Imagine this. You finally mustered up the courage to go to your loved ones doctor for an embarrassing problem. You sit down. Your family doctor says:
before we start, I take advantage of a pc to log my visits. This is AI – it is going to write a summary of notes and a letter to the specialist. Is this OK?
Wait – AI writes our medical records? Why would we wish that?
Documentation is important for protected and effective healthcare. Physicians must keep good records to keep your registrationHealth services must provide good record keeping systems for accreditationRecords are also legal documents: they could be essential within the event of an insurance claim or legal motion.
But writing things down (or dictating notes or letters) takes time. During visits, doctors can divide their attention between good recordkeeping and good patient communication. Sometimes doctors have to work on records after hours, at the top of an already long day.
So it’s understandable excitementfrom every kind of healthcare professionals about “ambient artificial intelligence” or “digital scribes.”
Who are digital scribes?
This is not an old-fashioned transcription program: you dictate a letter, and this system transcribes it word by word.
Digital scribes are different. They use AI – large language models with generative capabilities – similar to ChatGPT (or sometimes GPT4 myself).
The app silently records a conversation between a health care provider and a patient (using a phone, tablet, or computer microphone, or a dedicated sensitive microphone). AI converts the recording right into a word-by-word transcription.
The AI system then uses the transcript and directions received to write clinical notes and/or letters for other clinicians, ready for the clinician to review.
Most clinicians know little about these technologies: they’re experts of their specialty, not in AI. Marketing materials promise to “let AI take care of your clinical notes so you can spend more time with your patients.”
Put yourself within the clinician’s shoes. You can say, “Yes, please!”
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How are they regulated?
Lately, Australian Medical Practice Regulatory Agency published a code of practice for the usage of digital scribes. Royal Australian College of General Practitioners an information card was published. Both warn physicians that they continue to be accountable for the content of their medical records.
Some AI applications are regulated as medical devicesbut many digital scribes usually are not. Therefore, it is commonly up to health care providers or physicians to determine whether scribes are protected and effective.
What does the research say to date?
Real-world data and evidence on the effectiveness of digital writers could be very limited.
In a big California hospital system, researchers tracked the work of 9,000 physicians for ten weeks. within the digital scribe pilot test.
Some doctors liked the scribe: their working hours were reduced, they communicated higher with patients. Others didn’t even start using the scribe.
And the person taking the notes made mistakes – for instance, writing down the incorrect diagnosis or writing down that a test was done when it must have been done.
So what should we do with digital writers?
This Recommendations the primary Australian National Citizens’ Jury on AI in Healthcare show what Australians expect from AI in healthcare and supply start line.
Building on these recommendations, listed below are some things to be mindful about digital scribes the following time you go to the clinic or emergency room:
1) You must be informed if a digital scribe is used.
2) Only healthcare-grade typescripts must be used in healthcare. Ordinary, publicly available generative AI tools (comparable to ChatGPT or Google Gemini) shouldn’t be utilized in clinical care.
3) You should have the ability to give or refuse consentto use a digital scribe. You must have all relevant risks explained to you and have the ability to freely agree or decline.
4) Those who create digital records for clinical purposes must meet strict privacy standards. You have the precise to privacy and confidentiality in healthcare. The entire record of a visit can contain way more detail than a clinical note. So ask:
- Are your meeting transcripts and summaries processed in Australia or one other country?
- How are they protected and secured (e.g. are they encrypted)?
- Who has access to them?
- How are they used (e.g. are they used to train AI systems)?
- Does the scribe have access to other data out of your record to make the summary? If so, is that data ever shared?
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Is human supervision enough?
Generative AI systems could make mistakes, get confused, or misunderstand the accents of some patients. But they often communicate these errors in a way that sounds very convincing. This signifies that close human review is important.
Doctors are told by tech and insurance firms that they need to check every summary or letter (and they need to). But that is not It’s that straightforward. Busy clinicians can turn into overly depending on a scribe and easily accept summaries. Tired or inexperienced clinicians might imagine their memory have to be incorrect and the AI have to be right (referred to as automation bias).
Some people have suggested these scribes must also have the ability to create patient summaries. We don’t own our own medical records, but we normally have the precise to access them. Knowing that a digital scribe is in use can increase consumers’ motivation to review what’s of their medical records.
Doctors have all the time written notes about our embarrassing problems and have all the time been accountable for those notes. Privacy, security, confidentiality and quality of those records have all the time been essential.
Perhaps at some point, digital scribes will mean higher records and higher interactions with our clinicians. But without delay, we want good evidence that these tools can work in real-world clinics without compromising quality, safety, or ethics.
