By: Craig Norquist, MD, chief medical information officer

Over the last several months, we’ve been discussing AI’s potential uses, as well as limitations and cautions. At the same time, we’ve been rolling out AI tools both within Epic and elsewhere. Experiencing these tools firsthand helps put theoretical concerns into context and clarifies our strategy for safe deployment.

Generative AI can sometimes confabulate, or “hallucinate,” meaning it might make things up or misinterpret data to give an answer it thinks you want. While this is fascinating from a research perspective, it can be dangerous in healthcare. For example, misattributing a result to a research paper is concerning, but attributing a diagnosis to a patient incorrectly could have serious consequences.

Understanding these risks guides our approach. When new generative AI features are introduced in Epic, a dedicated group of analyst-builders and frontline clinician informaticists first test them outside the production environment. Once the tool is deemed reliable, a larger group including Epic physician builders, Smartusers and department leaders, tests it in the live environment, providing feedback on usefulness and caution areas. Typically, this pilot phase lasts one to two months before system-wide release.

Current AI tools in Epic

• InBasket Augmented Response Technology (ART): Reads patient messages and drafts a reply for physicians or APPs, who must review and edit before sending. Patients are informed that AI assisted with the response.
• AI Text Assistant: Allows highlighted text in notes to be rewritten in different formats — clinical, patient-friendly, bulleted or paragraph style. While useful, adoption was slower than expected; however, the tool is safe and now available to all users.
• Note summarization tools: Generative AI can now summarize previous visit notes to provide a synopsis of patient history, with tools tailored to specific care settings:
  • Ambulatory and inpatient note summaries provide a synopsis of patient history customized for each workflow. Response was so positive that several of these tools were released early at the request of hospitalist leaders.
  • AI-generated discharge summaries draft a discharge summary based on notes from the entire visit, which can be copied as the starting point for the official note. Note that it only summarizes notes and does not yet review labs, procedures or radiology results not documented in a note.
  • Emergency Department patient note summaries, co-developed in partnership with Epic, highlight relevant prior visits and risk factors for patients arriving in the Emergency Department — a collaboration we’re particularly proud of. For example, for a patient with chest pain, the tool can focus on prior cardiac visits, potentially saving significant time for the clinician. This tool will be released to all Emergency Department physicians and APPs in the next wave.

While all these tools have the potential to confabulate or make mistakes, our mitigation strategies and careful rollout allow clinicians to use them safely.

Other AI resources

• Co-Pilot Chat: Available to those signed in with HonorHealth credentials, this tool can safely be used with PHI. It helps search for clinical information, draft text or summarize findings without sending data outside the system. Clinicians remain responsible for reviewing outputs before use.
• UpToDate AI: UpToDate AI will provide faster, AI-assisted clinical insights directly in UpToDate, along with single sign-on access and CME tracking for clinicians. More details on rollout and training will be shared soon.
• CTEC presentations: Presentations will cover emerging technology, AI tools and best practices in healthcare at HonorHealth. Look for QR codes and calendar invites to join these sessions and stay up to date on innovations that impact your workflow.

Also, look for the upcoming EHR Experience survey soon. We really appreciate your feedback, and this is one of the best ways for us to know where to focus our efforts.