Harborview Medical Center is a large health system based in Seattle, WA, operating across hospital medicine, emergency care, and outpatient specialties. As Chief Medical Information Officer, Dr. Daniel Cho is responsible for evaluating and implementing clinical technology across the organisation. When physician burnout scores reached their highest recorded level in 2023, documentation load was identified as the primary driver.
Harborview had been using a legacy dictation system for over a decade. Physicians tolerated it but rarely found it efficient. "It required a level of active effort that interrupted the flow of the encounter," Dr. Cho said. "Physicians were managing the tool instead of the patient." The decision to evaluate ambient documentation came from the physician satisfaction data, not from IT.
The pilot began with three departments: hospital medicine, cardiology, and psychiatry. Each specialty ran Diagnose alongside their existing workflow for 30 days. At the end of the pilot, physician feedback was consistent across all three departments. Note quality was equal to or better than their previous documentation, and time spent charting had dropped significantly. "We didn't have to sell it internally," Dr. Cho said. "The physicians came to us asking when it would roll out to the rest of the organisation."
Burnout scores, measured across Harborview's quarterly physician wellbeing survey, showed a statistically significant improvement in the three departments using Diagnose at the following measurement period. The correlation between documentation time reduction and wellbeing improvement was direct and measurable. "This is the first technology intervention we have implemented that showed up in our wellbeing data," Dr. Cho said.
Harborview is now rolling Diagnose out across all remaining departments. Dr. Cho is also in conversation with Diagnose about publishing a joint outcomes study on the documentation time and burnout correlation. "The data is compelling enough that it deserves to be shared," he said. "Other health systems are dealing with the same problem."