Nsight 2.0 FAQ

Frequently asked questions for AvodahMed's Nsight platform

General Information

What is Nsight?

• Nsight, powered by AvodahMed, is an ambient clinical intelligence platform that transforms the provider/patient experience and improves provider wellness. Nsight is able to virtually enhance appointment scheduling, transcription, and summarization allowing you to spend more time focusing on the patient.

• Nsight is a powerful tool that can be utilized at any practice as long as a supported device and normal network connection speeds are used. Nsight provides an uptime of 99.9%.
• Currently, Nsight offers: 
  • • Summaries in the form of both SOAP Note and Encounter Summary: 
      • Both of these summaries will be available to choose from in Nsight 2.0.
    • The Provider Note (dictation workflow step) will now be included at the end of an appointment summary.
• Quick Start is now available in Nsight 2.0!
  • Quick Start is a way for providers or staff to quickly begin appointments in Nsight. 
    • This is especially helpful for same-day or walk-in appointments.
    • Quick Start only requires the patient to be added into Nsight before the appointment can begin.

What conversations are supported by Nsight?

• Nsight can support conversations held both in-person and virtually.

What types of practices does Nsight support?

• Nsight can support all practices and areas as long as audio is recorded.

Do we need to ask our patient for consent?

• Nsight powered by AvodahMed is a HIPAA-compliant webRTC platform and meets the security and compliance requirements set forth by HIPAA. According to federal regulations, a practice is not required to receive consent from the patient to use Nsight during their visit. Regarding this information, we recommend that the executive management handle these conversations with providers and clinical staff to educate them when responding to these questions.

Is your technology HIPAA compliant?

• Yes. We require partner organizations to agree to a BAA that requires them to adhere to best practices related to privacy, security, and notification protocols in the event of a breach. We make use of HIPAA-approved AWS services; our resources are covered under the list below. https://aws.amazon.com/compliance/hipaa-eligible-services-reference/
  All data is encrypted in transit and at rest.

SOAP Note generation - how is the data scrubbed to ensure HIPAA compliance?

• We use a closed LLM model that doesn’t use the requested PHI data to retrain the model.

How long does it take to generate a summary?

• Speaker diarization and transcription summarization are typically generated within 10% - 15% of the session time.

Can each section of an appointment be completed separately or do they need to be completed in order?

• Unfortunately, each section of an appointment will need to be completed in order at this time. Previous sections cannot be accessed or processed until the entire appointment is completed.
  • Our product team is currently working on improvements to allow providers to access the sections in any order.

Where are the conversations stored, and for how long?

• All data is encrypted on transfer and at rest per HIPAA compliance. The data is stored in the AWS cloud, where we have a BAA in place with AWS. Conversations are held for as long as the account is active. If a customer cancels their subscription, all data is held in cold storage for six years and is available by written request within 90 days. 

Can this information be requested? If so, what does this process look like?

• Customers can submit a written request to customersuccess@avodah.com for the information. After doing so, Avodah will send a Google Drive link within 90 days.

Are integrations with an EMR available? How long will this take?

• Yes, we are currently building out integrations with select EMRs; please reach out to your Customer Success Manager for more information.

Enhanced Medical Transcription

• Our large language model has been improved and specifically enhanced to allow a better understanding and capture of medical terminology.
• We have improved the following:
  • Improved processing time
  • Improved medical vernacular identification
  • Improved spelling of medical terminology
  • Increased accuracy and formatting of dosage values and vitals

Optimal Practices for Effective AI-Assisted Summarization

• Transcript Quality Matters: The quality of AI-assisted summarization relies on the clarity of the verbalized transcript.
• Enhance Communication: To ensure comprehensive documentation, make it a practice to repeat vital information, including vitals, plans, diagnoses, and medications, during the patient visit.
• Use Action-Oriented Language: Employ action words like "I'm going to prescribe," "I'm going to refer," or "I'm going to schedule" to convey your intentions clearly.
• Be Specific in Referencing Documents: When referencing documents, specify the exact name of the test or result you're discussing, enhancing precision.
• Thoroughness Is Key: Utilize specific and exhaustive language when documenting vital signs, physical assessments, plans, or exam findings for the most accurate and informative notes.
• Contextual and Final Summaries: Keep in mind that a contextual summary will be available in each section, while the final S.O.A.P. note is generated exclusively in the "Documentation" section when all sessions are completed.
• Personally Identifiable Information: Please keep in mind that certain specific information is needed for an efficient capture of information. For example, gender identification is needed for our model to identify the patients properly. If “other,” for example, is selected as a gender, our model will not know the sex of the patient unless specifically stated in the transcription.
• Effective Summarization: For appointments exceeding one hour, we recommend summarizing the important points of the session aloud. This way, the important points of the appointment can be especially summarized and captured effectively in the Full Encounter Summary or SOAP Note. 

By adopting these optimal practices, you can maximize the effectiveness of AI-assisted summarization and ensure comprehensive patient documentation.

Technical Requirements
Nsight is compatible with all PC desktops/laptops and Microsoft Surface Pro devices using the Google Chrome or Safari web browsers. At this time, we recommend avoiding any other web browsers to avoid running into potential issues. Nsight is not compatible with tablets or smartphones at this time.

Internet Requirements: According to the Federal Communications Commission (FCC), video telemedicine requires a minimum download speed of 25 MB/s and a minimum upload speed of 3 MB/s. Higher download and upload speeds may be needed depending on the number of devices simultaneously streaming content, latency, and other factors.

General Hardware Requirements and Recommendations
PC laptops, Chromebooks, Apple Macbooks, Microsoft Surface Pro

• Minimum 16 GB RAM
• The device may come with a webcam/microphone
• Example products: Microsoft Surface Pro 6, HP Thin 14” Laptop, Microsoft Surface Laptop 

Desktop PC with monitor/display

• Minimum 16 GB RAM
• Example products: Dell Business Desktop, OptiPlex Desktop PC, HP Business Tower Desktop

Bluetooth-enabled speakerphone (or microphone) for voice recording between provider/patient: 

• Bluetooth or USB (preferably Bluetooth)
• Noise isolation
• Voice optimization and background noise reduction
• Able to pick up multiple speakers’ voices inside of patient room
• Minimum 16kHz HD voicex
• Example products: Anker PowerConf Speakerphone, Jabra Speakerphone

Webcam with or without microphone

• Full HD (1080p) resolution
• Example products: eMeet 1080P Webcam, ROCWARE Webcam 1080P

Environmental Recommendations

• Test your equipment before starting your first appointment. Be sure everything is working properly, and there is no background noise or distractions. Close doors and windows, if possible, to keep background noise at a minimum.
• Place the recording device on a clear desktop or counter surface, do not place the device near cabinets or other devices, if possible, to ensure the sound quality is clear. We also recommend not holding the device itself.
• Run a test appointment with your staff to ensure everything is ready for your first appointment. 

Device/Audio Troubleshooting:

I keep getting kicked out of the tenancy...

• We recommend checking your Wi-Fi first, then checking your device to ensure it is not closing your web browser, logging you out of the device, or going into sleep mode. If any issues persist, we recommend reaching out to our support team at support@avodah.com.

My device/web browser is unresponsive...

• We recommend resetting your device/web browser and checking for updates; clearing your web browser’s cache may also resolve issues if issues persist.

Security

• The customer maintains the right to customer-specific data
• Avodah maintains the right to any aggregated data

What are your data security and encryption standards?

• All data is encrypted on rest and in transit (AES-256) with rotatable managed KEYS. 

If the data is stored in the cloud, please describe the security measures taken with PHI information. 

• Access to the cloud where the data is stored is only granted to Avodah’s technology department, which has signed HIPAA confidentiality agreements and is required to attend HIPAA training once a year. All cloud access credentials are rotated every 90 days and require MFA (multi-factor authentication). Access to production data is limited to only those in Avodah’s technology department that have been granted access. No PHI data is stored in any environment other than production.

How can our organization request access to our patient data?

• Submit a written request, and we will grant you access within a 90-day period.

Can we request the deletion of our patient data?

• Unfortunately, we cannot fulfill data deletion requests. We maintain encrypted patient data for at least six years in cold storage (data in cold storage refers to rarely accessed data).

In cases of legal action, can data be subpoenaed?

• In legal cases, Avodah will disclose data where required by applicable law.