In a recent report in Medscape (June 23, 2023) on a clinical study, patients and providers agreed that AI applications that are of the highest priority in primary care involve support for clinical documentation, practice operations, and triage, as well as support for clinical decision-making. Surprisingly, patient education was not on the list.
Patient education is one area where AI chatbots are already beneficial. They will probably become the preferred option for patient medical education, due to their ease of access and time availability. One example is for patients undergoing a colonoscopy, the chatbots can provide education about what they can expect both pre- and post-procedure. And it can even send a series of text messages to encourage proper preparation for the colonoscopy, resulting in better outcomes.
Here’s one real life example of the results of patients interacting with either a healthcare professional or an AI chatbot. Of the 195 questions and responses, evaluators preferred chatbot responses to physician responses in 78.6% of the 585 evaluations. Physician responses were significantly shorter than chatbot responses (on average 52 words vs. 211 words). Chatbot responses were rated of significantly higher quality than physician responses. The proportion of responses rated as good or very good quality, for instance, was higher for chatbot than physicians. This amounted to 3.6 times higher prevalence of good or very good quality responses for the chatbot. Chatbot responses were also rated significantly more empathetic than physician responses. The proportion of responses rated empathetic or very empathetic was higher for chatbot than for physicians. This amounted to 9.8 times higher prevalence of empathetic or very empathetic responses for the chatbot.
In another cross-sectional study in an online forum, a chatbot generated quality and empathetic responses to patient questions. Further study is needed to see if AI can support patients in clinical settings. Chatbots could draft responses to patients’ questions, which could then be edited by a healthcare professional. Additionally, AI assistants might improve responses to patients’ questions, lower clinician burnout, and improve patient outcomes.
Other ways Generative AI can help in medicine:
Summarizing data: This could be useful for summarizing lengthy and extensive patient charts. This is especially valid when providing medical information to other healthcare professionals and insurance companies.
It can also be used to summarize a patient encounter and enter it into an EMR, much like a medical scribe. For example, Well Health has announced an AI Voice software, that is described by the company as an “ambient scribe” which listens to the patient encounter and generates a “succinct and medically relevant chart note.” It’s currently being integrated with OSCAR Pro for testing.
Virtual Health Care: This is especially of interest to patients who live in rural areas with limited access to healthcare, or to those with mobility issues who are challenged to attend appointments in person. However, at least in Ontario, with pharmacists having extended authority for prescribing medications for certain conditions and Ontarioans also having access to telehealth, this could be less important.
Personalized Treatment Plan: If you trust it, ChatGPT is capable of providing personalized treatment plans for patients, taking into consideration the patient’s specific needs and preferences. A more likely scenario is that ChatGPT could listen to the patient encounter and then provide a summary of the physician’s comments and instructions. This would help patients to remember accurately what was discussed in the encounter, and likely would lead to improved compliance with physicians’ instructions.
Administration. Dealing with the ever-mounting mounds of paperwork, ChatGPT is also capable of writing letters, and perhaps even capable of filling in forms for employee health, insurance companies and camp physicals. One real life example of this is a physician who asked it to write a letter to an insurance company to approve an echocardiogram for a patient with scleroderma. It even provided two medical references to substantiate the information it provided in the letter. However, the physician did later caution that all references should be checked personally and suggested that you cite your own.
Mental Health Initiatives. Another use of ChatGPT is to support mental health initiatives. Seniors and other adults who are isolated often feel lonely. Several years ago we encountered an early AI powered “robot” that could be accessed via the Internet. It responded to questions and then asked its own questions. It could remember details specific to each person it chatted with, such as children’s names and hobbies. While not nearly as impressive as today’s AI options, it still was effective in helping people feel less alone, leading to improved mental health. Today there is ElliQ, touted as “the sidekick for healthier, happier aging”. It can remind someone to do their stretching exercises, take their diabetes medication and even ask how you slept last night. It can help with isolation and loneliness, as well as with improving general health.
Improving Nurses’ Utilization: From the Tampa Bay Times, “Two of BayCare’s 16 Florida hospitals are now equipped with voice technology, enabled by Amazon’s voice assistant Alexa and health tech firm AVIA, that allows patients to communicate needs directly to the appropriate nurse’s phone rather than pressing the call button.” It can also help with lighting levels and other patient needs.
Prior Authorization Requests: According to Harvey Castro, MD, one of AI’s best utilizations is to expedite the process of verifying insurance coverage for diagnostic tests, prescription medications, or other therapies. This could drastically reduce wait times for patients from days to mere minutes! And drastically improve patient healthcare outcomes.
Analyzing Radiology Images. AI can review existing images, but not replacing a radiologist reading the images. AI can use this date to find additional information about the patient, that are not related to the primary reason for the investigation. One such study was reported in MedScape by F. Perry Wilson, “What AI Can See in CT Scans That Humans Can’t”.
Other Options. And, of course, there are all the mundane tasks that AI can do, such as appointment scheduling, following up on lab and imaging requisitions, and even accessing different patient portals to populate the information into an EMR. That would be a big time saver for physicians. Removing the burden of paperwork and administration would be an excellent use of AI and ChatGPT.
However, in June 2023 in Medscape, Paolo Sipriano wrote “Despite optimism for the use of AI in primary care, there has been no comprehensive review of the contribution made by AI so far, and there is little guidance on how it should proceed.”
Still, AI can not only help with healthcare decisions and diagnoses, it can also help with managing costs, planning and best use of resources.
For more articles in the series on Artificial Intelligence, go to:
- An AI (Artificial Intelligence) Primer
- AI Achievements
- ChatGPT (or any AI bot) and Your Medical office
- Teaching AI in Medical School
- Patient Trust in AI Chatbots & ChatGPT
- Competitors to ChatGPT
- AI Policies and Regulatory Challenges
- Ai Bias
- AI’s Limitations, Concerns and Threats
- What AI Can’t and Shouldn’t Do
- AI and Accountability
- The Dangers of AI
- The Future of Generative AI
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