Automating Patient Note Summarization Using Gen AI

Executive Summary

In the healthcare industry, particularly in specialty pharmacy services, optimizing workflow efficiency and reducing operational bottlenecks is crucial for improving patient satisfaction and service quality. A leading American healthcare company faced challenges in managing workflow efficiency, particularly with patient service representatives (PSRs) manually processing patient notes. This process created delays in decision-making and escalations, which affected both patient outcomes and colleague productivity.

Factspan introduced a Generative AI-based solution to automate the summarization of patient notes. By leveraging advanced techniques such as contextual processing and semantic chunking, this AI-driven approach reduced manual effort, accelerated decision-making, and minimized escalations. This technological integration significantly enhanced operational efficiency, positioning the company to maintain a competitive edge in the specialty pharmacy market.

About the Client

The client is a major retail pharmacy giant in the United States, offering a wide range of pharmacy and healthcare services, including specialty pharmacy. With a focus on innovation, the client continuously seeks to leverage cutting-edge technology, such as the Specialty Pharmacy (SPRx) system, to streamline operations and deliver exceptional patient care.

Business Challenge

The organization struggled with the manual, labor-intensive process of managing patient notes across multiple channels in the SPRx system. PSRs were required to sift through detailed, multi-faceted patient notes, resulting in increased handle time, slower decision-making, and reduced patient satisfaction.

The complexity of patient notes, often lengthy and filled with nuanced medical details, led to significant operational inefficiencies. The challenge was to automate the summarization process while maintaining context and accuracy, thereby reducing PSR workload, improving decision-making speed, and enhancing overall productivity.

Our Solution

Factspan developed a Generative AI-powered solution to automate patient note summarization within the SPRx system, incorporating the following key components:

• Template-Based Summarization: Predefined templates ensured consistency and relevance across diverse note categories, reducing interpretation variability.
• Human-in-the-Loop Feedback: Expert reviews refined and validated AI-generated summaries, preserving critical details, especially in complex cases.
• Contextual Awareness: The AI used sliding windows and semantic chunking to capture the full context of patient interactions while breaking long notes into manageable segments to prevent information loss.
• Confidence Scoring: Powered by Named Entity Recognition (NER), this system prioritized key entities (e.g., drug names, dosages, escalations) to ensure accurate and complete summaries.

The solution integrated into the SPRx system, automating the summarization process and significantly reducing manual intervention. By leveraging context-aware AI, the system summarized notes without losing critical details, enabling quicker, more informed decisions, and enhancing both overall productivity and patient care outcomes.

Business Impact

• Manual effort reduced by 68%, significantly easing the workload for PSRs
• Decision-making became 40% faster, leading to quicker issue resolution
• Improved workflow efficiency with a 30% decrease in escalations
• Patient satisfaction increased, with service quality improving by 25%