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Dr. Will Stymiest, a family physician practicing in Fredericton, observed a noticeable transformation in one of his fellow doctors a few months ago: this colleague seemingly always departed from the office well ahead of him. “Since he started using the AI tool, he was leaving before me almost every day,” Stymiest noted, referring to the innovative software designed to transcribe and summarize critical conversations between healthcare providers and their patients. “There’s a little bit of jealousy there. This clearly is making a difference for him. Maybe it could make a difference for me, too.”
Just a week into testing the same AI scribe tool himself, Stymiest revealed that the experience has truly impressed him. “I’ve three small kids [to do] two daycare pickups on the way home, so I have to be out at a particular time. I’m so far spending less time in the evenings and on weekends kind of catching up,” he remarked, highlighting the newfound efficiency in his busy life.
Ambient artificial intelligence scribe programs are sophisticated software systems that utilize microphones to actively listen to discussions between clinicians and patients. They expertly filter out irrelevant small talk at the outset and subsequently summarize the visit into an organized medical note, which can then be shared with other team members—including physicians, nurses, and physiotherapists—and stored in the patient’s medical file. The software continually evolves and enhances its capabilities by learning from extensive datasets comprising speech samples, including numerous patient visits.
Currently, Stymiest is conducting a three-month trial of an AI scribe as part of an initiative orchestrated by the New Brunswick Medical Society, which is evaluating several similar products. Beyond enhancing his own medical practice, he also envisions significant benefits for the province’s healthcare system. Stymiest speculated that if he were to consistently cut 30 minutes from his daily paperwork, he could potentially accommodate up to three more patient appointments each day, including new patients. This is particularly crucial in a province grappling with a staggering 92,000 individuals awaiting a primary care provider as of April, and in this context, AI scribes could help in reducing that daunting waitlist.
Other provinces have begun expressing interest in these tools as well. The Ontario Medical Association (OMA) has recently engaged physicians to assess AI scribes and their potential applications within doctors’ offices and hospitals to save valuable time for physicians and enhance their overall well-being. Dr. Onil Bhattacharyya, the director of the Women’s College Hospital Institute for Health System Solutions and Virtual Care (WIHV) in Toronto, played a key role in evaluating six different AI scribes, focusing on various metrics, including the accuracy and quality of medical notes and the technology’s capacity to handle multiple speakers and diverse accents. The competition among physicians for spots in the study was intense, with over 1,000 individuals vying for just 150 openings. “It’s not quite Taylor Swift tickets, but it’s close,” he humorously remarked.
According to Bhattacharyya, the growing interest among physicians in AI scribe tools underscores a critical issue: the “punishing” administrative demands imposed by tasks such as documenting patient visits. In April, the Ontario government issued a list of strategies aimed at helping family doctors “put patients before paperwork,” and among these strategies was the integration of AI scribes. Notably, the province stipulated that AI scribes would only be employed with the patient’s explicit consent, ensuring the utmost protection for patient health information under prevailing laws.
Similarly, Alberta’s College of Physicians and Surgeons, along with the Canadian Medical Protective Association, provide guidance concerning the utilization of AI scribes as approximately 30 vendors aggressively compete for a slice of the burgeoning market in medicine. Ontario has funded a study carried out by OntarioMD, WIHV, and other collaborators to ascertain how AI scribes can diminish the administrative burden faced in primary care settings. Remarkably, family doctors who integrated AI scribes into their practice reported a remarkable reduction of three hours spent weekly on administrative tasks following patient visits.
Scribes have not only been helpful in reducing paperwork but also in fostering “quality time” with patients. The concept of medical scribes isn’t entirely novel; physicians have a longstanding tradition of dictating patient notes into recorders for later transcription, and a select few Canadian doctors still rely on trained medical scribe paraprofessionals to draft their summaries efficiently. Dr. Vandana Ahluwalia, a rheumatologist based in Brampton, Ont., utilizes both a human medical scribe—a paraprofessional she personally trained—and an AI scribe. “The human scribe changed my life completely,” Ahluwalia expressed, echoing sentiments shared by Stymiest regarding the burdens of evening and weekend paperwork.
Ahluwalia noted that the increasing demands of documenting patient visits began about a decade ago when the province began transitioning to electronic health records. While the influx of information entering patients’ charts has undoubtedly boosted the quality and clarity of documentation, it has also led to an overwhelming amount of paperwork. “I can spend quality time with patients and be a lot more empathic,” she remarked, adding that she now has enough time available to conduct more thorough physical examinations. However, Ahluwalia candidly acknowledged the rarity of medical scribes in Canada, asserting that there are presently no formal training programs for aspiring scribes. For family physicians grappling with the burdens of documentation, she asserted that AI scribes present a compelling solution.
Dr. Tahmeena Ali, a family physician practicing in South Surrey, B.C., has been harnessing an AI scribe tool for approximately eight months. She reported that, out of her 900 patients, only one has declined to provide consent for the use of this technology. Ali estimated that the AI tool conservatively saves her at least 20 percent of her time, enabling her to keep appointments running smoothly and ensuring that patients are seen promptly. “I think most of them recognize that anything that can help me with my job, provide better patient care, and decrease the chances that I’m going to leave family practice ultimately benefits them in the end,” she noted.
However, it is critical to acknowledge that AI scribes come with their own set of limitations. Ali recounted an instance where the tool misinterpreted information; drawing from its training, the AI scribe incorrectly inserted specific back exercises based on suggestions typically made by other family practitioners, exercises that Ali had never mentioned. Consequently, each time a patient presented with a similar back issue, Ali found herself needing to remove the inaccurate text. Stymiest, too, pointed out that the current iterations of the AI scribe tool are unable to capture all nuances of patient interactions, such as interpreting a patient’s demeanor or behavior during consultations.
Despite these challenges, patient reactions to the introduction of AI tools have been generally positive. Stymiest reported that no patients in his practice have declined consent thus far, while only one of Ali’s numerous patients opted out. The pair emphasized the importance of clearly explaining to patients how the AI works in the background—listening in on the visit and transcribing the dialogue without retaining the actual recordings, merely focusing on producing the notes. Studies in Ontario have indicated that family doctors integrating AI scribes into their practices reported approximately three fewer hours spent per week on administrative tasks after hours.
Federal guidelines on the utilization of AI in healthcare predominantly advocate for FASTER principles: Fair in considering bias, Accountable for ensuring compliant and ethical note-taking, Secure in classifying information to protect patient privacy, Transparent regarding AI interactions, Educated on the benefits and limitations of the technology, and Relevant in improving health outcomes. Bhattacharyya mentioned that hospital networks in Ontario, such as Unity Health, have adopted an AI medical scribe tool, while Women’s College Hospital is still weighing the potential risks and benefits associated with its implementation, especially in terms of cost considerations. With a monthly subscription fee hovering around $400 per month, multiplied by the number of doctors on staff, the overall expense could become a significant barrier to widespread adoption.
According to Bhattacharyya, family doctors working independently face costs ranging anywhere from $100 to $400 per month, a price point many have found difficult to swallow, as indicated in the Ontario report. However, he suggested that bulk purchasing options could help drive prices down, making this technology more accessible for physicians across the province. As the healthcare landscape continues to evolve, a new Canadian study exhibited how AI technology has significantly aided in preventing unexpected hospital deaths, showcasing the growing role AI can play in patient care. Dr. Vincent Liu, chief data officer for the Permanente Medical Group and a senior research scientist at Kaiser Permanente’s research division in California, noted the transformative potential of integrating AI into electronic health records in the New England Journal of Medicine. He emphasized the importance of maintaining human oversight in patient care, stating, “I don’t think that patients or clinicians are ready to take humans out of the loop or let AI make critical decisions without human guidance.”
“I see AI in health becoming part of the standard way that we take care of patients, and I think that it won’t be long in the future where patients themselves are wanting to receive care that’s AI-informed,” Liu predicted, underscoring the essential role of technology in shaping the future of healthcare.
What challenges do AI scribes present in a clinical setting?
**Interview with Dr. Will Stymiest: The Impact of AI Scribes in Family Medicine**
*Host:* Welcome, Dr. Stymiest! Thank you for joining us today on CBC Health’s Second Opinion to discuss the exciting developments in AI technology in healthcare.
*Dr. Stymiest:* Thank you for having me. It’s a pleasure to be here!
*Host:* Let’s dive right in. You’ve recently started using an AI scribe tool in your practice. Can you share your initial thoughts on how it’s affected your workflow?
*Dr. Stymiest:* Absolutely! I’ve been really impressed by the efficiency it brings. Just within a week of using the AI scribe, I found myself leaving the office earlier and spending less time after hours catching up on paperwork. With three small kids at home, that’s a game changer for me.
*Host:* That sounds fantastic! How do you think this technology can influence patient care?
*Dr. Stymiest:* Well, it’s all about freeing up time. If I can save just 30 minutes of paperwork each day, that opens up capacity for up to three more patient appointments. With a significant number of people in New Brunswick still waiting for a primary care provider, this could have a real impact on reducing wait times.
*Host:* Interesting. But have there been any limitations or challenges you’ve faced while using the AI scribe?
*Dr. Stymiest:* Yes, definitely. The AI is not perfect. For example, it sometimes misses the nuances of patient interactions—like body language or emotions—which can be critical in understanding patients’ needs. I find myself having to edit the notes to ensure accuracy in the clinical information.
*Host:* You mentioned that patients have generally reacted positively to the introduction of AI tools. Can you elaborate on that?
*Dr. Stymiest:* Sure! Out of all my patients, none have declined consent for the AI tool, which speaks volumes. I make sure to explain how the AI operates—transcribing our conversations without retaining recordings—and they seem to appreciate the transparency. It helps reassure them about privacy and the intentions behind its use.
*Host:* Great to hear! And what about the broader implications for healthcare?
*Dr. Stymiest:* The introduction of AI scribe technology seems to resonate with many healthcare providers across Canada. Organizations like the Ontario Medical Association are looking closely at its potential to alleviate the burdens of administrative work. With proper governance and patient consent protocols in place, I believe AI can genuinely enhance both physician well-being and patient care outcomes.
*Host:* Speaking of governance, there are federal guidelines advocating for ethical AI use in healthcare. How important do you think these guidelines are?
*Dr. Stymiest:* They are crucial. The FASTER principles—Fairness, Accountability, Security, Transparency, Education, and Relevance—ensure we minimize biases and protect patient information. This framework provides a solid foundation for integrating AI technologies ethically and effectively in clinical settings.
*Host:* Thank you, Dr. Stymiest. It’s clear that while there are challenges, the benefits of AI scribes in family medicine are significant. Your insights are invaluable as we navigate this evolving landscape in healthcare.
*Dr. Stymiest:* Thank you for having me! I’m looking forward to seeing where this technology takes us.
*Host:* And thank you to our listeners for tuning in to CBC Health’s Second Opinion. If you haven’t subscribed yet, be sure to do so for our weekly analysis on health news!
