07- for clinicians.
- 14:09- And so I think that that that's really
- 14:11- the difference between
- 14:13- digitalhealth1.o,
- 14:16- versus where we're at now. And that this
- 14:18- is this is a tool that that is
- 14:20- being built by physicians,
- 14:22- for physicians,
- 14:23- by nurses,
- 14:24- for nurses who have a deep understanding of
- 14:27- the workflow.
- 14:28- Excellent.
- 14:29- Let's move now to talk about sort of
- 14:31- the revenue aspects here. You know, with Ambient
- 14:34- AI, it can certainly speed up clinical documentation,
- 14:36- make it easier, but cleaner notes don't necessarily
- 14:39- always translate into accurate,
- 14:41- coding and billing. Right? How should leaders think
- 14:44- about aligning documentation, quality, and revenue integrity
- 14:48- as they try to scale these tools? What
- 14:50- should they be thinking about?
- 14:51- I don't think that these are necessarily competing
- 14:54- priorities.
- 14:55- I I think that
- 14:56- documentation
- 14:57- quality
- 14:58- and revenue integrity
- 15:01- should go hand in hand. There there's an
- 15:03- old saying out there. Right? Don't follow money,
- 15:04- let money follow you. And and I'm a
- 15:07- big believer if you focus on quality,
- 15:10- the the value will follow. And and and
- 15:12- one of my one of my friends who's
- 15:13- the revenue cycle leader,
- 15:15- at at MultiCare,
- 15:17- she fiercely corrected me when I used the
- 15:19- term upcoding.
- 15:20- We don't upcode. It's it's accurate coding based
- 15:23- on appropriate documentation.
- 15:25- And the better your documentation is, the more
- 15:27- likely it is that you won't get a
- 15:28- downstream
- 15:29- denial. And so I think that that we
- 15:32- are
- 15:33- quite aligned with our revenue cycle friends
- 15:36- to make sure that we begin the work
- 15:38- upstream
- 15:39- to improve documentation quality and it will reduce
- 15:42- work on the, downstream,
- 15:45- in terms of
- 15:46- of denials and what have you.
- 15:49- Yeah. It's not just moving fast, it's moving
- 15:51- more accurately. Correctly?
- 15:53- That's correct. Yeah.
- 15:55- So I guess to close here, doctor Hahn,
- 15:57- when you're talking to clinicians or health system
- 16:00- leaders that express
- 16:02- skepticism about ambient AI,
- 16:04- what do you tell them?
- 16:06- How do you try to help them move
- 16:07- beyond skepticism? I mean, you can't possibly change
- 16:10- everyone's mind all the time, but
- 16:12- what are you telling them?
- 16:14- The other final question,
- 16:16- looking ahead, what will it take to build
- 16:18- sustainable programs here
- 16:21- industry wide? So two parter there for you.
- 16:23- What do you tell people who are skeptical?
- 16:25- And also when you think about big picture,
- 16:27- what's what's it gonna take to drive
- 16:29- truly, you know,
- 16:31- transformational
- 16:32- sustainable programs?
- 16:34- I think that the first thing that you
- 16:36- need to do when you approach anybody who
- 16:39- is skeptical
- 16:40- is is to really ask them, well, what
- 16:43- problem is it that they're trying to solve?
- 16:45- And help them to see that we we
- 16:48- may be aligned on the problem that you're
- 16:50- trying to solve, whether it is burnout, whether
- 16:53- it is productivity, whether it is position time
- 16:56- savings.
- 16:57- We may be aligned. So so ask them
- 16:59- what problem it is that you're trying to
- 17:01- solve.
- 17:02- I think that the second thing that that
- 17:04- you really need to to to bring forward
- 17:06- is the data.
- 17:07- Right? And and I think that I mentioned
- 17:08- the 60 to 16,
- 17:10- we reviewed the the Yale data in terms
- 17:12- of burnout.
- 17:13- And and and at one point, I I
- 17:15- think I've said that that if you're not
- 17:16- at least thinking about implementing an ambient clinical
- 17:18- documentation solution, you don't care about your providers.
- 17:21- That that might be a little spicy,
- 17:24- but, you know, there there is data from
- 17:25- multiple institutions now saying that even if you
- 17:28- don't see time savings, you still see subjective
- 17:31- improvements in burnout.
- 17:33- And and I think that we all can
- 17:34- agree that that that burnout is a significant
- 17:36- problem that is left to be solved in
- 17:38- healthcare.
- 17:39- In terms of sustainability,
- 17:41- I'm gonna go back to that sort of
- 17:43- people process technology framework.
- 17:46- You've gotta gain trust of the people. And
- 17:49- I think that the first way you do
- 17:50- this is by delivering the best possible product
- 17:53- to them that you can.
- 17:54- And you can't ignore
- 17:56- how it fits into process.
- 17:58- So again, technology
- 18:01- is the easy part, but focus on the
- 18:03- people, gain their trust,
- 18:05- don't ignore how it fits into the process,
- 18:08- and then deploy this technology in a thought
- 18:09- manner.
- 18:11- Yeah.
- 18:12- Some strong points, doctor Hahn, especially when you
- 18:14- consider,
- 18:15- if folks get burned by a technology,
- 18:18- even if, like, the solution improves and you
- 18:20- get better
- 18:21- a couple months down the road, they're less
- 18:22- likely to take a look at that, right,
- 18:24- because they've had a bad experience.
- 18:26- Yep. Absolutely. And I think that that's that
- 18:28- that's the hill that we're climbing right now
- 18:30- from the initial implementation or rollout of electronic
- 18:32- health records. Right. Is is that that that
- 18:35- that physicians and APPs and nurses are are
- 18:38- innately suspicious
- 18:39- of technology.
- 18:42- Right. Because when that that came out,
- 18:44- with the the promise sort of attached to
- 18:46- it that it was gonna change the the
- 18:48- clinician experience, I don't I I think it
- 18:50- did, but perhaps not in the way folks
- 18:52- wanted to see. Correct?
- 18:54- Yep. And I'm super optimistic
- 18:56- that this generation
- 18:58- of technology
- 18:59- that's been built again, you know, by clinicians,
- 19:02- for clinicians
- 19:03- is going to help and turn that narrative
- 19:05- around.
- 19:06- Well, doctor Hahn, we'll leave it there. Thank
- 19:08- you so much for coming on the podcast.
- 19:10- Thank you. It's been great. We also wanna
- 19:12- thank our podcast sponsor, Ambiance Healthcare.
- 19:14- You can tune into more podcasts from Becker's
- 19:17- Healthcare by visiting our podcast page at beckershospitalreview.com.