Duke Health's Microsoft pilot puts nurses at forefront

Duke University Health System has been an early adopter of a new tool from Microsoft and Epic that aims to streamline nursing documentation, Kay Lytle, DNP, RN, chief nursing information officer at the health system, told Becker's.

The new tool uses ambient technology to create flow sheets for review. The Durham, N.C.-based health system is among several early adopters, including Advocate Health in Charlotte, N.C., Baptist Health in Jacksonville, Fla., Intermountain Health Saint Joseph Hospital in Denver., Mercy in St. Louis, Northwestern Medicine in Chicago, Stanford Health Care in California and Tampa General Hospital in Florida.

Duke Health's involvement in this collaboration, which began in August 2023, includes conducting design sessions with a select group of staff members who provide feedback on prototypes, icons and workflows. Over the past five to six months, Duke's staff have worked closely with Nuance, a Microsoft subsidiary, and Epic to observe daily workflows and offer insights.

According to Dr. Lytle, the collaboration recently moved into a "private preview" phase, where nurses at Duke Raleigh (N.C.) Hospital are participating in the testing and refinement of the tool.

Currently, about 30 staff members, including registered nurses and nursing care assistants, are involved in the pilot, with participants chosen based on their willingness to engage with the technology and provide feedback.

"We are currently gathering extensive feedback on the tool, which means that the solution isn't a complete time-saver for our staff at this stage, unlike what we anticipate it will be in the future," she said. "This feedback component is crucial, as not all documentation needs can be met yet, particularly regarding flow sheets like vital signs and certain daily care tasks. It's important for our team to understand that we are still in the product development phase, and this solution is not yet widely available."

While the technology is still in its early stages, feedback from participants has been positive. Nurses appreciate having a voice in the process, and discussions with Microsoft and Epic are ongoing to establish metrics for assessing the tool's success, Dr. Lytle said. 

The collaborative environment among the pilot group's participating health systems has also fostered valuable insights.

"We're trying new approaches and tools to support workflow, and we've had discussions about metrics, such as how these changes impact the time spent on documentation at the end of shifts. We're also exploring potential quality impacts and a variety of other factors," Dr. Lytle said. "Having the opportunity to bounce ideas off of each other has been incredibly beneficial."

Looking ahead, Dr. Lytle expressed enthusiasm for the potential impact of this technology on nursing practices. She highlighted the goal of alleviating administrative burdens so nurses can focus more on direct patient care. 

"Anything that can help them to bring their joy back to their day-to-day care is important," she said.

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