Epic’s generative AI goes live

The EHR maker has made good on its promise, but what does that mean for Aussie health data?

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The NSW government’s future electronic health record now has the possibility of using generative AI, but whether or not it will be included is anyone’s guess. 

Epic announced last week that its promised generative AI is now fully embedded in its electronic health record. It is being used by more than 150 hospitals and health systems across the US but NSW Health cannot, at this stage, reveal if it will be a part of the state’s new EHR. 

Epic’s new feature is provided by Microsoft’s Nuance Dragon Ambient eXperience (DAX). DAX combines Nuance’s conversational and ambient AI – which engages with speech and sensor information – with the problem-solving power of the GPT4 AI model. 

The feature will enable clinicians to draft notes automatically from the exam room, or via telehealth, for quick clinical review and completion after each patient visit. 

Brent Lamm, CIO at UNC Health, said that DAX enhances the Epic EHR by making clinical documentation “intuitive and straightforward”.  

“Patients also say how much they value the conversational interactions they have with their providers and how they truly feel seen and heard during visits while DAX Copilot unobtrusively takes care of the clinical documentation,” he said at the announcement. 

However, there is controversy over how far AI should assist with diagnosis. Using AI to assess imaging, and offer diagnoses, is becoming more widespread and some clinical AI tools, both local and from abroad are now assisting doctors with diagnosis during face-to-face-consultations.  

Epic came under fire last year after Mayo Clinic published research that spotlighted the poor results of Epic’s AI-based algorithm for predicting the onset of sepsis. Epic’s sepsis AI tool failed to identify two-thirds of the patients who went on to develop sepsis. 

Dr John Halamka, president of Mayo Clinic Platform, said those kind of findings “amplify the reservations many clinicians have about trusting AI-based clinical decision support tools”. 

eHealth NSW has not yet shared which Epic features are to be included in its contract with the global behemoth but advised in October last year that “work is now starting on the initial design and build of this next generation system”. 

An eHealth spokesperson said last year that the new EHR will enable clinicians to access a patient’s clinical records quickly, securely, and safely, regardless of their location.  

“The SDPR will also provide simplified clinical workflows in an intuitive, user-friendly system with streamlined technical support,” said an eHealth NSW spokesperson. 

The Epic rollout across NSW Health hospitals is expected to take six years with the Hunter New England Local Health District to be the first LHD to go live with the new platform in 2025-26. 

Hypothetically, Epic could bring Nuance functionality to Australia without breaking any rules as long the data chain keeps all health data onshore. 

Last August, Epic announced a partnership with Microsoft’s Azure, a provider of massive, cloud-based data centres that deploy software and scale data provision according to demand. Epic’s generative AI, DAX, is hosted in Microsoft’s Azure OpenAI Service. Azure have three data centres in Australia. 

ACT Health and Parkview hospital precinct in Melbourne also solely use Epic’s EHR. An ACT Health spokesperson has confirmed that generative AI functionality is not a part of Epic offering provided by ACT Health.