Chief medical officer discusses how AI is helping health professionals, patients at Rochester Regional Health; the system’s expansion into Geneva; and the lessons learned from the pandemic
By Chris Motola
Q: As the chief medical officer for Rochester Regional Health, what are some interesting things going on in the system? I understand you’re using AI Ambient Scribe for patient visits.
A: Yes, we are. It’s a sort of a listening transcription tool that is turned on when a doctor meets the patient and then it summarizes the entire visit with the patient, organizes a note according to medical documentation standards. And so it saves the doctor a huge amount of time in documentation and then it also frees up the doctor from being distracted from documentation while they’re face-to-face with the patient. So it improves face-to-face interaction as well as reduces documentation burden after the visit.
Q: How is the accuracy overall?
A: Oh, it has come so far. So I have the unique perspective that the practice I’m in, 20 years ago bought a Dragon voice recognition software product. It was one of the very first versions available. It was just gobbledygook. Most of what it printed wasn’t even words or it was jumbling words. It was completely useless and we stopped using it. This is a total game changer. The accuracy is incredible. We’ve tested the accuracy internally with providers, but it’s also taking hold very quickly across the country, and now there are probably tens of thousands or hundreds of thousands of medical records daily now being transcribed through this tool. And it’s incredibly accurate. Every doctor that has used it in our health system has commented on how amazed they are at the accuracy of the notes.
Q: Does it input information into medical records too or is it just pure transcription?
A: Right now, it’s just a transcription tool, but it’s not far distant where a tool like this might even begin recommending follow-up lab tests or follow-up medication changes or something of that. So right now, let’s say I’m seeing you for high blood pressure and your blood pressure is not adequately controlled, and we’re talking about the challenge of controlling your blood pressure. It’s recording that for notes now. In the future, it will probably say, “You know, Chris is on XYZ blood pressure medicine and is at a low dose. Why don’t you consider increasing the dose?” So that’s not the case now, but it’s conceivable that that would be the case in the very near future.
Q: How about the virtual nursing services? How does that work in a hospital setting?
A: Oh, that’s an awesome tool as well. The way it works is that it’s a nursing unit-based process. So let’s say the 2600 unit at Unity is a large unit. It’s about 38 or 40 beds. Every day, one of the nurses from that unit is assigned to be the telehealth nurse or the virtual nurse. The way it works is that, when a patient is admitted, the virtual nurse will appear on the TV screen in that patient’s room. They’re introduced to the patient. Virtual nursing never occurs without the patient knowing. The patient always knows that it’s virtual when the virtual nurse is present in the dialogue. So the virtual nurse will be documenting what he or she is observing the bedside nurse doing. So it streamlines the work of the bedside nurse. So when the bedside nurse is doing the screening questions it’s the virtual nurse who’s doing the documentation. Now this sounds a lot like a human form of the Ambient Digital Scribe and it probably is true the Ambient Digital Scribe will move into nursing realms fairly soon. But right now a lot of this documentation is in templated form, which the digital scribe can’t do yet. But at any rate, the virtual nurse will help with documentation. The virtual nurse will answer call bells when the bedside nurse is tied up. Now, as I mentioned, these virtual nurses are from every unit that they support. So today John might be the virtual nurse and tomorrow John could be that patient’s bedside nurse. So the patient actually sees the same nurse in both roles. It makes the virtual interaction more engaging than if they were to never meet in person.
Q: You’ve also got the new medical campus in Geneva.
A: Oh yeah that is an amazing campus. I don’t have the stats handy, but I think it’s about 80,000 square feet. It’s a huge one-story building. It’s our most comprehensive destination camp to date. When all the specialties have moved in, there will be almost 20 specialties there. There’s a lab draw service, there’s radiology service, there are other testing and procedure rooms there. It is a very advanced clinical environment there. So we’re really excited about it. Its ribbon cutting was a little more than a month ago. And clinical services have been moving in week by week ever since.
Q: You were CMO during the pandemic. What sort of lessons did you take away from it? Did it reveal any strengths or weaknesses in the system?
A: There’s certainly a lot to reflect on that. There are crises all the time, they just aren’t at that scope and scale. I would say that one of the really strong take-home things was the power of collaboration across the community and across the region. It was amazing to work with U of R, with the Monroe County Department of Health, with New York State Department of Health, with governmental leaders, county leaders and people all over the state for a common good. As for weaknesses? In a government regulatory and organizational bureaucracy there’s usually a lot of inertia for change, but that melted away in the crisis. The governor was issuing executive orders right and left making it possible to manage the pandemic. The organization was incredibly nimble and adaptive. As the pandemic wore on, consistent communication became an issue. Messages about COVID, messages about the vaccine, messages about our response to it fragmented greatly.
Q: Are you still practicing clinically?
A: I have a small clinical practice. It’s focused on chronic kidney disease and dialysis, and my wonderful partners take all my on-call and take care of my patients when I’m not there. So it’s not what I would call ideal, because I would love to be more involved clinically but it’s just not possible with my leadership responsibilities.
Lifelines
Name: Robert R. Mayo, M.D.
Position: Chief medical officer of Rochester Regional Health System, where he leads the design, integration and implementation of multiple leadership teams, clinical departments and patient safety and regulatory functions. Previously, he served as CMO at Rochester General Hospital.
Hometown: Windsor, Ontario
Affiliations: Rochester Regional Health System
Credentials: Nephrology, American Board of Internal Medicine, 1996; medical degree from University of Michigan Medical School, Ann Arbor, 1990; bachelor’s degree from Brigham Young University, Provo, Utah
Organizations: American College of Physicians, American Medical Association, Monroe County Medical Society, New York State Medical Society
Family: Wife (Karin), three children
Hobbies: Church of Jesus Christ of Latter-day Saints church-related services; cooking; entertaining