Electronic medical records (EMRs) are providing tremendous benefits to laboratories across the country because they create secure patient history databases that clinicians can easily access and update. But it can also hurt the doctor-patient experience, as doctors have to enter notes into the system instead of giving their full attention to the patient.
To help doctors get back in front of their patients and away from their keyboards, UC Davis Health has introduced an artificial intelligence (AI) scribe that automatically records and transcribes conversations during consultations. These systems store detailed medical records so doctors can focus on their patients.
In preparation for the rollout of digital tools, UC Davis Health conducted a comprehensive survey to assess patient perceptions of this technology. The results, which demonstrate how Scribe was implemented, were recently published in the Journal of Medical Internet Research (JMIR) Medical Informatics.
“We didn't know how patients would respond to these AI transcriptions,” said Gary Leizerowitz, chair of obstetrics and gynecology and lead author of the paper. “There was little information from other facilities, so we worked with our patient experience colleagues to understand how patients felt about it.”
Survey results
The survey was emailed to more than 9,000 patients and approximately 1,900 responded. While 73% felt listened to during clinical visits, 23% of physicians said they were more focused on taking notes than on themselves.
“Many people feel that medical documentation is a necessary evil, but they don't like the idea of doctors sitting at a computer trying to record everything they say,” says Leizerowitz. “They feel like that connection has been lost.”
In the survey, 48% of respondents reported that AI scribes are a good solution, while 33% are neutral and 19% have concerns. Younger patients (18-30 years) were more skeptical about the technology than older patients.
Patients were primarily concerned about the accuracy of their notes (39%), privacy and security (13%), and the possibility of being recorded (13%). Many related comments expressed concern that the recordings could be hacked. About 10% felt it had a negative impact on doctors and staff.
Seamless transition
When asked when is the best time for patients to be informed during their care experience that digital tools will be taking notes, patients strongly supported early notification. Patients wanted to know when they made an appointment, arrived at their doctor's office, or checked into their doctor's office. Most (57%) preferred to be notified in person, but many (45%) were fine with email.
The results of the study provided UC Davis Health with valuable guidance on how to inform its transition to AI scribes. The team incorporated multiple educational touchpoints to gain consent and prioritized face-to-face discussions with patients.
“One of the key takeaways from the study is the need to educate patients about what AI scribes can and cannot do,” Leiserowitz said. “Security was a key issue, so when vetting vendors, we ensured they only used domestic servers.Also, while AI notes are sent to the EMR, the records themselves are erased within 10 days.”
Additionally, to ensure complete accuracy, clinicians check and edit notes before entering them into the EMR. Patients can also discuss and advise their doctors on possible modifications. Finally, if patients are not satisfied with the system, they can opt out.
At UC Davis Health, a dedicated analytics oversight committee reviews all advanced analytics models (including AI-powered models) used for clinical decision-making. The goal of this committee is to develop a streamlined and innovative approach that ensures that medical AI is implemented responsibly, ethically, and effectively, always keeping the best interests of patients and communities in mind.
“This is often due to the quality of the relationship between doctor and patient,” says Leizerowitz. “If patients trust us and understand why we're using it, they're more likely to accept it. That's why education is such an important element. It helps patients get used to the technology.”
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