The growing use of artificial intelligence scribes by general practitioners (GPs) to automate note-taking during appointments carries potential risks to patient care, according to a new study. These AI tools, which convert spoken consultations into text and generate summaries, may miss vital non-verbal information such as facial expressions and gestures, potentially leading to incomplete medical records.
Around 40% of GPs are now utilizing these AI scribes, also known as ambient voice technology (AVT). While the technology aims to allow doctors to focus more on patients and reduce administrative burdens, researchers from the University of Edinburgh have raised concerns. Their review of 27 articles highlights that AVT primarily captures spoken words, overlooking nuanced communication that clinicians often rely on.
This "written language bias" means that potentially crucial information conveyed through tone of voice, movement, or emotional affect could be lost. Furthermore, the study suggests that patients might alter their behavior or withhold sensitive information, such as details about substance abuse, domestic violence, or mental health struggles, if they know an AI is listening. This lack of trust could lead to less disclosure and, consequently, poorer care, particularly for patients already marginalized in healthcare systems.
Academics noted that AI summaries tend to prioritize clinical data, sometimes at the expense of patients' personal narratives and their experiences of illness. This prioritization could disadvantage patients whose stories are not strictly clinical but are essential for understanding their overall health and well-being.
NHS England has encouraged the adoption of AVT, advising hospitals to deploy it quickly. However, they emphasize that doctors must meticulously review AI-generated notes and obtain patient consent before using the technology during appointments. The review in BMJ Digital Health and AI underscores the need for careful adaptation of these tools to clinical settings and a comprehensive understanding of their impact on healthcare work and organization.
Some physicians have reported not recognizing AI-generated notes and experiencing difficulties recalling patient details during subsequent visits. Medical Protection, an organization providing medical indemnity for doctors, acknowledges the benefits of AI scribes in reducing administrative tasks but reiterates the risks highlighted by the study. They stress that gestures, facial expressions, and tone of speech are critical for patient assessment and aid doctor recall.
Medical Protection advises doctors that they remain ultimately responsible for the accuracy and completeness of medical notes generated by AI. They recommend seeking informed consent from patients before using AI scribe tools, especially those involving third-party data sharing, and documenting this consent. Doctors should also receive adequate training on the limitations and data protection implications of AI scribes to effectively reassure patients about the use and storage of their personal information.