AI scribes rolling out for community specialists

There was lots of evidence that community specialists are adopting AI scribes at the OntarioMD virtual symposium on April 25.“They have completely changed my job as a community psychiatrist,” said Dr. Usha Parthasarathi of Hamilton. She said a thorough note used to take up to two hours to transcribe but using an AI scribe has drastically cut that. Psychiatrists should aim to get 35% to 45% of your admin time back, Dr. Parthasarathi noted.But she said when she looked at AI scribes, “many struggled with psychiatric details.”She said key factors to consider when getting an AI as a psychiatrist:Need one that understands psychiatric termsHandle complex patient casesEasily generate assessments and different types of notes from same encounterRobust privacy controlsDr. Parthasarathi said when setting up an AI scribe in a clinic it is important to take time to customize your templates. “(Also) it is helpful to have a go-to person for any questions about AI scribe,” she said. Read: The great AI scribe rolloutScrutinizing contractsOntarioMD has a practice hub to help clinicians and a patient consent toolkit. But one of the obstacles for clinicians is that they are advised to scrutinize contracts carefully with a focus on flexibility, data ownership and security provisions. “I signed off with a hope and prayer I wasn’t been (messed) with; being totally honest,” said Dr. Rosemarie Lall, a family physician in Toronto, as she was she was going to have to scale back or retire if she didn’t take the step and sign a contract with an AI scribe.“Surely contract navigation is something that (OntarioMD) can do for us to avoid duplicating work?” one of the conference attendees wrote in the comments. That wasn’t directly answered but it was mentioned that Supply Ontario is soon to release a multi-vendor Vendor of Record (VOR) for AI scribes that will, it is believed, give clinicians information that tells them which AI scribes have been vetted. In another panel there was discussion about AI scribes that are integrated with EMRs versus non-integrated ones. “Integration right now doesn’t really offer significant advantages over non-integrated AI scribes IMHO, having tried both,” one commenter said. Dr. Parthasarathi agreed with that: “Non-integrated AI scribes may be better for some.”Rheumatology case studyDr. Vandana Ahluwalia, a rheumatologist in Brampton, Ont. and former president of the Canadian Rheumatology Association (CRA), talked about a trial. She said they looked at four or five AI scribes and did a rheumatology template but ultimately settled on two AI scribes for the trial: Scribeberry and Heidi.“We find these two seemed to be effective for our specialty,” she said. She said the participants in the trial engaged in a WhatsApp group and reported AI scribes saved a "significant" amount of time. But they also reported “significant” challenges (drug names wrong, etc.).After using both AI scribes simultaneously with a mock rheumatology patient, Dr. Ahluwalia took questions. When she wanted something changed about the clinical note, she just told the AI scribe to “remove the bold” in one section and how to change another section and it produced a revised clinical note. She said speaking requests for changes is faster than typing. “We can speak at 150 words per minute but typing is about 40 words per minute.” She was asked if it is standard that the audio is deleted. “My understanding is the recording is not saved but what is saved is the transcription . . . but then you can delete it,” she said. Dr. Ahluwalia was also asked about AI scribes for other specialties, in particular pediatrics. “I think AI scribes can be used for any specialty but it is all about the templates,” she said. Use templates by other colleagues, she said; you can send them in an email. She said the AI scribes are only used for their primary purpose not learning for privacy reasons so she said she regularly will edit her templates a bit to improve them. At the end of the case study, the CRA recommended Scribeberry and Heidi and negotiated contracts with both vendors ensuring a four-week free trial for members. Here’s sample posters doctors put up in waiting and exam rooms to explain:

AI scribes rolling out for community specialists

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