If we try to digitise every last element of the patient/clinician encounter, we may lose the quality of the original conversation that made it useful in the first place.
There’s going to be a lawsuit in the future where a patient and doctor’s recollection of the visit differ, and the patient will pull out their AI scribe and say: “Yes, it happened – here’s the note my AI scribe took.”
The doctor will load up their note in the EHR and say: “We have an AI scribe too … and no, that didn’t happen, look at MY note.”
And unless one or more of the parties can pull out an actual verified recording (which usually is not being stored by ambient companies), it’s going to be a “he said, she said” situation.
Now, this isn’t a huge risk right now because most patients aren’t bringing AI scribes to their encounters. BUT this will be inevitable as consumers bring AI scribes on their phones to all kinds of other situations.
It makes me wonder how this will change the clinician/patient engagement.
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On the one hand, there will be good that comes out of all this ambient documentation.
If AI is always turned on, and a clinician knows they can’t simply “edit the only version of the note after”, there’s a new safety net. Clinicians who were not truly explaining both risks and benefits of a treatment will, all of a sudden, do proper shared decision-making and consent.
Those who haven’t been compassionate will likely change their tune as well. And the very small minority of bad actor clinicians who might have harmed a patient will absolutely think twice.
On the other hand, I wonder if the constant presence of AI police will negatively affect what historically would’ve been considered tough and direct but helpful communication from a clinician.
Maybe clinicians will become worried about coming off as too direct and harsh, and then start diluting how they advise and coach patients.
We’ve all seen the effects of scribes during our non-clinical work meetings – the moment you know you’re being recorded … it’s just different. You’ve got to watch what you say, “just in case” it gets taken out of context later.
At this point, the train has left the station. And in a world where lawsuits can (and unfortunately will) happen, the risk of being on the pointy end of one will make the patient/clinician encounter increasingly conservative. Lawsuits will happen where a health systems lawyer is going to create a policy that increasingly controls what clinicians can and can’t say to a patient.
I wonder if we will end up in a world where conversations start off like this:
“Hey Ms Smith – we can either both turn on our AI scribes, or we can be old school and keep them off. It’s your choice, but know that if the AI scribes are on, there are certain things I just won’t be allowed to say. What do you want to do?”
I genuinely hope that doesn’t happen.
There’s something special, important, and sacred about the patient/clinician relationship, and a lot of that lives within the actual live visit. If we try to digitise every last element of it, we may lose the quality of the original conversation that made it useful in the first place.
Dr Joshua Liu is a Canadian physician turned cofounder/CEO of SeamlessMD, a health tech company which enables CMIOs, CIOs and health systems to digitise patient care journeys with automated reminders, education, and symptom monitoring – leading to lower length of stay, readmissions and costs.
This article was first published on Dr Liu’s LinkedIn feed. Read the original article here.