AI may eavesdrop on your next doctor’s appointment

Written by Michelle Crouch

Co-published with Charlotte Ledger

Every time pediatrician Jocelyn Wilson sees a patient at Atrium Health Levine Children’s Charlotte Pediatrics, she begins with a simple request. That means getting permission to record the conversation.

The reason is efficiency, not oversight.

Like a growing number of doctors, Wilson is using artificial intelligence tools to listen to conversations with patients. They can then be converted into clinical visit summaries that can be reviewed, edited, and uploaded to the patient’s medical record in just minutes.

the goal? To help doctors spend less time on paperwork and more time caring for their patients.

“I’ve never really liked using the computer when I’m in the exam room…I just feel like it’s not very immersive,” Wilson said. “You don’t have to write anything anymore. You can make direct eye contact.”

She said the AI ​​tool, known as DAX Copilot, saves her more than an hour per day entering appointment details into patients’ medical records.

While health systems are using AI in many ways behind the scenes to reshape care, these “virtual writing” tools are among the most visible to patients, bringing AI into the exam room. be introduced directly.

More than 1,500 Atrium Health physicians are licensed to use DAX Copilot, an Atrium spokesperson said. At least three other systems in North Carolina use similar technology: Novant Health, UNC Health and Duke Health.

The platform is similar to the AI ​​tools that many other industries, from finance to marketing, have adopted to streamline tasks like note-taking and summarizing information.

AI tools are not perfect

However, AI assistants aren’t perfect, and healthcare providers are grappling with some of the same challenges they’re experiencing in other industries.

Research shows that speech recognition programs do not always understand racial minorities, people who speak English as a second language, and people with language disorders. The tool can also misinterpret information or fabricate responses, a phenomenon known as hallucinations, highlighting the need for physicians to review the overview.

“Human involvement is essential to properly evaluate these tools and ensure they are effective for all types of patients and physicians,” says Alison Koenecke, assistant professor of information science at Cornell University. , his research uncovered problems with AI-generated medical notes.

Health systems must also address patient concerns about privacy and ensure they explain how the software works so patients can make informed decisions about whether to participate.

What patients can expect

Atrium is the first healthcare system in the country to test DAX Copilot (short for Dragon Ambient eXperience Copilot), a platform developed by Microsoft subsidiary Nuance. The software installs a secure app on the doctor’s smartphone that performs the recording.

Wilson piloted an early version, which she described as “a little clunky.” But she said the latest version is incredibly accurate and she’s been using it consistently for the past few months.

Here’s how it works: Before entering the room, Wilson records a short note about the patient and the reason for the visit.

Once inside, she introduces herself and explains the process, saying: If you’re okay with that, please sit here and listen to our conversation. ”

So far, no patient has refused.

Wilson then placed the phone on the counter and never touched it again until she left and stopped recording. Within minutes, the software sends a summary of the visit to her computer for her to review and edit.

How to treat physician burnout?

In a perfect world, doctors would have time between visits to update their notes while the details are still fresh in their minds, Wilson said.

“But the reality is that you may be in the room longer than expected, and there may be two or three additional patients waiting to be seen,” Wilson said. “And when you have five or six patients in the hospital and you haven’t started anything[with notes]that internal pressure starts to build. You’re worried that you’re going to forget something, and you’re wondering how long it will take to get it back. I feel stressed.”

Wilson said DAX Copilot has significantly reduced the stress of incomplete notes. She’s waiting for a draft summary instead of staring at a blank screen.

“It’s much easier to edit your notes than it is to start writing them,” Wilson says.

Since she started using the technology, she said, she has more time to take lunch breaks, exercise, and make dinner instead of “writing notes until bedtime.”

When the clinic is busy, DAX Copilot can also be used to focus more patients in a day, she said.

Burnout is a crisis among physicians across the United States, with nearly half reporting symptoms by 2023, largely due to increased documentation burdens. A 2020 Mayo Clinic study found that doctors spend an hour or two outside the office writing necessary notes from patient visits, cutting into personal and family time.

According to a study published in JAMA Network Open, 47% of Atrium Health physicians using DAX Copilot reported a significant reduction in the time they spent on documentation at home.

Eric Poon, chief medical information officer at Duke Medicine, was also an early tester of DAX Copilot technology in his primary care practice.

After years of being late to appointments, he said the tool has made him much more efficient.

This three-part NC Health News/Charlotte Ledger series examines how artificial intelligence is shaping health care in the state.

Now: Doctors are using “virtual scribes” to take notes, raising privacy concerns.
Tuesday: How North Carolina health care providers are leveraging AI.
Wednesday: How state regulators are approaching the use of AI in healthcare.

“Since I started using this technology about a year ago, it has actually allowed me to get away from the keyboard and have a more intimate conversation with my patients in a natural way, without having to pick up a telegram while I’m talking to a patient. ” he said. “So, guess what? For the first time in my clinical career, I’m able to finish my appointment on time.”

Poon said about 50 doctors at Duke University have been trained in DAX Copilot so far.

Privacy and accuracy concerns

According to a 2024 study, approximately 70% of patients nationwide are uncomfortable with doctors using AI during appointments. However, public opinion polls show that there is some resistance among patients, with just over half saying that healthcare AI is “a little scary” and 70% expressing concerns about data privacy.

Now that any phone or computer can be hacked, some patients worry about where their recordings will end up. Atrium said the DAX Copilot app on a doctor’s phone can only be accessed through biometric or password authentication, and the records disappear once the doctor approves the associated AI-generated clinical record.

When it comes to accuracy, Koenecke said it’s important for doctors like Wilson to carefully review AI-generated content to ensure it’s correct.

Her research into Microsoft’s speech-to-text tools revealed that black speakers had twice the error rate as white speakers. We also looked at non-Microsoft models and found examples where the technology omitted facts or fabricated content. For example, in one case, we invented a drug that didn’t exist called a “hyperactivated antibiotic.”

As with many AI technologies, the success of these virtual scribes will likely depend largely on how they are implemented, Koenecke said. Will they be used to ensure enough time for screening and review and reduce physician burden, or will hospitals deploy them to allow physicians to see more patients and increase revenue? ?

Without proper oversight, Koenecke said, AI assistants “could cause tremendous downstream damage, especially for certain groups whose voices are not well captured by these tools.” “How do we make sure that already overworked workers don’t just skim and click OK?”

NC Health News reporter Emily Vespa contributed to this report.

This article is part of a partnership between The Charlotte Ledger and North Carolina Health News to produce original health care reporting focused on the Charlotte region. You can support this effort with a tax-deductible donation.