Becker's Hospital Review

44 Health Information Technology Dignity Health's Google Glass Success By Helen Gregg "Historically, a lot of the technology we've asked physicians to adopt seems to have created inef- ficiencies along with the benefits," says Davin Lundquist, MD, CMIO of Dignity Health in San Francisco. That hasn't been the case with Google Glass and an integrated app from startup Augmedix. "I don't think you could pry it off the doctors who are using it," he says. Since mid-January, the combination has allowed three Glass-wearing Dignity physicians to have a more natural conversation with their patients. The technology records the interaction and uses a combination of automated and human-assisted transcription on the Augmedix end to send pa- tient histories, vitals and other information di- rectly to a patient's electronic medical record. Dignity Health had been working with Augmedix for months before the technology was introduced in the clinic setting, says Dr. Lundquist, to ensure privacy and security standards were met, and to help the physicians feel comfortable integrating Google Glass into their workflow. After a couple weeks of dry runs, three physicians — Dr. Lun- dquist, an internal medicine specialist and one of the group's most popular family medicine physi- cians — began using Google Glass and Augmedix for every patient encounter. "I still carry my iPad or laptop with the EMR info [into patient encounters], but now I don't have to interact with those tools because I'm confident that as I have a conversation with the patient about what their symptoms are and [as] we discuss a treatment plan, everything that's happening is going into the progress note," says Dr. Lundquist. The physicians review all the Augmedix EMR en- tries at the end of the day for accuracy, but Dr. Lun- dquist says any changes that need to be made are often very minor. This workflow change — from entering notes into the EMR to just checking them — has been a significant time-saver. The physicians were spending 10 to 11 hours a day at the clinic between patient visits, documentation and other related tasks; now they're spending eight or nine. "For me personally, at the end of a clinic day when I see 15 to 20 patients, it was taking me two to three hours to finish charting all those visits," says Dr. Lundquist. "Now, it takes me 10 to 15 minutes." Additionally, the percentage of the day these phy- sicians spent with their patients increased from 35 percent to 70 percent and the percent of their day spent on documentation dropped from 33 per- cent to 9 percent. As a result, the new technology has dramatically improved the physicians' work-life balance. Not wanting to cut down on time spent with patients at the clinic, the physicians would take their work home and continue completing charts well into the evening. With Google Glass and Aug- medix, "we feel like we've gotten our lives back," says Dr. Lundquist. He says patients have appreciated the change as well. While he expected at least some patients to be uncomfortable being recorded through Google Glass, he says a large percentage of patients don't even notice he's wearing the high-tech glasses. "When patients come in, they're concerned, they're not feeling well," he says. "Mostly, they're just grate- ful I'm there, meeting their eyes and listening." Those that do recognize the technology are often impressed. Dr. Lundquist says these patients often equate advanced technology with advanced clini- cal knowledge and expertise, and often end up trusting him more. Throughout the four-month trial, less than 1 percent of the patients asked their physicians to remove Google Glass, he says. Dr. Lundquist and his team are currently in dis- cussions to expand use of the technology to more Dignity clinics. If trials continue to go well, he ex- pects Google Glass and Augmedix to be adopted more widely throughout the Dignity system. The limiting factor in the expansion will be cost. Dignity Health, like all other healthcare providers across the country, needs to be cognizant of the utility of every additional line in the budget. Dr. Lundquist plans to begin a more focused explora- tion into the return on investment of the technol- ogy, comparing costs with time savings, addition- al patients seen and other benefits. Preliminary analyses suggest it will be at least comparable to other time-saving strategies, he says. "Of course, if you asked doctors if getting two hours of their day back was worth the cost, they'd obviously say 'yes,'" he says. Dr. Lundquist is thankful, however, that the de- cision to expand may not come down solely to money. "I've been with Dignity Health for a couple of years now, and one of the things that has impressed me is how they make the patient the priority," he says. He sees this application of Google Glass as aligned with Dignity Health's goal of fostering kindness. "Ironically, being technol- ogy, it's really harnessing the human side of medi- cine," he says. n 10 States With Highest, Lowest EHR Adoption By Akanksha Jayanthi M ore and more hospitals and health systems are slowly going live on electronic health records, though implementation is uneven across the country. Here are the states with the highest and lowest EHR adoption rate, according to an infographic produced by the University of California, Berkeley School of Information. The five states with the highest EHR adoption rates: 1. Utah: 71.6 percent 2. South Dakota: 71.2 percent 3. Wyoming: 71.0 percent 4. Iowa: 70.8 percent 5. North Dakota: 69.2 percent The five states with the lowest EHR adoption rates: 1. Rhode Island: 52.1 percent 2. New Jersey: 53.1 percent 3. District of Columbia: 53.6 percent 4. Louisiana: 54.1 percent 5. New York: 54.6 percent n

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