Within the next few years, patients will go to their primary care facility for a medical problem. They'll be greeted by a nonhuman who speaks in the language of their choice. Based upon the initial interview, which will be taken in note form, the patient will be diagnosed, and a prescription called into the pharmacy. They'll pay the robot at a reception kiosk, and their meds will be delivered via driverless car.
Or so suggests Allan Stewart, MD, medical director and chief of cardiothoracic surgery at HCA Florida Mercy Hospital in Miami.
The writing is on the wall. Artificial intelligence (AI) is only going to play a more significant role in healthcare, and the entire patient experience will be much different in the next 5 years, he told Medscape Medical News.
If that sounds far too futuristic, buckle up. AI is already here and being used by most medical specialties. However, it's primary care that stands to gain the most from this technology — right now — thanks to its ability to radically streamline patient care.
Seeing the Doctor and His or Her AI Assistant
AI is making doctors' work lives easier, whether the technology helps with risk prevention and intervention or closing care gaps. It can also triage patient complaints, monitor patients remotely, or even perform digital health coaching to keep patients on track with their lifestyle regimens or monitor their health conditions.
Each of these AI components enables primary care physicians to reduce some of the paperwork requirements of their jobs and do what they were trained to do — listen and assess patients. Doctors currently spend 12 hours on average each week submitting prior authorization requests, according to an American Medical Association survey.
"Primary care can be overwhelming, especially today, with the advent of electronic records and data," said Davin Lundquist, MD, a family medicine physician and chief medical officer at Augmedix, an automated medical documentation company that provides tools to reduce clinician burnout. "The amount of data we have to go through to try to get a complete and clear picture of our patients can be overwhelming on top of the referrals, administrative burdens, and regulatory requirements, which seem to be focused on the primary care space," Lundquist said.
With an AI assist, primary care physicians can reduce their prep and pre-charting time, lessen the time needed for paperwork outside of clinic hours, and streamline information, including access to lab results, radiology reports, and consults.
"AI is already helping doctors manage their practices, make differential diagnoses, and input progress notes or histories," said Stewart.
In Seattle, Ford Parsons, MD, chief of operational analytics at Providence Hospitals in Seattle, has been leading a generative AI project that recently developed a tool called Provaria to prioritize incoming messages from patients. The tool ensures that those with more urgent needs get immediate attention, and it supports the personnel who lead the responses.
The process begins with Provaria reviewing patient messages to ensure those with more urgent needs, such as a mental health crisis, get immediate attention instead of answering messages in the order they were received.
Provaria also provides resources to help responding staff craft a reply. If a patient's message cites back pain, for example, the system might suggest a referral to a physical therapist, include a link to that department, and prompt the staff to ask about red flags that indicate a more urgent situation.
After an initial rollout, Providence recently deployed Provaria to manage the messages for all 4000 of its primary care, family medicine, and internal medicine providers. The system has reviewed and categorized more than 500,000 messages so far.
"This is another example where AI can increase the human connection in healthcare," Parsons said. "That's the opposite of what others are saying, but by using AI, you can automate the stuff that isn't critical that doctors have wound up doing."
AI Helps Foster Better Person-to-Person Communication
In recent years, the first thing most doctors do when they enter the exam room with a patient is log into the in-room computer and start to take notes — which can be off-putting to patients.
Now devices can ease this process, such as PLAUD, an AI voice recognition device that attaches to a cell phone. Just the size of a credit card, the device enables conversations to be easily recorded. It not only streamlines note-taking but also enables a physician to listen intently to a patient's concerns instead of furiously jotting down notes.
"That device is already helping transcribe conversations into notes and then into a patient's electronic medical record," Stewart said. "This helps save doctors the work of having to input patient information."
AI Can't Be a Compassionate Human
The one thing AI can't do is show compassion, at least not yet. The someday "vision" when a robot will gather intel about a patient's symptoms and even offer a diagnosis does have some downsides. There is no replacement for human interaction, especially in the case of dire health news.
"If you have signs of a metastatic cancer and a nonhuman is delivering this news, there's no way AI can share this news with compassion," said Stewart.
For now, AI is becoming instrumental in helping reduce the number of extra demands on primary care doctors, as well as physicians in other specialties, so that they can continue focusing on what matters — healing patients.
Lambeth Hochwald is a New York City-based journalist who covers health, relationships, trends, and issues of importance to women. She's also a longtime professor at NYU's Arthur L. Carter Journalism Institute.