AI scribes may fail to capture patients’ experiences

The use of artificial intelligence (AI) tools to take notes can change the nature of interactions between patients and clinicians, sometimes missing vital information, according to the results of a new review.

The report also states that the use of these tools, referred to as ambient AI scribes, may lead to deskilling and deprive clinicians of opportunities to acquire clinical reasoning skills.

While ambient AI scribes can help with administrative work, more research needs to be done to understand how these tools work in specific health care settings and how their design supports both patients and clinicians, experts say.

Some 40% of GPs in the UK said they used ambient scribes, which integrate speech-to-text technology with AI to assist with capturing patient notes during a consultation.

Researchers from the University of Edinburgh conducted a review of 27 articles in scientific and medical literature to examine AI scribes’ adoption and the implications of scaling up their use.

One of the key findings of their analysis was that although the AI tools can help capture what patients say, they can sometimes miss important aspects of consultations, such as facial expressions, gestures and emotional states.

AI summaries tend to prioritize clinical information, which can come at the expense of patients’ stories and experiences of their illness.

The review also found that patients may be hesitant to reveal sensitive information, such as substance abuse, domestic abuse or mental health struggles, when they know the consultation is being recorded and processed by AI.

The team also describes how manual note-taking serves important functions for clinicians in clinical reasoning and reflection on what the patient has said.

Using AI scribes could result in clinicians outsourcing mental effort—known as cognitive offloading. This can have benefits, such as creating the opportunity for more meaningful conversations with patients and more time to focus on complex tasks.

By contrast, these tools can also reduce memory recall and skill development. Clinicians report instances in which they do not recognize their own notes or remember the patient the next time they see them.

The researchers conclude that these systems must preserve the patient’s voice rather than overwrite it.

They also say more work needs to be done to understand the medium- and long-term use of these AI tools in specific settings and emerging risks, particularly for tools used in countries with health care systems different from those where the AI tools were built.

The findings have been published in BMJ Digital Health and AI.

Dr. Lucas Seuren, GAIL Fellow and research fellow at the University of Edinburgh’s Centre for Biomedicine, Self and Society, said, “Many clinicians are excited about ambient AI scribes because they promise to cut down on paperwork. But the experiences of patients are poorly considered, and there are real risks that patients’ stories are lost. This can further disadvantage people who already face marginalization in health and social care services.”

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Swati Mestri

Swati Mestri holds a bachelor’s degree in Electronics Engineering and has worked as a content editor since 2019. She has experience editing research documents across technology, health care, and materials science, and has a particular interest in technology and space.

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Robert Egan

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