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Bots vs. burnout: Waterloo physician developing automated software to reduce administrative workload

The Joule Innovation grant program offered funding, professional support and mentorship to physicians and medical learners making a difference in health care. This is part of a series of stories about the 2020 recipients and their innovations.

Bernie is busy.

He is spending all of his time – 24 hours a day, 7 days a week – working away in the electronic medical records (EMRs) at a number of primary care medical clinics, generating notifications that flag patients with chronic conditions that are overdue for an appointment and identifying missed billing opportunities for physicians.

He can review 800 charts in a matter of minutes, about six times faster than any medical practitioner.

Bernie is a bot — automated software that replicates the actions of a human — developed by Dr. Mohamed Alarakhia and his team at the eHealth Centre of Excellence in Waterloo, Ontario. Their aim is to build technology to improve workflows in clinical care.

“Bernie burns out so clinicians don’t have to. It takes that load off by monitoring when patients’ results come in and scheduling a follow-up for those patients.” — Dr. Mohamed Alarakhia, managing director of the eHealth Centre of Excellence

Lessening the administrative load

Dr. Alarakhia developed Bernie in response to a new policy introduced by the College of Physicians and Surgeons of Ontario (CPSO) in the fall of 2019. It set out expectations that physicians must better manage patients’ test results, including having an effective system to record the thousands of tests they order, receive and review every year.

Overwhelmed by the scope of the policy, yet wanting to ensure proper patient follow-up, physicians approached Dr. Alarakhia for a solution.

“Clinicians were already drowning in electronic and paper information. The new policy added additional work because of the degree of rigour they needed to demonstrate,” he explains.

Turning to the insurance and banking industries for inspiration, Dr. Alarakhia found the use of bots and artificial intelligence helped reduce time-consuming and repetitive tasks by about 30%.

“There was some automation software already designed to perform some of these tasks,” explains Dr. Alarakhia. “We were able to leverage that and bring it into a health care context.”

Reducing burnout through automation

Though the introduction of EMRs has changed the face of health care for the better, it has also created a significant administrative burden for physicians. A 2019 report from the Canadian Medical Association, which looked at job indicators and their links to physician wellness, found that more than half of the 3,000 respondents were dissatisfied or very dissatisfied with the efficiency and resources in their workplace.

By automating information management in medical clinics, Dr. Alarakhia says he is aiming to reduce the risk of physician burnout by freeing physicians up to spend more time with patients and on self-care.

Right now, the Bernie bot is being piloted at a number of primary care clinics throughout southwestern Ontario — operating in the background of existing EMR systems as a kind of virtual employee, by notifying clinicians that a patient is overdue for an appointment and flagging if they are eligible for billing opportunities. Every action is tracked to meet all privacy and security safeguards.

Dr. Alarakhia is using Bernie in his own family practice and says it has helped decrease the time he spends on mundane tasks. With 700 patients, the bot has helped him identify and follow up with those who need more care.

“I think about the COVID-19 pandemic. How do you identify those who are at higher risk for assessment or even vaccination?” he asks. Having a bot do that would be extremely helpful.”

Building a customized virtual assistant

Dr. Alarakhia and his team plan to use the $50,000 Joule Innovation grant to upgrade Bernie to automate lab requisitions for patients and to schedule follow-ups to ensure the testing has been completed.

The long-term goal is to add more functions to the software and allow physicians to customize the bot on the basis of their respective clinical needs. The hope is to replicate and scale the innovation to providers across Canada.

“We are essentially creating a workforce of virtual assistants that reduce administrative burden and allow physicians to focus on the patient,” says Dr. Alarakhia.

The 2020 Joule Innovation grant program provided $500,000 to support physician-led innovations in the areas of sustainable health care, physician health and wellness, health care solutions and access to care.

Read about the other innovations funded through the program:




About the author(s)

CMA Joule supports physicians and medical learners in the pursuit of clinical excellence. As a subsidiary of the Canadian Medical Association (CMA), we support the profession with continuing education and other learning opportunities as well as leading evidence-based clinical products and research.