University Hospital at Downstate Piloting Customizable AI Consult Tool
University Hospital at Downstate in Brooklyn, N.Y., is one of the early customers of a new customizable AI consult tool for clinicians. In an e-mail Q&A with Healthcare Innovation, David Berger, M.D., the hospital’s CEO, shared his impressions of the potential impact.
The solution, Ask Avo, is from a company called Avo that has developed a clinician support platform with the goal of helping healthcare organizations standardize care and reduce burnout by seamlessly incorporating guidelines and protocols into the clinical workflow, helping to drive clinician adoption of quality initiatives and decrease costs for health systems.
The company says that Ask Avo leverages patient data, local population context, institutional pathways and protocols, and continually updated society guidelines to ensure trustworthy and relevant responses to complex clinical questions. Ask Avo allows providers to ask for a patient chart summary pre-visit, a care gaps analysis, an ambient note, an order placement, and more.
Healthcare Innovation:: What kinds of issues that clinicians have with accessing patient data does the Ask Avo tool help with?
Berger: Patient care remains highly fragmented with true interoperability still a ways away. This makes it hard for clinicians to access the full picture of the patient across EHRs in the limited time they have during a visit. Because Avo has built a platform that pulls patient data from across the nation using healthcare information exchanges (HIEs), clinicians cannot only “ask Avo” to share a synopsis of the patient, but also ask how to approach the patient’s unique scenario accounting for their whole history without needing to click on multiple tabs and attempt to pull many different records.
HCI: How did SUNY Downstate learn about this tool and decide to pilot it?
Berger: SUNY Downstate has worked with Avo since 2023. Our clinical teams use Avo’s clinical decision support functionality, including its digital pathways and medical calculators, its ambient listening “AI Scribe” and documentation solutions, and now Ask Avo. We learned about Ask Avo in its beta phase, and it was clear it would be an amazing tool to begin testing with our residents as a means for them to learn how to practice evidence-based care. We are thrilled about the early feedback we are receiving from our clinicians and are excited to expand across the organization.
HCI: Do you use Epic? Is this integrated with Epic or other EHRs and does it pull data from other sources as well?
Berger: We are not currently using Epic. What’s great about Avo is that it can work both in and out of the EHR and pull data appropriately. For example, even if a resident is using Ask Avo outside of the EHR, they can copy/paste the patient context and it will understand and surface an appropriate evidence-based response.
HCI: Can you describe the experience from the clinician’s point of view at the point of care?
Berger: Traditionally, when clinicians see a complex patient — say they are in the Emergency Department and are treating several complex issues, they first need to gather as much information as possible from the patient, their chart, and their medical history. From there they often go to UpToDate, which is essentially a library of thousands of medical articles, and sift through to try to find the evidence or protocol they are looking for.
The challenge with this workflow is that it takes a tremendous amount of time. Especially in the ED, you simply do not have time to search patient records and read through articles. So clinicians end up making assumptions, which means they could miss a significant care gap. Additionally, they then need to draft a note with all of the necessary information, like a differential diagnosis so that we as a health system get reimbursed appropriately.
So now imagine instead that the clinician is able to use the patient context within Ask Avo and ask things like, “What is the differential diagnosis of this patient?” or “What is the correct dose for this medication based on their age and symptoms?” and get a quick summary, based on evidence, of the full patient picture and any care gaps they could potentially have missed. And they are then able to click to draft a note automatically from that same query. This helps with patient care and burnout at the same time.
HCI: Did you pilot it with a small group of physicians with plans to roll it out more broadly?
Berger: We are piloting with our residents and then plan to roll it out more broadly post-pilot to the rest of our organization.
HCI: Any other observations about this deployment so far?
Berger: What makes Ask Avo truly game-changing is its ability to transform the way our clinicians access evidence at the bedside. UpToDate is great for folks who have time to spend time reading up on the latest, but Avo’s utilization of cutting-edge AI technology allows hospital systems to surface relevant info to the clinician, save them time, and save the institution money. I mean it when I say this is going to change the way we approach evidence-based and personalized medicine.
