Julie Demaree, executive director of clinical innovation and transformation at St. Mary’s Hospital in upstate New York, recently spoke with Innovation in health care on the implementation of Suki’s Artificial Intelligence Assistant integrated with the hospital’s Meditech EHR.
Many of our interviews about implementing AI ambient assistants are with CIOs at academic medical centers and larger health systems. But small community hospitals are also working with these new digital tools, even if they have fewer supporting resources.
“I came from another health system where I felt like I had lost the ability to make changes because I couldn’t be agile anymore,” Demaree said. “And the truth is, I have the ability to make decisions and make changes here. I appreciate the opportunity to highlight a small hospital that does great things with fewer resources.”
St. Mary’s physicians have had to deal with many issues in recent years, he explained. In addition to dealing with the pandemic, in 2020, St. Mary’s left the much larger Ascension Health System and became independent, which meant that many support systems, including information technology, became local again. In February 2022, the organization switched electronic medical records from Meditech Magic to Meditech Expanse, and physician offices moved from a separate electronic medical record to Meditech.
St. Mary’s Healthcare is a 130-bed rural hospital northeast of Albany, New York, with about 80 physicians on staff. Demaree joined the organization last year to help streamline Meditech’s EHR, including leveraging technology and innovation to reduce physician documentation burdens and decrease burnout.
Healthcare Innovation: Do you have any physician partners that you are working with on this EHR optimization work?
Demaree: No, I am a personal assistant [physicians assistant]My role is to work with all of our healthcare providers to optimize the system using their feedback. Our CIO and his team manage the hardware, security, and infrastructure, while the clinical integration team supports the clinical build of the EMR.
HCI: So when it comes to piloting a voice AI assistant, who is involved in making that decision?
Demaree: When I arrived last July, we started evaluating different providers and bringing them to the physicians to see and evaluate. Since then, we have also created a physician steering committee.
HCI: When your CEO decided to work on this, was there an obvious problem the organization wanted to address: physicians were spending too much time on documentation?
Demaree: Like any small town, we are trying to recruit doctors, many of whom are nearing retirement and we want to keep them as long as possible. How can we attract new doctors and encourage experienced doctors to stay in practice? My CEO and I had previously worked together at a health system that had implemented environmental listening, so he knew the impact the technology could have and I was able to use that experience to make decisions this time around.
HCI: Were there specific things you were looking for?
Demaree: I first saw Suki last September at a Meditech conference. There were a few things that were important to me. I wanted doctors to check it out and see what they liked and what worked. Customer service is very important to me. I didn’t want to have to do all the project management. I needed it to be a seamless integration and I wanted doctors to have good support after go-live.
HCI: Did the work Suki had done on the Meditech integration influence the decision?
Demaree: At the time, Suki was the only AI vendor that had an integration with Meditech. As a customer, it’s important to have two vendors to maintain a relationship with. This made things much easier when it came time to activate the API that Suki and Meditech were working on together. Having the vendors work together makes a huge difference rather than me being the middle child trying to get the parents to talk.
HCI: Did you find things in the pilot that you needed to adjust to suit your needs?
Demaree: Network connectivity at some of our sites was insufficient for high-quality data transmission, so we took corrective action at some sites. Our users quickly became dependent on the Suki assistant, and if they rely on Suki to record the patient encounter and do not take any notes, they are very disappointed when it does not work.
HCI: Do you have any recommendations for other people in small community hospitals who are just starting this process?
Demaree: I think a demo for physicians is very important. I think it’s important to understand the data that’s going to be obtained and the customer service that’s going to be obtained. And the EHR integration is important: what advantages does that integration offer to you versus the vendor. That influences the cost. This was a very straightforward implementation. It’s very affordable for us. It’s easy to scale, and it’s been a very good experience. Of all the things we can afford to invest in, this is one that’s paying off on multiple fronts: patient satisfaction, physician satisfaction, and quality.
HCI: Do you plan to track ROI?
Demaree: Yes. Our key performance indicators have been the time it takes them to complete their paperwork and the paperwork on time. I can also track the time they spend out of their office working on charts. It would be a huge benefit if their charges or RVUs continue to increase, which is what we’ve seen initially post-Suki. I attribute this to AI documentation capturing their medical decision making better than previous documentation methods. Just physician and patient satisfaction is really important. If that’s a way to attract new physicians and keep physicians here, I think that’s a huge win.
