Clinician well-being is a priority at UMHW — one that all their leaders are deeply committed to — which enabled widespread buy-in of the solution. Leaders understood that DAX would eliminate what UMHW considers to be the hardest 90% of a clinician’s job — documentation. Reducing that burden alone would decrease burnout, improve clinician morale, and promote the organization’s commitment to their clinicians.

This mindset drove clinician adoption because they recognized DAX as a solution meant to work for them. UMHW leaders were very clear that DAX’s primary purpose was not to force clinicians to increase the number of patients they should see or take on more work. Instead, leaders believed that improved well-being would benefit clinicians and naturally result in increased productivity and financial returns for the organization.

Clinicians were excited about a solution that would relieve their documentation and cognitive burden, help them get home on time, and prioritize personal interests outside of work. Many UMHW clinicians recognized the potential for DAX to improve their quality of life right away.

UMHW identified a group of initial users, comprised of primary care clinicians, to try DAX before scaling the solution across their entire primary care program. UMHW found that these clinicians were well suited to DAX for two reasons:

• Primary care has seen an increase in complex, less “templated” visits. 
• UMHW’s primary care clinicians demonstrated an openness to technology.

Primary care has seen an increase in complex, less “templated” visits.

Primary care clinicians at UMHW see many patients with complex illnesses, and whose health information can’t easily be documented in standard note templates in the EHR. UMHW’s clinicians have always treated patients with multiple issues, but it’s becoming even more common to see these patient types. For example, patients increasingly come to their annual visits with a list of many unrelated issues to discuss. Standard note templates aren’t designed to gather information for matters outside of the standard annual visit, so clinicians must take the time to manually fit this information into the note. The typical visit isn’t long enough to capture the added complexity, so clinicians must finish notes between visits or at the end of the day. This requires them to remember each patient’s specific details for hours and increases the risk that clinicians will forget key information by the time they’re able to complete a note.

UMHW found that their primary care clinicians were eager to use DAX for patients with complex needs. DAX securely records conversations in real time, which eliminates the potential to forget or miss key details. The solution also eliminates the need to use a template because it creates a structured note on its own. Even clinicians who were initially hesitant gave DAX a chance because they saw how it alleviated documentation burden.

UMHW’s primary care clinicians demonstrated an openness to technology

UMHW has worked hard to promote innovation among its staff, and their primary care clinicians embody that philosophy. They use a top-down approach with clinician leaders who model how to be comfortable embracing change and approaching new technology. The result is that many of UMHW’s primary care clinicians were willing to start using DAX because they self-identify as “technologists” and “early adopters.”

Primary care is often overlooked and underinvested in when it comes to new technology for a variety of financial and logistical reasons. Knowing this specialty hasn’t always been at the forefront of new investments, UMHW was intentional about offering DAX to their primary care clinicians first to include them in their culture of innovation. They found that these clinicians were genuinely excited and appreciative of the opportunity to test a new way of documenting care.

After initial success, UMHW expanded DAX across their entire primary care service line. Due to the overwhelming success, UMHW decided to expand the program to all ambulatory specialties.

UMHW found that DAX was relatively quick and easy to implement. The onboarding process was simply a one-hour training for all users. UMHW leaders said that the hardest part of onboarding was finding a free hour in clinicians’ busy schedules to do the training.

UMHW acknowledged that there’s a period of adjustment as clinicians go through the learning curve and adapt to changes in their routine. Even among innovative organizations, change is hard, and that’s especially true for clinicians who are often set in their ways.

To help with adoption, UMHW enlisted provider champions, such as Dr. Lance Owens, CMIO of UMHW, to frequently check in with clinicians and aid them through the adoption process.

Sharing key performance indicators (KPIs) was also key to adoption. Instead of forcing clinicians to use DAX, UMHW shared KPIs from their initial DAX cohort, which included information on documentation time saved, to help them see how they could achieve the same results with consistent use.

Clinicians realized three improvements when they started using DAX consistently:

• DAX freed up clinicians’ time and decreased cognitive load. 
• Patient care improved and billing was more complete due to the increased detail and structure of the notes. 
• The use of DAX strengthened patient relationships by allowing more focus on the patient and no distractions with note taking. 

DAX freed up clinicians’ time and decreased cognitive load

Clinicians found that DAX drastically improved workflows and their cognitive burden by automating clinical documentation.

Clinicians don’t have to manually type notes or stress about documenting after hours when they use DAX. They also don’t have to struggle to remember details from the visit since they could refer to the transcript. As a result, clinicians were able to give patients their full attention during a visit and focus on other clinical tasks, like coordinating with members of their care teams between visits.

Patient care improved and billing was more complete due to the increased detail and structure of the notes

Clinicians found that the notes generated by DAX were more comprehensive and at times phrased differently than the notes they would manually create. In the beginning, clinicians spent time reviewing their notes to check the information and adjust the note to their own preferences. The review process became faster the more clinicians used DAX.

Clinicians came to appreciate the level of detail in the DAX-generated notes, recognizing DAX included information that clinicians either didn’t have time to capture, or would have left out if they were manually typing notes. This leads to better patient care since clinicians have a more accurate record of what occurred during a visit. They can double-check that every lab they said they would order was submitted, or that they didn’t miss anything when explaining treatment plans to patients. Patients can also look at notes to review anything discussed during a visit, such as care instructions or procedural information. This results in retaining patients who feel their clinician was focused on them and creates loyalty with the health system.

Higher quality notes also enable more accurate billing and improve RVUs. Having a detailed record of everything that occurred during a visit allows clinicians to ensure that the documentation accurately reflects the services rendered.

DAX strengthened patient relationships

Overall, clinicians said that DAX strengthened their relationships with patients. In rare cases, there were patients who had questions about being recorded. In those instances, clinicians would take a few additional minutes at the beginning of the visit to explain how DAX worked and answer any questions.

Clinicians found that patients appreciated having face-to-face conversations, instead of watching clinicians type notes on a computer the entire visit, which strengthened their relationship. Many patients commented on this change directly to their clinicians, saying that they seemed more present, and the interactions were more personal. Patients were also impressed by the “high-tech” nature of the solution, which had a halo effect on their entire care experience.