Augmedix in the ED: Overcoming Documentation Burdens in High Volume, Fast Paced Settings
“The Augmedix platform is extremely valuable, especially in the emergency department. It supports the important work of keeping patients moving and capturing key details from the natural patient conversation that would otherwise be impossible for clinicians during busy shifts. The fact that Augmedix is virtual ensures additional team members are not getting in the way of the care team. Furthermore, Augmedix loads my procedures in advance and customizes the note, which saves me time."
Dr. Jeffery Davies
Dr. Jeffery Davies is a double boarded physician in emergency and family medicine in Southern California. Davies currently serves as director of emergency medicine at St. John’s Regional Medical Center in Oxnard and St. John’s Camarillo, both a part of Dignity Health. Davies also serves as an emergency physician consultant at Common Spirit, an organization focused on community health and parent company of Dignity Health.
The challenge in any emergency department (ED) is the speed at which physicians have to make decisions, chart the encounter, and then move to the next patient. According to Davies, it can be chaotic. “Our workflow is not spaced out to three or four patients an hour,” he says. “We see 15 patients an hour, then have a lull, then maybe two or three the next hour.” The volume and bouncing so quickly between patients makes capturing accurate, complete information in the electronic medical record (EMR) during the encounter challenging.
Although Davies had access to charting tools in his hospital’s health information systems, those tools used automated templates. Davies says it’s important to have more flexible and customizable options in the ED, like customized Health and Biomedical Information, because those encounters don’t follow a standard clinical flow. Davies needed a solution that helped with documenting patient encounters in a way that aligned with the unpredictable and often chaotic workflows of the ED.
Davies chose to partner with Augmedix for its virtual medical documentation solution. Davies heard about Augmedix from Dr. Davin Lundquist, a personal friend and family practitioner also working for Dignity Health. Lundquist serves as chief medical officer at Augmedix.
Augmedix virtual medical documentation specialists (MDS) are specially trained to work within an ED environment. They act as always-present assistants to the physician, converting real-time physician-patient encounters into precise medical documentation. They can also manage admissions, place orders for labs, medications, and imaging, and manage transitions of care.
Using the non-intrusive hands-free Google Glass technology, physicians can give their full attention to the patient in a way that is natural and more personable.
Davies appreciates that his Augmedix virtual MDS was on board and up to speed in just four shifts, saying, “He’s hands down the best.” Davies says it’s great to have someone always available to assist when needed but whose presence is not intrusive, which is essential in an ED environment. Davies says his MDS understands the nature of ED encounters and will often proactively tell Davies that he’s going to “go off camera,” even before Davies remembers to ask.
Davies also appreciates that his MDS prompts him for things throughout the workflow, reminding him when something is missing, like labs that need to be ordered or imaging documentation that needs to be added. The MDS can then do those things on Davies’s behalf because the MDS is specially trained in ED workflows. The MDS understands critical care protocols and can alert for things like whether the patient meets the protocol for intravenous (IV) hydration. “Because of the sometimes frantic pace of the ED, it can be easy to miss things,” says Davies.
Another important aspect of using Augmedix concerns work-life balance. “If your physicians are staying late to chart and they’re not getting it done on time, that’s an unpaid cost to the hospital,” says Davies. He believes hospitals often overlook that impact as part of their overall return on investment. ED physicians are highly susceptible to burnout, and the burden of documentation only adds to that stress.
Yet another benefit of using Augmedix, according to Davies, is protecting revenue, especially in cases where physicians are contracted and might not be as thorough with coding. Davies says a lot of hospitals fail to charge for things like ultrasounds or IV hydration. Davies says Augmedix helps mitigate this risk, helping to ensure more timely, accurate reimbursement.