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Dr. Michael Curren, Cardiologist; Medical Director, Clinical Informatics, University of Pittsburgh Medical Center (UPMC) Moderator: Chrissy Farr, Second Opinion Media

Brainstorm Health 2024: AI In Action

Conferences

Well, hello. How are you? Good. Yeah, enjoying the post lunch aspect of this. Absolutely. Always my favorite session, post lunch session. Um Well, who is ready to see a demonstration of some very exciting technology? Chrissy for the day today. It's the first time you don't have to moderate, you could play the role of a patient. So most importantly, she's gonna be playing a role. None of this is going to be real medical history just for the rest. Don't worry about her. She may or may not have some interesting diagnoses that we discover. Um And we're gonna get right to it. So why don't we jump in? That's all right. So we're going to be demoing an application called a Bridge today. So, Chrissy, while we talk about your medical problems here in the office today, I'm going to use this technology. It's going to record our conversation so you and I can talk and then it's going to help me to do a better job of delivering care to you. Does that sound OK. Sounds good? All right. Well, give it a go, I'm going to start the recording and so Chrissy, what brings you to see me today. I hear you've been having some problems. So, um, since I arrived at the Fortune Brainstorm Health Conference, I've been feeling quite a bit of fatigue. Hm. Just since you arrived, just, just since I arrived. And have you had any other symptoms with that? Have you felt short of breath at all? I haven't been experiencing that, but I did wake up this morning with giant ankles, giant ankle. Oh, goodness. Could you put your shoes on, Betty. I had to squeeze them on. Oh, goodness. So your ankle swelled up, huh? And did you have any other symptoms? Did you feel like your heart was racing or your heart was skipping beats at all? Nothing like that. Nothing like that. Just swelling and you're sure no shortness of breath over the past week or two. Maybe going up a flight of stairs, feeling more short of breath with that prior to getting here. Maybe you will be chasing all the panelists around today. Certainly do it. I could certainly do it. Um, and, uh, have you ever had any symptoms like this previously? Um, nothing, no crazy swelling in my, in my feet previously? I think this is the first time. Well, anytime I hear that as a cardiologist, I always worry about it being a heart problem. And I'm looking through your records here. And do you remember a few years ago you actually did have a heart problem where something similar happened it was during the height of the pandemic, there was a lot of stress was going on, you know, being a journalist traveling all over the place all of a sudden, you couldn't do that and you developed something called a stress cardiomyopathy. You don't remember that, do you? I think I somehow blocked, we all tried to as much as we could at the pandemic. So this is concerning that, maybe this symptom has come, this condition has come back. And so I think we should take it seriously. So I'd like to do a couple of tests if that's ok with you. I'd like to order some blood work. I'm going to use the medical terms just to help me document something called a complete blood count. I'm going to get a BNP level going to get a basic metabolic profile. And then I want you to come in and get something called an echocardiogram as soon as you can, maybe this afternoon or tomorrow, that's an ultrasound of your heart. And while we do that, we're also going to order an EKG. Does that sound? OK? Sounds good. And then we'll review all of these test results and talk about what our next steps are going to be. But in the meantime, I noticed something back in the green room when we were coming out on stage here, if you walked in with two big bags of mcdonald's and you opted to skip lunch today. And I'm asking you about that because your blood work, your cholesterol was a little bit high. And that, yeah. You know, I'll tell you, I was surprised but, you know, I understand sometimes it gets all of us. So, you know, we're going to have to talk about that and I'd actually like you to talk to a nutritionist and really start to focus a little bit on maybe cutting out the mcdonald's and think about maybe doing something a little healthier like a vegan diet. How does that sound a vegan diet? It's a lovely diet. Yeah. So with that, we'll touch base again, as I said, with all these test results and then we will move forward. So I'm going to stop our recording now. Ok. And let's take a look at what we had. So how long does this usually take this pod? Yeah. So you're going to watch here on the screen, it will show you how long it takes and what's happening now that the beauty of this model is this is getting ready to prepare communication for a number of different people. Uh From my, my selfish standpoint, I'm going to use it to write my notes. It's going to write my note for me at the same time. It's generating a document for my patient for you that's going to be in more layman terms that you can review and have at your, at your disposal and you see it's already completed additionally, what we'll look at is some pulling from this unstructured data, some structured data elements and recommend some ICD 10 codes to me just based upon the conversation that we had. The last thing that it will do is it does support actually multiple different languages. So you actually heard that introduction a little bit of before we came out a little bit of French. And we do this, a bridge does support multiple languages. So if I have a conversation with a patient in creole, for example, that will translate for me into an English document and it supports multiple languages within a single conversation. So let's take a look at what we got here. So I'm just gonna focus on the desktop here and here's the output of my notes. So I'm going to make this a little bit bigger. So it's a little bit easier for us to see. I'm just going to slide this over. Give us a nice view. OK? So the first thing that I want to show you that, so the model is smart, but sometimes even it can't determine what an individual's pronouns are. And I know from your record that your pronouns are not day them, they are she her. And I can very quickly change that in the note, correct itself very quickly. It's very easy for me to do that without having to think much about it. But let's just look very quickly. Let's read a couple of lines of the history of present illness make that a little bit bigger as I look over at the screen there. So patient presents with fatigue and ankle swelling. It started at the arrival at the conference. You had no other symptoms, although you did note some increased exertion while chasing the panelists around here, we talk about your preference for fast food specifically at mcdonald's that, that, that picked that up as we talked about that. And I'd love to see, I mean, you know, you could forget about what we talked about. So how do you even know if this is even a, so this is really cool. So this is um you know, I forget what I talk to my patients about, believe it or not, you know, if you see 20 patients in a day and you get four patients behind or five patients behind, many doctors stack their documentation at the end and they say, what did I talk about when they first patient? How do I know that this is correct? So I can actually go in here and talk about in order to have high cholesterol levels. And it's going to take me to the recording and I'm going to, and I'm asking you about that because your blood work, your cholesterol was a little bit high and I was surprised but, you know, so I can go and validate the conversation that I had from the note that it was created. And so it confirms to me. Yes, that was discussed and the patient told you about that. So I can, I can prevent those hallucinations from happening just by, by, by confirming that within my note. And as I scroll down here, just to go through and talk about the assessment and plans. So I talked about stress cardiomyopathy, recurrence and the diagnostic testing that I'm going to order in a nice bulleted fashion. This is in a format that we call a soap note to anybody who's trained in medicine, understands what that format means. It's how we all create our documentation, make it very straightforward to follow. So it looks, I mean, it looks dead on. But what do you do at the next point where you need to figure out how to build this visit. So, um you know, as a provider, you know, we have to create codes because part of what we do gotta make money. So I'm going to show you from our conversation. So these are codes that came out related to the conversation that it's asking me if I want to include with the chart. It's not leading me at all. It's just saying, hey, based upon the conversation that I heard this is what you could possibly use and I can click through here and select those that I see and you can see for cardiomyopathy is a diagnosis that has a lot of codes with it and it gives me some very generic codes and it gives me more specific codes and I could use those as a way to, to document. So it's interesting, I didn't even say Takato syndrome. Actually, a stress induced cardiomyopathy is another term for Takato Syndrome. So it's fascinating that it can do that for me. Yeah, I mean, you know, just seeing this, it, it does give me some degree of confidence that you can basically kind of just sit here and, and communicate with me, which is what you want to be doing as a, as a physician. But what, what would you say is kind of the one downside if you had to say want to a system like this, the downside, it's, it's, it's learning a new workflow. That's the only, that's the biggest step. It does sit an epic. So it's within, it's an epic, it can work independently. It's really, there's different ways to utilize it for a provider who works in an electronic health record to have that within the health record. It definitely is an easier thing to do because I have to use the health record for everything else that I do. I'm just showing you very quickly the patient summary, right? And just the summary for you as a layperson as opposed to me in my clinical documentation. Wow. Well, thank you so much. This has been great. Thank you. And I'm glad I'm not dying. Yeah, you're going to be ok. Just cut off. Thank you.

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