Having a technology that goes with you from meeting to meeting and transcribes notes from all interactions would be welcome in almost every profession. In medicine, it could greatly ease administrative burden around patient care.
Artificial intelligence (AI) medical scribes are already being developed and implemented in practices, and both manufacturers and providers believe they could play an even more efficient and effective role.
“Documentation burden is a huge burden on family physicians [and] pretty much every physician,” said Steven Waldren, MD, MS, chief medical informatics officer of the American Academy of Family Physicians (AAFP).
Swapping Paperwork for Audio Recordings
“On average, a clinician will spend 2 hours on administrative work for every 1 hour of actually interacting with patients, and one of the big drivers of that is clinical documentation. So, the concept of the AI scribe that can help alleviate that load is something that we as an organization have tackled now for a handful of years,” said Rebecca Schechter, senior vice president and general manager for the Dragon Ambient eXperience (DAX) with Nuance.
Nuance, which was purchased by Microsoft in 2021, has been developing speech recognition and voice dictation software since the 1990s. Its DAX Copilot software builds on this technology with a smartphone-based solution that converts conversations between clinicians and patients into a structured, clinical note immediately after the visit that can be integrated into the electronic health record (EHR). Schechter said this saves an average of 7 minutes per encounter, reducing documentation time by 50%, and allows for an additional five appointments per day.
Atrium Health, which has approximately 11,000 doctors and 22,000 nurses across 40 hospitals and hundreds of practices in North Carolina, South Carolina, Georgia, and Alabama, has integrated DAX Copilot into its primary care practices. Results of a survey of Atrium Health providers discussed at the HLTH 2023 Conference in Las Vegas in October showed that 84% reported an improved documentation experience and 85% said they would be disappointed if they no longer had access to DAX Copilot.
“One of the doctors that used DAX Copilot as part of the private preview said to me, ‘I can't believe this is my life now,’ and it’s because he’s not going home after a full day and having to remember what happened in appointment number three and having to type and review it,” said Schechter.
AI Scribes May Soon Come with Video, Too
While using AI medical scribes to record audio conversations between clinicians and patients can reduce administrative work, Vik Moharir, MD, CEO of ScribeLink, said the possibilities with these technologies is greater if video is captured. The San Jose, California-based company is developing a tool to do just that.
“Until one can get high-quality information from the bedside as the physician is treating the patient and return results in real-time, artificial intelligence systems and live scribes will not be able to reach their full potential,” said Dr. Moharir.
To date, ScribeLink has successfully finished beta testing to do just that and the next step is to “refine our solution for scaling,” he shared. The combined communication and video technology should enable scribes to gain context of the situation to allow for better documentation, he added.
As for the DAX Copilot program, Schechter said that solutions in the works include a natural language interface where clinicians can customize the AI to do things like convert paragraphs into bulleted form, bold sections, and change all pronouns from “he” to “she,” and so forth.
Is an AI Scribe Worth It? Docs Share Experience
While some medical practices have historically been able to overcome documentation challenges using human scribes, Dr. Waldren pointed out they are “very expensive” and often come with all the tangible challenges of hiring and retaining an additional employee.
To understand how clinicians are using these evolving technologies today, Dr. Waldren said the AAFP has been talking with physicians about their experience. In some instances, Dr. Waldren noted that, if a practice is proficient in using its EHR and efficient in documentation, then the gains from AI may not be worth the extra effort and cost.
“That was the main reason that we heard people decide not to go ahead with the technology after they tried it,” he said.
The AAFP also has a resource center that offers non-scribe based techniques for family physicians to reduce documentation burden. For those who are trialing scribes and other forms of AI technology, the organization has released a set of principles for ethically applying the tools in family medicine.
“That lays out some of those things that are really important because there is also potential for peril for these technologies if they’re not done in an accurate way and if they increase bias,” said Dr. Waldren.
Disclosures: None reported.
