My Personal Assistant Dream Coming True

Is my dream of having a personal assistant finally about to come true? Will this come in the form of an artificial intelligence (AI)? What if this were a small family of AIs each with their own unique tasks? It would not exactly be at the level of Downtown Abbey, as the concerns of the AIs would have their focus on patients and the tasks of healthcare delivery as opposed to running a household. My decades-long dream is now coming true with a number of new AI features in our electronic medical record software.

With eClinicalWorks CEO Girish Navani and VP Sameer Bhat at the eCW National Conference 2025

Having been an early adapter of health information technology, having implemented eClinicalWorks as our electronic medical record and practice management software all the way back in 2006 when the practice started, I was a surprising holdout with AI. In the early years of health IT adoption, I went through many moons of after-hours projects customizing, tackling wireless network and software system crashes, and mapping our EHR for data capture. With the advent of AI, I was concerned about privacy with features like ambient listening. My early experience of Gemini as a search engine made me quite concerned about hallucinations. It had opposite modifiers like "hypo-" and "hyper-" completely mixed up. I found that data aggregators would produce massive quantities of information and present it in a format that was hard to digest. Then there were concerns about allowing AI to write on my behalf. Would this cause my writing skills to atrophy (writing is a very precious hobby to me)? Would this affect my cognitive engagement or clinical reasoning? 

Well, it is the dawn of a new era! After attending the eClinicalWorks National Conference in Orlando this weekend, I have become convinced that it is time to move forward with a family of personal AI assistants. Sunoh, the ambient listening AI developed by eClinicalWorks, will allow me to focus on my patients during office visits. It will take notes and summarize the visit, update medication lists and put in orders. It will save me from typing and will allow me to review the recorded conversation to help ensure that concerns were addressed. I am confident that it will improve the quality of the visit for patients and documentation. I now have greater confidence in this tool, having learned about how eCW has been refining it. 

EclinicalWorks also has partnered with Microsoft. Microsoft has been admirably thoughtful in creating AI principles as follows: accountability, transparency, fairness, reliability and safety, privacy and security, and inclusiveness. Because of these underlying principles which align with our own ethics at our practice, I feel we can be confident in using Sunoh for ambient listening. Dr. Nayak adopted this tool from eCW over the summer, and I am starting to use it now. The promise for physicians is that this will free up time and attention for what is most important. Patients have the right to opt out of ambient listening, but we think that our patients will not wish to do so. 

We are also implementing an administrative AI tool, which I will be naming Solomon. Solomon will help our team in various functions such as lab ordering, managing incoming documents, routing messages, and scheduling. Solomon is an expert in eClinicalWorks and can help train new staff members and physicians so that their work is supported. I choose Solomon, because King Solomon was described in the Bible as "the wisest man who ever lived". May my assistant, Solomon, live up to his name!

Hopefully next year we will be able to implement eCW's Genie feature to help answer incoming calls 24x7, providing helpful answers to questions and being able to manage appointments and route messages to the right staff members when necessary. We will call this AI assistant Sophie. While we realize that most phone chain systems are annoying and do not work well, if we set up Sophie well, it will be far better than typical phone services and free up our staff for service. This AI has appropriate limitations and will only talk with our existing patients. Other callers will be routed appropriately. We will not activate Sophie until we are certain she is up-and-running, accurate and ready to be most helpful. 

For years, our patients have wondered why health information doesn't work more like the banking system where information is available not only around the country but also around the world. Our staff have spent countless hours calling for test results and consult notes, and often the information has not been available at the time of the visit. I would like to introduce Prizma. Prizma is a tool which pulls in health information not only from Maryland but from a network across the country. This network has taken well over a decade to build upon the Carequality platform. Now, instead of having to go to a separate platform using an interface, Prizma presents data directly within our EHR. 

We have been using Prizma for some time, but have leaned more on our statewide health information tool (HIE) through CRISP because the information was more organized. Now there is an AI within Prizma which will provide a summary of health data. Often medical records are massive and cumbersome to sort through. Prizma will do this work on our behalf, saving hours of time. This enhancement will help me tackle, for example, that 34 page discharge summary for an overnight visit for chest pain. We are seeing huge notes coming out of EHR systems like Epic, making it difficult to find the key information quickly. Now, if Prizma will distill the key findings, I will have better focus upon what is most important for patient care. This feature could potentially keep me from producing super-long clinical notes as well!

Back to Gemini, that search AI tool has become much better this year. Articles are referenced alongside the summary of information. Medical doctors are trained to find and understand technical articles. Gemini speeds up this process. Also enter Open Evidence: a search engine for health professionals partnered with Harvard and Mayo Clinic. This search tool only pulls data from published and reliable medical articles. 

At times like this, covering for my associate who has been out with an illness, there is the need for speed but also the need for relief, for help, for accuracy and  for accurate information. I am so thankful that all the way back in 2006 we chose eClinicalWorks to be our EHR/PM software partner. Though we have been through various toils and snares together, we have also had the joy of innovating together to make patient care, the practice of medicine and processes in healthcare work better. The time is now for my personal assistants to come into being at the practice. Twenty years ago, I would not have imagined these to be non-human. I think this will interestingly help bring more humanity into what the physicians and staff at the practice do every day.