The next time you go to a local emergency department, don't be surprised if the doctor has some high-tech help taking notes about your case. A University of Alberta team of researchers is testing an artificial intelligence scribe tool to take notes and summarize interactions between physicians and their patients.
The goal is to ease the administrative burden of record-keeping on doctors so they can focus on delivering better patient care, according to project lead Jake Hayward, assistant clinical professor, emergency physician and deputy clinical head of quality improvement with Alberta Health Services.
“The main idea is that by taking away the time pressure and the cognitive pressure of generating your notes by manually typing and always trying to remember the encounter, you can be more present as a physician with your patient,” Hayward explains. “You can have more direct eye contact and more time for the physical exam — all of the more compassionate and empathetic elements of patient care — by alleviating some of the documentation burden.”
Hayward and his team have been awarded $1 million as part of the Health Care Unburdened Grant Program, presented by the Canadian Medical Association, MD Financial Management Inc. and Scotiabank, to pilot test the tool.
An assist, not a replacement for doctors’ expertise
The Alberta scribe tool was first created by Michael Weldon, an emergency doctor and engineer based in Red Deer. The program uses artificial intelligence based on large language models — of the same sort used to power popular AI tools like ChatGPT — to transcribe and summarize the meaning of the conversation. The note generated from an emergency department visit includes details about the history of presenting illness, past medical history, a summary of medications, results of the physical exam, the diagnosis and treatment plan.
It’s then up to the doctor to ensure the record is accurate and sign off before it’s added to the patient’s chart. Similar tools are commercially available and widely used in the U.S. health-care system, but there are not yet any guidelines for their use in Alberta hospitals. Hayward plans to develop that guidance to doctors, administrators and the public.
“It’s an assist with note-taking,” Hayward underscores. “It’s not a replacement for the doctor’s responsibility and ability to make a diagnosis and come up with a treatment plan.”
Feedback from patients and physicians
Hayward’s two-year project will have three phases: first, to refine Weldon’s tool to ensure it meets all of the needs of Alberta emergency departments; next, to create patient consent forms and data security rules that meet the same standards as Alberta’s electronic medical records system; and finally, to pilot test the program in three emergency departments at the Red Deer Regional, Royal Alexandra and University of Alberta hospitals.
The research team includes Weldon and Ross Mitchell, professor of medicine and fellow and Canada CIFAR AI Chair at the Alberta Machine Intelligence Institute. In partnership with Alberta Health Services, they will consult with patients and emergency doctors to understand the impact of implementing the AI scribe tool.
“We’re going to measure cost-effectiveness and outcomes — things like how many people decide to use the tool, how often they use it and whether it improves their experiences,” Hayward explains. “We will get feedback from physicians: Did you perceive that it improved your care? Did it save you time? Did it reduce your levels of stress and burnout at the end of a shift?”
Hayward says new technologies, such as Alberta’s recently introduced electronic health record, are often met with trepidation within the health-care system because they require additional skills and time. He sees the AI scribe as a “second wave” of new technology that will actually help to ease that burden.
“We see a lot of burnout in our medical system overall and in particular in the emergency departments, where we’re really struggling to attract and retain people because it’s such a difficult place to work,” Hayward says.
“I think a big part of improving the health-care services in our province is paying attention to the service providers themselves, what they want and need, and trying to find solutions that enable them to be the best versions of themselves at work.”
Hayward says once Alberta’s AI scribe tool has been tested, the team plans to share the code as open source so it can be adopted by as many physicians as possible.
