dr Matthew Hitchcock, a family doctor in Chattanooga, Tennessee, has an AI assistant.
It records patient visits on its smartphone and summarizes them for treatment plans and billing. He easily edits what the AI generates and is done documenting his daily patient visits in about 20 minutes.
dr Hitchcock spent up to two hours writing these medical notes after his four children went to bed. “That’s a thing of the past,” he said. “It’s great.”
ChatGPT style artificial intelligence is making inroads into healthcare and the grand vision of what it could bring is inspiring. Enthusiasts assume that every doctor will have a super intelligent companion who will offer suggestions on how to improve care.
But first come more everyday applications of artificial intelligence. A primary goal will be to reduce the overwhelming burden of digital paperwork that physicians must create by typing lengthy notes into electronic medical records required for treatment, billing, and administrative purposes.
For now, the new AI in healthcare will be less of a genius partner and more of a tireless writer.
From executives at major medical centers to primary care physicians, there is optimism that healthcare will benefit from the latest advances in generative AI — a technology that can produce everything from poetry to computer programs, often using human language skills.
However, doctors emphasize that medicine is not a wide field for experimentation. AI’s tendency to occasionally create inventions or so-called hallucinations can be amusing, but not in the high-risk realm of healthcare.
This clearly distinguishes generative AI from AI algorithms already approved by the Food and Drug Administration for specific applications, such as scanning medical images for cell clusters or subtle patterns that indicate the presence of lung or breast cancer. Doctors are also using chatbots to communicate more effectively with some patients.
Physicians and medical researchers say regulatory uncertainties and concerns about patient safety and litigation will slow adoption of generative AI in healthcare, particularly its use in diagnosis and treatment plans.
“At this point, we need to carefully choose our use cases,” said Dr. John Halamka, President of the Mayo Clinic Platform, who oversees the adoption of artificial intelligence in the healthcare system. “Reducing the amount of documentation would be a big win in itself.”
Recent studies show that doctors and nurses often report burnout, which causes many to leave the profession. At the top of the list of complaints, especially for general practitioners, is the time required to document electronic patient files. This work often extends into the evening hours, the work after office hours, which doctors refer to as “slumber time.”
According to experts, generative AI seems to be a promising weapon to combat the workload crisis among doctors.
“This technology is improving rapidly at a time when healthcare needs help,” said Dr. Adam Landman, Chief Information Officer for Mass General Brigham, which includes Massachusetts General Hospital and Brigham and Women’s Hospital in Boston.
For years, physicians have used various types of documentation support, including speech recognition software and human transcribers. But the latest AI does much more: It summarizes, organizes and marks the conversation between doctor and patient.
Companies developing this type of technology include Abridge, Ambience Healthcare, Augmedix, Nuance, which is owned by Microsoft, and Suki.
Ten doctors at the University of Kansas Medical Center have been using generative AI software for two months, said Dr. Gregory Ator, an ear, nose and throat specialist and the center’s chief medical informatics officer. The medical center plans to eventually make the software available to its 2,200 doctors.
However, the Kansas health system is eschewing the use of generative AI in diagnosis, fearing its recommendations may be unreliable and its rationale opaque. “In medicine, we cannot tolerate hallucinations,” said Dr. ator “And we don’t like black boxes.”
The University of Pittsburgh Medical Center was a testing ground for Abridge, a start-up founded by Dr. Shivdev Rao, a practicing cardiologist who was also an executive in the medical center’s venture division.
Abridge was founded in 2018 at the dawn of large language models, the technology engine for generative AI. The technology, said Dr. Rao, opened the door to an automated solution to the healthcare clerk overload he saw around him, even for his own father.
“My father retired early,” said Dr. rao “He just couldn’t type fast enough.”
Today, the Abridge software is used by more than 1,000 physicians in the University of Pittsburgh’s medical system.
dr Michelle Thompson, a family doctor in Hermitage, Pennsylvania who specializes in lifestyle and integrative care, said the software saved her nearly two hours a day. Now she has time to attend a yoga class or linger over a family dinner.
Another benefit is improving the patient visit experience, said Dr. Thompson. There are no more typing, note-taking, or other distractions. She only asks patients for permission to record their conversation on their phone.
“AI has enabled me as a doctor to be 100 percent there for my patients,” she said.
The AI tool, added Dr. Thompson adds, I’ve also helped patients become more engaged in their own care. Immediately after a visit, the patient receives a summary accessible through the University of Pittsburgh Medical System online portal.
The software translates all medical terms into plain English, about fourth grade reading level. It also provides a record of the visit with “medical moments” color coded for medications, procedures and diagnoses. The patient can click on a colored marker and listen to part of the conversation.
Studies show that patients forget up to 80 percent of what doctors and nurses say during visits. The recorded and AI-generated summary of the visit, said Dr. Thompson is a resource her patients can access to remind themselves to take medication, exercise, or schedule follow-up visits.
After the appointment, physicians receive a summary of the clinical notes for review. There are links back to the doctor-patient conversation log so the work of the AI can be reviewed and verified. “That really helped me build confidence in AI,” said Dr. Thompson.
In Tennessee, Dr. Hitchcock, who also uses Abridge software, read reports that ChatGPT scored high on standard medical tests and heard predictions that digital doctors will improve care and solve staffing shortages.
dr Hitchcock tried ChatGPT and was impressed. But he would never, for legal, regulatory, and practical reasons, upload a medical record to the chatbot and ask for a diagnosis. For now, he’s grateful to have his evenings off and no longer bogged down in the tedious digital documentation that the American healthcare industry demands.
And he sees no technological solution to the shortage of healthcare workers. “AI isn’t going to fix that any time soon,” said Dr. Hitchcock, who wants to hire another doctor for his four-doctor practice.