AI Scribes Part 2: Clinicians Want Better Tools

Read part 1 here

Image credit: © VetalStock - stock.adobe.com

The Growing Demand for Advanced Technology Solutions in Clinical Practice

In today’s rapidly evolving health care landscape, clinicians face mounting pressures that extend far beyond patient care. The need for efficient, accurate, and user-friendly technology solutions is long overdue. As health care demands grow, so does the need for better tools that can streamline operations, reduce burnout, and ultimately improve patient outcomes.

The Reality of Modern Clinical Practice

In 1972, the first electronic medical record (EMR) was created. Since then, clinicians have found themselves increasingly trapped by administrative duties. Now, clinicians dedicate a staggering 35% to 37% of their time to documentation tasks. For primary care providers and specialists, this translates to 16 minutes of every patient visit spent on EMR duties. This has led to widespread dissatisfaction, with technology often viewed as a burden rather than a benefit.¹

The frustrations with current systems are not merely anecdotal. Studies have shown that the overwhelming administrative burden placed on clinicians is a significant contributor to burnout—a troubling problem in the healthcare industry. Burnout affects the well-being of healthcare professionals which directly impacts the quality of care provided to patients.^2,3

The Rise of AI Medical Scribes

One of the most promising advancements in addressing these challenges is the development of AI medical scribes. These advanced tools leverage technologies like speech recognition, natural language processing (NLP), and machine learning to automate the documentation of clinical encounters in real-time. By accurately transcribing clinician-patient interactions into structured medical records, they handle complex medical jargon and medication details with ease.

When I was invited to participate in an AI Scribe-a-thon hosted by XPC, a primary care innovation community founded by Dr. Paulius Mui, Dr. Kenneth Qui, and Dr. Dave Nichols, I jumped at the chance. The AI Scribe-a-thon was a unique virtual event spanning several days, inviting clinicians from across the United States to explore the cutting-edge capabilities of AI-powered medical scribe platforms. Over 3 exhilarating days, I tested 5 advanced AI scribe platforms: HealthNote, ChartNote, AVO, Empathia.ai, and ScribeMD. What I discovered was nothing short of remarkable. These weren’t your run-of-the-mill transcription services; they were intelligent systems designed not just to transcribe but also to organize and write notes, setting a new frontier in medical documentation.

As the event kicked off, a palpable energy filled the 70+ group consisting of an interdisciplinary mix of health care professionals, with 62.2% being physicians, followed by nurse practitioners (NPs), physician associates (PAs), pharmacists, medical students, and others.

How AI Scribes Meet the Growing Demand

The appeal for clinicians is clear: by reducing the time spent on documentation, AI scribes allow clinicians to focus more on patient interaction. They promise to drastically reduce the time clinicians spend on documentation, allowing them to refocus on patient care—a vital shift in an industry where time is one of the most precious resources. This shift potentially can improve the efficiency of health care delivery and reduce the administrative burden.⁴

During the event, I had a mock patient share a long history. As I listened, a feeling of relief washed over me: “I know this is all being captured.” I found myself refocusing on the human connection and remaining present. What a feeling!

Ethical Considerations and Challenges of AI Medical Scribes

Despite their impressive capabilities, the reliability of AI medical scribes in capturing nuanced and complex medical information at scale remains uncertain. There were a few instances where the AI provided false information about a patient case, known as a hallucination and well-documented problem. Another argument is that clinicians could become overly dependent on AI scribes, leading to a potential loss of critical documentation skills.

Patient data security is a paramount concern with AI scribes. While current measures, such as encryption and secure data storage, aim to protect patient information, experts argue that these may not be adequate to address all potential threats.

A key ethical debate revolves around whether patients should be informed about the use of AI scribes in their care. Current standards and practices regarding AI use in healthcare emphasize the importance of transparency and obtaining patient consent. Ensuring that patients are fully aware and agreeable to AI involvement in their care is crucial for maintaining trust and ethical integrity.

Determining accountability when an AI scribe makes a mistake is also complex. Should the clinician, the AI developer, or both be held responsible? Legal precedents and potential policy frameworks need to address these issues comprehensively. The ethical implications of errors made by AI scribes necessitate clear guidelines to protect patients and clinicians and ensure fair accountability.

Startups and Clinicians Leading the Way

Earlier this summer, the XPC community kicked off with an EMR Scavenger Hunt, which served as a springboard for innovative thinking and problem-solving in clinical settings. This month’s AI Scribe-a-thon, which doubled in participants, has become increasingly interdisciplinary, drawing in experts from various fields to collaborate on refining these AI tools. XPC co-founder Dr. Paulius Mui said, “These learnings have provided the necessary insights to open up XPC Clinic, a dedicated space designed to facilitate these types of collaborations on a continuous cycle. We aim to keep the momentum going with an increasing demand from both startups developing technology for clinicians and clinicians who want to shape technology that will impact patient care.” Dr. Paulius Mui continued, “XPC Clinic aims to combine medicine, technology, and education to advance primary care in the U.S.”

Embracing the Future of Healthcare Technology

As I reflect on my experience with these AI scribes and the growing engagement of clinicians advocating for a better healthcare system, I’m filled with optimism for the future of clinical practice. These newer technologies promise to free up more time for what matters most—direct patient care. However, it remains uncertain whether their lofty promise of reclaiming the heart of medicine—the sacred relationship between clinician and patient—can truly be achieved, or if this will become another broken promise, like the EMR’s flawed implementation in medicine. One thing is certain: there is a growing group of clinicians demanding change, and that’s a future worth getting excited about.

Michael Rubio, PA-C, is a dermatology physician associate (PA) at Infinity Dermatology in Brooklyn, NY. He is the vice co-chair of the Society of Dermatology PAs (SDPA) Communication Committee and a contributor to the National Commission on Certification of Physician Assistants (NCCPA) development of the Certificate of Added Qualifications (CAQ) in Dermatology. He is also a co-founder of Well Revolution (www.wellrevolution.com), a same-day direct primary care platform helping to address the primary care shortage crisis in the United States.

References

1. Atherton J. Development of the electronic health record. Virtual Mentor. 2011;13(3):186-189. Published 2011 Mar 1. doi:10.1001/virtualmentor.2011.13.3.mhst1-1103
2. Tawfik DS, Scheid A, Profit J, et al. Evidence relating health care provider burnout and quality of fare: a systematic review and meta-analysis. Ann Intern Med. 2019;171(8):555-567. doi:10.7326/M19-1152
3. National Academies of Sciences, Engineering, and Medicine; National Academy of Medicine; Committee on Systems Approaches to Improve Patient Care by Supporting Clinician Well-Being. Taking Action Against Clinician Burnout: A Systems Approach to Professional Well-Being. Washington (DC): National Academies Press (US); 2019 Oct 23. 4, Available from: https://www.ncbi.nlm.nih.gov/books/NBK552615/
4. Tierney AA, Gayre G, Hoberman B, et al. Ambient artificial intelligence scribes to alleviate the burden of clinical documentation. NEJM Catal Innov Care Deliv. 2024;5(3). doi:10.1056/CAT.23.0404