By: Emily M. Bender and Decca Muldowney At a recent appointment, Emily’s physical therapist (who knows some about her research) said, “Before we get started,...

At a recent appointment, Emily’s physical therapist (who knows some about her research) said, “Before we get started, there’s something I want to ask you about.” The something was an automatic “scribing” system their office is trialling for two weeks and deciding whether to purchase. These systems take in a (presumably audio-only) recording of the patient encounter and then output a draft patient note for the chart.

So what’s the big deal with “AI” charting? Here are nine reasons why we recommend refusing to consent to the use of scribing tools in healthcare settings:

  • streetfestival@lemmy.caOPMEnglish
    10·
    2 months ago

    https://benngooch.substack.com/p/i-was-an-enthusiastic-early-adopter

    This is not a small thing. The clinical note in general practice is not merely a medicolegal record. It is, as research in the Journal of General Internal Medicine has articulated, a form of narrative medicine — a clinician-authored story that reflects how the physician understood the patient’s situation at that moment in time. The act of writing it is itself a cognitive process: it forces synthesis, prioritisation, and reflection. It is, in a real sense, how we think.

    When an AI records everything rather than what we chose to record, this feedback loop breaks. The note stops being a reflection of clinical reasoning and becomes a verbatim archive. And as a PMC piece on note bloat explicitly warns, this risks obscuring the most medically important information under a volume of equally-weighted detail.

    The problem is not just that notes become longer. It is that they become less curated, less authored, less ours. And the clinical memory they are supposed to scaffold — the ability to pick up a case six weeks later and immediately reorient — degrades with them.

    • streetfestival@lemmy.caOPMEnglish
      1·
      2 months ago

      same source:

      We are in the relief phase of ambient scribing. The efficiency gains are real and the risks are not yet visible in our outcome data — partly because we haven’t looked, and partly because the timescales are too short. The absence of evidence is not evidence of absence.