When you visit your provider at Advance Community Health, you might notice something different: they’re looking at you more. Making eye contact. Really listening. There’s still a computer in the room, quietly sitting on the desk or counter, but your provider isn’t frantically typing notes while you’re talking. They’re present.
This shift didn’t happen by accident. It’s the result of Advance Community Health’s strategic embrace of digital health tools designed to do one thing: give providers more time to focus on what matters most.
The Documentation Burden
For years, healthcare providers have faced a growing challenge that patients rarely see but ultimately affects their care experience. After (and often during) every patient visit, providers must document everything: the reason for the visit, symptoms, medical history, assessment, treatment plan, and patient education materials.
“When you’re in a visit with a patient, the provider has to document what the patient is there for, document all their symptoms, the history, and then come up with the plan and then write educational pieces at the end after the visit,” explained Ziad El Tannir, PA, Director of Informatics, Technology and Optimization at Advance. “So as you can imagine, that takes a lot of typing, and usually that was done while the patient is in the room, and that takes the provider’s attention off the patient and puts it more on the computer, because they’re just typing up as the patient is talking.”
For federally qualified healthcare centers like Advance, which serve large patient populations and have extensive documentation requirements, this burden was becoming unsustainable. “A lot of our providers were struggling with keeping up with all their notes,” El Tannir said. “Providers were needing assistance in finishing their notes on time and being able to keep up with the demands of the job.”
The consequences extend beyond provider burnout. “If they don’t finish their documentation, they can’t sign their chart. If they don’t sign their chart, we can’t bill the patient’s insurance,” El Tannir noted. “So we wanted to make sure providers are closing their charts on time.”
Enter Abridge: AI-Scribing Technology
Advance initially explored traditional solutions, including remote scribing where a virtual assistant joins visits via video to type notes for providers. “We had eight providers that were actually using that solution, but the solution was expensive, and we couldn’t roll that out to the rest of the providers across the organization,” El Tannir explained. “It isn’t scalable because of cost and availability.”
That’s when Advance turned to artificial intelligence. Specifically, a solution called Abridge. Abridge is an AI-scribing software that listens to patient-provider conversations and automatically generates clinical documentation.
“Abridge is a software that is embedded into the provider’s device,” El Tannir explained. “So what happens is, as the visit is going on, it’s literally just listening in the background, and then when the visit is over, the provider moves the note from the phone into the computer system, into the EMR (electronic medical record).”
The technology is sophisticated enough to distinguish between medically relevant information and casual conversation. “The AI scribe is able to take all the conversations between the provider and the patient and literally write out the history, present illness, the assessment plan and after visit summary,” El Tannir said. “It’ll factor what’s important, throwing away what’s not medically important, things like personal things, or if you’re just chatting about your day or how your daughter is doing, or how Grandma’s doing. It’ll take what’s not necessary out of the chart, leaving the important things in there about the visit.”
Importantly, providers maintain full control over their documentation. “Obviously, the provider has the final say in what’s in their chart, what’s not, and has the final edit,” El Tannir emphasized. “The provider, he or she, can decide what their note looks like at the end.”
What Patients Notice
From a patient’s perspective, the technology operates almost invisibly. “To be honest, for our patients, it really doesn’t change anything about their visit with their provider,” El Tannir said. “The only thing that it will change with them is they’ll notice that their provider is looking more at them, looking more in their eyes, as opposed to focusing as much on the computer.”
Here’s how it works during a typical visit: before entering the exam room, the provider opens a secure app on their phone, selects the patient from their schedule, and clicks “record.” Upon entering the room, the provider informs the patient that they’re using AI-scribing technology called Abridge to record the encounter and generate notes. With the patient’s consent, the phone is set down, and the visit proceeds naturally.
“The provider just asks all their questions, communicates with the patient. Patient asks their questions; provider responds. Everything is done like you would do it normally,” El Tannir described. “And then when the visit is done, as the provider is leaving the room, you just click a button that says stop recording, and then you click another button that says create note. And within 30 seconds to a minute, the software deciphers the whole note and conversation between the provider and the patient, and then pushes the note over into our EMR.”
The impact on provider efficiency is significant. “I had read a lot of studies about clinics and hospital systems that have adopted Abridge, and the difference in how much it’s saving providers time, which is about an hour a day on average for primary care,” El Tannir said. “So it saves providers about an hour of typing and doing certain activities that they were doing before.”
Privacy and Security
Patient privacy is a valid concern when conversations are being recorded and processed by AI. Advance and Abridge have safeguards in place to protect sensitive information.
“Once the information is inputted into your chart, everything is de-identified before it gets stored,” El Tannir explained. “So the Abridge software itself is not storing any personal data from the patients. Everything is pushed to our electronic medical record to Epic, but on the Abridge side, everything is de-identified on their end.”
What does this mean practically? “The software company does not have the patient’s date of birth or information or anything like that,” El Tannir clarified. “They’ll know that, for example, a 64-year-old female with diabetes and high blood pressure came to the visit, but they won’t know the specific name, address, date of birth for the patient. So they do collect the data about the visit, but it’s de-identified, meaning it’s not tied to the patient that was there.”
Advance also maintains transparency about the technology’s use. “We have signs in all of our front desk areas and patient rooms that say we’re using this solution, and the provider reminds the patient at the beginning of every visit,” El Tannir noted. And if a patient isn’t comfortable with AI scribing? “If they choose for us not to use it, we can do the old school and type up the note that way.”
Looking Ahead: The Future of AI in Community Health
Advance isn’t stopping with AI scribing and patient portals. The organization is actively exploring what other digital tools can improve operations and patient care.
“We’re trying to look more into AI and see where it can plug in and help us, whether that could be with referral management or possibly call center operations,” El Tannir said. “In the future, those would be some of the technological advances or upgrades that we would look to see if they could benefit us, just because those are some of the departments that are high functioning, but they’re always behind just because of the demand. So we need to see how we can use technology better to help those workers.”
Traditionally, community health centers have lagged behind large hospital systems in technology adoption due to resource constraints. However, with AI solutions, that gap is narrowing.
“Usually with community health, a lot of the solutions are a little bit behind the bigger hospital systems,” El Tannir acknowledged. “But to be honest, with Abridge, with our AI scribing, we weren’t that far behind. We were maybe a few months behind, because that solution became available to us very soon after it became available to major hospital systems.”
This creates exciting possibilities for the future. “I really think that there’s going to be a big role for it,” El Tannir said of AI in community health. “We tend to serve a large population, and a lot of our providers and staff tend to wear multiple hats. So wherever we can use technology to assist our providers or assist our support staff, we’re going to try to fill those gaps with technology.”
As Advance Community Health continues to grow and evolve, technology will play an increasingly central role in fulfilling the organization’s 53-year mission: providing accessible, high-quality, compassionate care to everyone who needs it.
