How athenahealth AI helped a neurology practice stay free

Allen Gee, M.D., Ph.D., is a neurologist and founder of Frontier NeuroHealth, a neurology and neuorohealth practice in Wyoming. We talked with him about how athenaOne® helps bridge geographic barriers to care, how artificial intelligence helps raise relevant patient information, and how athenahealth has helped his organization stay independent.

Q: What makes access to neurology care so challenging in Wyoming, and how are you addressing this?

A: Part of it is [the state's] large geography. In Wyoming, we have [over 580,000] citizens. And at last count, I think [the state has] eight full-time neurologists. Not only is the geography challenging, but so is having access to subspecialty care. That’s a big challenge for patients. The waiting time can be months or years to get in to see a subspecialist.

We have a virtual practice across the state, so we’re using all sorts of technology and tools to connect patients with care. I also do outreach clinics. Sometimes it’s a two-and-a-half, three-, four-, or five-hour drive. But it’s better than having 10 or 12 patients make the same trip for in-clinic [visits].

We also work with advanced practice providers and other clinics through virtual care. That’s where [athenaOne] technology helps us bridge geographic barriers to healthcare.

Q: How does athenaOne help you collaborate across distance and stay connected with patients?

A: athenaOne is an internet-based software-as-a-service model, [which means] the information is available no matter the location. That's critical for taking care of patients, having valid information, and making clinical decisions.

I work with advanced practice providers in different locations, and we can work in the same chart at the same time. We can collaborate on a patient's care, even though there’s a significant geographic barrier or distance between us.

Communication is key — and that's probably the holy grail in healthcare when it comes to helping individuals change their health trajectory. Historically, it’s not worked well to see a patient [only] on occasion.

Take hypertension, for example. A patient comes in and we take their blood pressure. They may or may not have white-coat syndrome (raised blood pressure because of the anxiety of medical visit.) They may or may not have hypertension when they’re not in the office. We can talk about their high blood pressure. We can say: "Take your medication." Or, we can say: "Exercise and get your sleep."

So anything we can do to communicate with patients, if they have questions, or give them nudges to help them change their behaviors, [then] I think we have an increased probability of helping them change their health trajectory. Nothing is perfect, but being able to communicate well through the portal is a very strong bonus of athenaOne.

Q: Why is it so important for technology to support patient connection instead of getting in the way?

A: It's the connection. While virtual medicine isn’t as great as seeing [patients] in person, it’s still effective in being able to help that communication.

I find that when we address the physiology and the neurophysiology — which includes the foundation of sleep, nutrition, movement, and mindfulness — we can better regulate the nervous system. Then, medical [conditions such as] cognitive impairments, hypertension, inflammation, and GI issues can be more easily treated. You've got to take care of the whole person.

[You also need] good technology that doesn’t distract. Historically, a big issue was the doctor sitting with her back to the patient looking at the computer. I was never of that mindset. Early on, I had a touchscreen tablet and voice recognition. But I was able to talk to the patient and communicate with patients without the distraction of looking at a computer screen the entire time.

That connection is important, and also having the relevant information presented in a way that, as clinicians, we can assimilate it and better understand the patients we’re talking to. And hopefully make better informed decisions about their care. And most importantly, communicate it well.

Q: How do you see AI improving the way clinicians use information?

A: We don’t need more records. We need information about the patient. We need knowledge about the individual. Just creating more records, more information for us as clinicians to try to sift through and assimilate is very challenging, time consuming, and distracting.

We’re moving beyond records and information to informatics — a [more] contextualized knowledge realm where athenaOne surfaces relevant knowledge for clinicians to address and speak to the patient, to change their course and their medical story.

Once we have trusted algorithms, they will help facilitate the contextualized knowledge. So instead of physicians spending hours — or at least a significant amount of clinic time — trying to assimilate all the information that is puked on us, AI is going to help us contextualize what’s relevant for that patient at that time for the discussion.

It’s going to improve the process considerably — the efficiencies, the reach. I think it’s going to facilitate my ability to reach across geography, connect with patients, and work with collaborators.

Q: How are you using AI today, and what’s working well so far?

A: One example is ambient AI, which is the summary of the transcription and conversations. We also use the AI that’s embedded in athenaOne to summarize the information that's been collected in previous visits or to organize [other] information.

Historically, an electronic health record was like an electronic file cabinet. You had to open different doors with clicks, look for [the information], and then try to assimilate it. [Now] I can ask the system: "What’s new for laboratory studies?" Or: "What new information has been acquired since a patient was last seen?" And it gives me a nice, concise summary of that information, rather than me clicking into different files.

Having [data] presented this way facilitates my ability to ingest it and make decisions, which currently still resides with the physician. But in the near future, I think we’re going to have a great collaborator in AI helping us with that process.

I am seeing the impact of ambient AI in business operations. It’s facilitating the process of data acquisition and documentation. We’ll be integrating process management AI to clean out the inbox and continuing to identify what’s relevant to put in front of a physician and what can be triaged or put in [different] inboxes for other members of the team to address. So, [athenaOne] is indeed increasing our efficiencies.

Q: What has to be true for AI in healthcare to be trusted?

A: We have to understand where the data comes from—[its] authenticity, validation, governance, and consent. I think this is an overlooked component in building AI algorithms. So, [we might be] building algorithms that we can’t trust, and that’s a problem.

AI is never going to replace physicians. There’s going to be a collaboration. If the AI can be trusted — if the algorithms are built on data or information that is valid and authentic — it's going to surface relevant knowledge that clinicians can review and discuss with patients.

[But perception of AI] varies with patients. I have elderly patients that are super into it, and I have others that are nervous about it, and rightly so. Again, it’s the trust and the governance of the data. "Whose data is it?" "Has it been consented to be used?" "I want to be in charge of my data." [Patients might say:] "I don’t want to have all my biologic data available for exploitation or for manipulation by big tech algorithms."

Q: How has athenahealth helped your organization remain independent?

A: I’ve been independent since 2004 and would not have been without athenahealth over the years.

The [platform's ongoing] upgrades have been great. I am very excited about what the future holds and what we can do with the technology infrastructure to improve care [delivery], improve the efficiencies in the practice, and, most important, improve the quality of care for patients. I’m reinvigorated after being with athenahealth for 19 years. The next chapter is looking really exciting.

What I would say is: Trust the process. There is always resistance to change. But when teams trust the systems to facilitate the interaction, the intake, the data acquisition, and the clinical visit, it's huge.