Anyone who has visited a hospital emergency department in Canada knows how doctors there are stretched far too thin, while patient volumes and wait times continue to grow.
But a team from the University of Alberta in conjunction with Alberta Health Services hopes to use artificial intelligence to cut down the amount of time and effort physicians spend on paperwork and other administrative tasks, so that time can instead be used to help more patients while reducing burnout and stress.
Their project is examining the use of an AI scribe program, which uses speech-to-text technology and artificial intelligence, during consultations with patients to record details and generate a clinical note. This may seem like a small task, but the average emergency room doctor can spend as much as two hours per shift on notes alone, said Dr. Jake Hayward, an emergency physician who is leading the project. Reducing that by even a fraction would translate to more patients being seen, while also allowing doctors to focus more on those conversations rather than taking notes, added Dr. Hayward, who is also a University of Alberta faculty member.
“A lot of our staff working in healthcare right now do feel under-supported and they are burning out… this is one thing that we can do to make their lives easier and to reduce the administrative burden that contributes to their burnout,” he said. “Ultimately, the interaction that you have with a physician, we believe, will be improved with artificial intelligence.”
Health Care Unburdened Grant Program recipients
The University of Alberta project is one of the projects receiving funding from the new Health Care Unburdened Grant program, a $10-million initiative aimed at supporting initiatives that help physicians reclaim lost time, enhance wellness and improve patient care. This program, backed by the Canadian Medical Association, MD Financial Management Inc. (MD) and Scotiabank, has awarded $500,000 to $1-million in grants to recipient organizations across Canada.
“The Healthcare Unburdened Grant program is an amazing opportunity to support the physicians that do so much for the health and well-being of their patients and communities,” said Pamela Allen, Chief Executive Officer, MD Financial Management Inc. “I am encouraged and excited by the innovative solutions that have come forward aiming to improve the administrative workload that has been weighing so heavily on our healthcare professionals.”
Administrative burden has been increasing over the last decade, said Dr. Joss Reimer, President, Canadian Medical Association.
“On average, physicians are working more than a full day on paperwork every week — on top of clinical responsibilities. Initiatives like these are critical to improving physician wellbeing and expanding access to care,” said Reimer. “Ultimately physicians want to spend time with patients, not administrative tasks. ”
The University of Alberta project is one of several recipient organizations across the country.
This project began when team member Dr. Mike Weldon — an emergency physician in Red Deer who was a software engineer before entering medicine — saw the rise of generative AI programs such as ChatGPT and began exploring how it could be used to help in his day-to-day work, said Dr. Hayward.
Dr. Weldon wrote the code for a simple but effective AI scribe tool he began to test in his practice.
The doctor would launch the tool, with the patient’s consent, before a consultation. The AI scribe would run in the background detecting the audio to record and condense the conversation into a clinical note, which is a summary of what happened in the encounter and the key points.
“It alleviates a bit of that cognitive burden and the stress of knowing that everything that you're doing or discussing, you have to try to remember and then find time to record that later,” said Dr. Hayward.
On average, physicians are working more than a full day on paperwork every week — on top of clinical responsibilities. Initiatives like these are critical to improving physician wellbeing and expanding access to care.”
Increasing quantity, and quality of medical care
Some hospitals and medical practices already use human medical scribes – people whose job involves sitting in on consultations, examinations and diagnosis sessions to record details so doctors can focus on providing medical care, he adds. But this can be expensive, and AI scribes would be able to provide a similar service.
And like with human scribes, the physician would be ultimately responsible for reviewing the clinical note and other notes entered into a medical chart for accuracy. A recording of the interaction will also be created, to enable the physician to review it later, Dr. Hayward noted.
“The initial anecdotal evidence is that this increases the number of patients you can see and the quality of interaction of patients without compromising the quality of care and maintaining safety.”
Ensuring AI tool meets technical and privacy requirements
There is a lot of work that needs to be done to be able to make this technology widely available to doctors throughout Alberta Health Services, Dr. Hayward added, including from a technical and regulatory perspective.
The funding from the Health Care Unburdened Grant will go toward refining the AI scribe that Dr. Weldon developed, as well as making sure it meets Alberta Health Services’ legal and compliance requirements.
“A lot of the work we're doing is working with regulatory bodies to figure out what the institutional policies are going to be around integration of artificial intelligence in clinical workflows,” said Dr. Hayward.
The team also plans to conduct research to gauge the accuracy of the clinical notes generated by different large language models.
At this stage, the project is focused on developing the technology through lab testing and laying the groundwork for policy and regulations pertaining to privacy, security, data storage, retention and patient consent.
“We’re working on those initial and foundational components that would have to be settled on before testing of a technology in the clinical environment,” Dr. Hayward said.
Interdisciplinary team needed for project
The grant funding is “hugely helpful” in putting together a team, with expertise ranging from artificial intelligence to software development to complex research.
“To do a project of this scope, we need human resources and capital to get it done. We need project managers, research coordinators, research assistants. It’s a very complicated project, and the money will be used to bring the right people into the environment and the team,” said Dr. Hayward.
Their goal is to start testing in an emergency room setting within the first six months. In the second year, the plan is to provide their AI scribe to a subgroup of 100 to 200 emergency doctors in Edmonton to continue testing and refining. The code for the tool will be open-source and freely available, he added.
Dr. Hayward said that after two years, they hope the project will deliver some high-quality evidence that can be used by anyone in Alberta, and Canada more broadly, to decide whether an AI scribe would be useful for their practice and how to go about it.
“The idea and the hypothesis is that you actually have a higher-quality interaction with your physician. The most tangible impact that you can think about is if your physician no longer has to look at the computer screen, but can look at you. That will be inherently a better interaction.”
He is also optimistic that this will help with physicians’ workload and wellbeing, and retention.
“If our physicians are a little less burned out, a little less stressed, a little bit more engaged, and they're enjoying their work, because in general they do not enjoy writing notes, they can enjoy the interaction with patients, which is the thing that they actually really want to do. Hopefully this all translates to a higher level of quality in the care we provide.”
