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Augmedix Uses AI and Remote Scribes to Improve Clinician Documentation: Interview with Founder Ian Shakil

March 11th, 2020 Cici Zhou Exclusive, Informatics

The advent of electronic health records (EHRs) has allowed clinicians to document patient visits in a way that permits more accuracy, shareability, and other critical capabilities. However, EHR documentation is time-consuming, contributes to clinician burnout, and impacts the quality of patient-clinician interactions. One solution is the usage of in-room medical scribes (quite literally a third physical presence in the room) who take notes while the clinician visits with the patient. Augmedix, a company with offices in San Francisco and Bangladesh, uses technology to take scribing one step further.

Augmedix users are outfitted with either a smartphone or Google Glass device which then transmits the patient-clinician interaction securely to technology-augmented remote medical scribes, who then complete documentation in real-time. With the platform, the company touts that clinicians can save 2-3 hours of documentation time per day.

Augmedix was founded in 2012. Since then, it has raised about $100 million in venture funding and now consists of a team of over 1,000 employees. The company’s customers include 15 health systems, which together employ 10% of clinicians in the United States.

Medgadget asked Ian Shakil, Founding Chairman and Chief Strategy Officer, a few questions to learn more about Augmedix.

Cici Zhou, Medgadget: Tell me about the founding of Augmedix. What was the inspiration behind making medical documentation more efficient?

Ian Shakil, Augmedix: Augmedix was founded with a mission to rehumanize the clinician-patient interaction and allow clinicians to focus on what matters most: patient care.

At the time of founding, there was a confluence of factors that made us feel that the time was now. Most importantly, at the time, the HITECH Act was spurring clinicians to adopt Electronic Health Records (EHRs), but mass-scale EHR adoption was also creating a provider burnout epidemic.

We felt that we could dramatically reverse burnout trends and allow clinicians to rekindle their love for the practice of medicine. In terms of creating market value, we also felt that we could reduce clinician churn and “partial quitting,” while also improving clinician productivity (which was taking a bit hit due to EHR adoption).

At the same time, we were further emboldened to start Augmedix because emerging healthcare-enterprise-grade cloud tools were slowly being embraced by conservative healthcare CIOs (vs. hard-to-scale on-premise solutions). In addition, smartphone, smartglass, and internet-of-things devices were finally becoming enterprise viable. And lastly, reliable global bandwidth and reliable wi-fi connectivity in ambulatory settings were becoming commonplace.

Medgadget: What makes Augmedix stand out compared to traditional scribing services? Does it take some time for clinicians and patients to adapt to the smartphone or Google Glass setup?

Shakil: For one, our service is truly ambient and conversational. We do not require the clinician to dictate word-for-word, press buttons, or speak wake words. Quite the opposite. We create timely, accurate, structured EHR notes from organic clinician-patient conversation. This is made possible because we do not rely on software or AI, alone, but we rationally incorporate human-assistants-in-the-loop (operating from ultra-secure locations).

The second and related key differentiator is that our platform works live, in real-time. This allows for rapid note completion and also enables numerous two-way interactive features, which our customers find to be very valuable. These features include Order Support, Reminder/HCC Support, Referral Support, and various other helpful capabilities. Our ability to offer this suite of customizable interactive services, above and beyond the core documentation, is critical in ensuring we can drive enterprise-scale adoption to meet health system strategic goals, which vary widely from system to system.

Medgadget: What are some of the biggest challenges facing the team? Looking to the next five years, what are the biggest goals for Augmedix?

Shakil: We feel that we’ve passed the pivotal point of finding product-market fit. Looking ahead, we are mostly focused on classical scaling challenges, as we get deeper penetration inside our health system customers and as we add in new customers and as the healthcare landscape continues to change.

On the technology side, we are investing heavily in pioneering automation within our scribe cockpits. Our goal is to continue to improve our NLP Notebuilder module and Automatic Speech Recognition modules to increasingly convert our scribes from content creators into content editors. This has a variety of quality and scalability benefits to our customers. But for the foreseeable years, we will certainly require humans-in-the-loop if we are to offer a service that’s truly ambient and conversational.

Looking out five years, we expect to be an iconic innovative indispensable service, spanning healthcare at a mass scale. Expect also to see our service including increasing amounts of platform interactive services such as Order Support, Reminder/HCC Support, Referral Support, with increasing levels of automation.

Link: Augmedix homepage…

Cici Zhou

Cici Zhou is currently a resident physician at Kaiser Permanente. In the past, she has done management consulting for medical startups and worked as a researcher at UC San Francisco. As a physician, she's excited by the intersection of medicine + technology because of its ability to completely transform the industry and touch millions of lives.

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