Saykara in the Office with Dr. Gabe Charbonneau and Dr. Teri Fisher

VFH Episode 69

In this episode, Teri welcomes Dr. Gabriel Charbonneau, a family physician (Family medicine specialist) in Stevensville, MT.

Dr. Charbonneau comes on to share his experience in using voice technology at his practice and specifically the voice assistant called Saykara. Saykara’s goal is to free physicians from the mountains of paperwork that await them at the end of each day. They use their own speech recognition model and AI, to tackle the issue of clinicians being in a room and having to chart their notes on a computer while they are interacting with their patient.

That AI-powered healthcare virtual assistant that simplifies the documentation process is actually called Saykara or Kara. Saykara listens to the interaction between a physician/clinician and their patient, and then transcribes the audio recording into the EHR.

Key Points From Dr. Charbonneau!

His experience using Saykara in his medical practice.
The huge role Saykara is playing in preventing physician fatigue and burn out.

Background

He experienced burnout right out of residency and it led him into researching whether there were tools that could help take the edge off of some of the electronic charting (EHR) they were doing, which was very slow back then.
He experimented with Dragon Assistant although it was not elegant.
He was competitive with his partner at the practice when it came to building tools to make EHR easier, and that included building skills. They then came up with a way to make the process of treating patients easier using Dragon and Macro Recorder.
They even taught other people to use the system and also built voice commands for other physicians.
When he got tired of being a travelling consultant, he started a software startup and built a prototype add-on macro tool that could be used to take multiple steps in an EHR and make them into one step. The business didn’t do very well, but he still uses the tool and there are other physicians who use it too.
He finds the intersection of technology and medicine very interesting.
He was introduced to Tenor, a company that builds digital medical assistants to help clinicians provide better care, be more efficient and make better decisions, and served there as a physician advisor. That’s where he developed a huge interest in AI and voice AI.
Tenor eventually went out business so he decided to focus more on what he could do to solve the issue of physician burnout. He started by creating a T-Shirt with the words, “Fight Burnout”, and his work was noticed by people at Saykara, which led to them working together.
He helped bring a Saykara pilot project to Montana and has been working with the company ever since.

Saykara in the Office with Dr. Gabe Charbonneau

Using Saykara

Before using Saykara, his office work environment was very optimized because he already had the tools he was using. He didn’t think Saykara would make any difference for him, but when he started with the pilot project, he was amazed by just how much more it streamlined things at his practice.
Saykara is a mobile iOS app he uses on his phone and it always has his patient list for the day on there.
He selects the patient he wants to see before going in to see them, and then walks in and requests the patient for permission to use the AI assistant in recording their conversation. So far, no patient has objected to it.
He then turns it into listening mode which enables the assistant to listen to the conversation. It captures all the audio, but one still has to give it occasional commands to get it to do things. The wake word is “Hey Kara” or “Okay Kara”
The technology is evolving towards a fully autonomous solution that will listen to whole conversations and work on everything without any human editing to produce accurate transcripts.
He basically uses Saykara like an Alexa in the exam room because he talks to it with voice commands and he doesn’t have to speak any punctuation because it’s very natural and intuitive.
He’s very excited that he is helping make Saykara better with the feedback he provides from using the solution.
He realized that previously, with Dragon, it took a lot of mental effort to proof read things, but Saykara has some editing and quality control that it does in the background to make sure whatever someone says comes out right.

Quality Control

Saykara has people who proofread the transcripts that the AI generates and they send the transcript over to Dr. Gabe to sign off on them.
Saykara is incredibly accurate so he doesn’t have to spend much time reviewing the transcripts.
Initially, Saykara’s turnaround time would take up to 24 hours to get a transcript, but the turnaround is now around 10 to 20 minutes.

The Impact

The COVID-19 pandemic has affected his practice (Rural primary care) since it’s operates within a fee for service business model. Therefore, diverting people away from the clinic due to the pandemic negatively affected his bottom line.
He has been doing more telemedicine to cope with the changes.
He recently had a 20 patient day and was done on the notes by 5.30pm, with an hour off for lunch time in between, and all that was made possible by Saykara.
The technology plays a huge role in preventing physician fatigue and burn out.