Annual OntarioMD conference highlights the growing use of AI scribes

MISSISSAUGA, ONT. – Many of the discussions at the annual OntarioMD conference – held in September – focused on AI Scribes for doctors. Seems these newfangled solutions, powered by ChatGPT and other forms of generative AI, actually work! They’re saving doctors who try them hours of administrative toil, as they’ve got the smarts to do a lot on their own.

A new study led by OntarioMD with partners at Women’s College Hospital and the eHealth Centre of Excellence, in Kitchener, Ont., confirmed these benefits. They quickly tested six AI Scribes and then rolled out three of the services to 152 family physicians and nurse practitioners, who worked with them for three months.

“It resulted in a reduction in after-hours documentation time of three hours (per week). That’s an enormous benefit,” commented Dr. Onil Bhattacharyya, director of the Women’s College Hospital Institute for Health System Solutions and Virtual Care – also known as WHIV.

AI Scribes can listen-in on the encounters between doctors and patients. They automatically write-up draft notes for the encounter, complete with specialized medical terms.

Doctors must then review these notes, edit them, and add them to their electronic patient records.

In the three-month test, that process not only saved time, but it also resulted in more complete record-keeping. Dr. Bhattacharyya observed that in his own practice, before deploying an AI scribe, he used to catch up on notes at the end of the day. By 6:45 pm or 7 pm, however, he’d pack it in, so that he wouldn’t miss seeing his children that night.

“I would plan on finishing the notes later, but what often happened is that months went by without doing this. Now, using an AI Scribe, the notes are complete.”

And by reducing the keystrokes a doctor makes during a patient encounter, AI Scribes are transforming the nature of the meeting – the encounter is more like the days before computers arrived in clinics.

“Doctors are looking at patients again, they’re forming bonds,” said Dr. Bhattacharyya.

Commenting on the time that’s being saved on administrative tasks like record-keeping, he mentioned that the generative AI systems are restoring work-life balance. “It’s remarkable,” he observed. “Physicians told us they’re volunteering again in their communities. And they’re getting closer to their kids.”

So even though the timesaving is just three hours a week, “those are very important hours,” he said.
Highlights from the study include:

• 70 percent less time spent on clinical documentation and up to 4 hours a week freed from administrative tasks.
• 83 percent of participants said they would use an AI scribe in their practice long term.
• 82 percent of participants said they would recommend AI scribes to their colleagues.
• 79 percent of participants said they were able to spend more time on patient care.
• 76 percent of participants reported a reduction in mental effort during patient consultations.

Part of the evaluation included the use of Robotic Process Automation (RPA), or bots, to automate actions documented by the AI scribe during patient visits, such as sending appointment reminders to patients.

Benefits included faster follow up with patients to book appointments, a more streamlined booking process for patients, and improved continuity of care.

Of course, not everything was resolved in the three-month study. Many issues remain, such as how much AI scribes are worth, in dollar terms, and whether the Ministry of Health will help doctors pay for them.

Indeed, during a panel discussion on physician usage of AI, Dr. Rosemarie Lall, a family doctor in Scarborough, Ont., noted that she has tried several of the systems and has found them to be incredibly helpful.

“AI scribes are saving my sanity,” she said.

She commented that her AI scribes – she has used several different brands – are quite able to take on many of the administrative tasks she used to do. These tasks were on the verge of overloading her to the extent that she was contemplating leaving the profession, she averred.

But with an AI scribe reducing the paperwork, “I was able to take Christmas off for the first time in many years. My kids were wondering what was going on!”

At the same time, she ventured that AI scribes are another cost for doctors, who are essentially small business operators. She already pays for an EMR, IT support, online booking, faxes, phone lines (her clinic has seven of them), email, security software and more.

“I’m not complaining, but I kinda am,” quipped Dr. Lall. “At some point, we are going to reach the breaking point.”

Another issue, observed Ariane Siegel, OntarioMD’s general counsel and chief privacy officer, is the legal and business challenge of obtaining an AI scribe. “The physician has to enter into a contract, and it can be very complicated,” she said.

While acknowledging the effectiveness of AI scribes, she also cautioned, “We don’t want to send doctors to the negotiating table.”

Dr. Lall concurred. “The contract for one of my AI scribes is 21 pages long. I signed, but I hoped I wasn’t signing away my first-born child.”

Ms. Siegel noted that OntarioMD is working with critical stakeholders, such as the Ministry of Health, Ontario Health and the Ontario Medical Association to consider ways of helping doctors reduce the burden of evaluating AI scribes and their contracts.

Speaking at a different session, Dr. Payal Agarwal, a family doctor and the integrated chief information and innovation officer at Grand River Hospital and St. Mary’s Hospital, in Kitchener, Ont., commented that policy makers are aware of the challenges of deploying AI in physician practices.

“They’ve been involved from the start with the study, and they’re working with the information and feedback,” she said. It’s possible they may come up with solutions to both the challenge of contracting with private-sector companies and the mounting costs of IT solutions for doctors.

What was most valuable about the AI scribe study, however, is that it quickly established the value of the systems for doctors.

And in the process, Dr. Agarwal said, “we developed a template for how to test things quickly.”
The partnership between OntarioMD, Women’s College Hospital and the eHealth Centre of Excellence worked extremely well.

There’s now a methodology in place, she said, for testing other AI-driven solutions.

Indeed, she noted that the partners are currently creating a “living laboratory” that will be able to evaluate other systems that could reduce the administrative logjams now facing doctors.

The living laboratory is already at work on e-referrals – it’s applying a similar methodology to assessing solutions that are on the market. “We’re looking at factors like how many clicks are needed, and how much time is needed, versus paper workflows.”

She said the living laboratory will consist of three components: an artificial setting, like a traditional lab that can measure product performance and conduct things such as time/motion studies.

A second part will consist of natural settings, where systems can be tested in “real-world” clinics.

And a final component will assess how systems can be scaled up, so they can be used across the province.

To learn more about AI scribes, visit OntarioMD’s website at https://www.ontariomd.ca/pages/ai-scribe-overview.aspx. To discuss adopting an AI scribe, please contact support@ontariomd.com.