The software, part of Microsoft’s nearly $19 billion bet on Nuance Communications and the future of artificial intelligence in healthcare, promises to generate notes in seconds but accuracy and liability may make some doctors hesitate.
ost doctors will tell you they chose their profession because they want to help people. But aggravatingly, many doctors spend hours of their days behind screens rather than with patients, entering copious details into medical records that often require them to work late into the night. Between government regulations and insurance requirements, filling out these details isn’t optional—but it puts a heavy emotional toll on top of an already stressful profession.
“In 20 years? Yeah, I think the vast majority of doctors are going to be doing all of their documentation using this kind of software. In five years? No.”So far there has been a human quality reviewer checking the AI’s work before it's sent to the doctor for a final review. But this summer Microsoft and Nuance will start rolling out a version that is fully automated and incorporates GPT-4 thanks to Microsoft’s partnership with OpenAI.
The possibility of a long adoption curve doesn’t necessarily mean DAX will be a dud for Microsoft. For one thing, it has a trust advantage over both existing and future competitors: around 550,000 doctors already use Nuance’s medical dictation software. And this push towards full automation is an incremental but important step in Microsoft’s broader ambitions to develop and sell new products into that existing foothold of around half of all doctors in the U.S.
“There's always potential for error with an AI system, these things are never going to be 100% accurate,” says Harper. “We're saving you time, however, the clinician is still ultimately responsible for reviewing the note.” Another concern is about the diversity of patient populations that doctors see every day and how these models will perform across different accents or non-native English speakers. Harper says Nuance’s models have been trained on 8 million patient visits throughout the United States. The software is currently built for “U.S. English,” but Nuance is planning to expand into mixed language encounters, such as Spanish and English.
For the time being, Microsoft and Nuance are planning to continue offering both versions to customers: human-reviewed and fully automated. But the next step will be figuring out how to make the automated version more personalized. Harper says this starts with developing different stylistic templates that doctors can choose from, for example, a “verbose versus succinct option,” when it comes to the length and amount of information included in the note.
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