AI growing in medical practice

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https://www.wsj.com/health/healthcare/ai-ambient-listening-doctor-appointment-e7afd587?mod=hp_featst_pos4

Why AI May Be Listening In on Your Next Doctor’s Appointment

New systems for documenting outpatient visits are adding features and moving into hospitals; ‘we are just scratching the surface’

By Laura Landro, The Wall Street Journal, May 27, 2025

Key Points

  • AI-powered ambient-listening technology is expanding in healthcare, documenting doctor-patient encounters.

  • AI scribes save doctors time on documentation, reducing burnout and improving focus on patients, according to pilot programs.

  • Concerns exist around patient privacy, data security and costs, but patient feedback has been largely positive…

Already gaining traction for outpatient medical visits, the AI-powered systems are also moving into hospital rooms and emergency departments to capture discussions at the bedside, update medical records, draft care plans and create discharge instructions. Healthcare systems nationwide, including Stanford Health Care, Mass General Brigham, University of Michigan Health and Ardent Health, are adopting the technologies widely referred to as AI scribes…

By connecting older data with new information in the medical record, for instance, the technology could help make sure that an incidental finding years ago was followed up on…

Researchers predict the systems will evolve into a 360-degree presence that extends before and after the medical visit: analyzing records before an appointment to identify red flags, prompting doctors about recommended tests and treatments based on patient symptoms, and teeing up follow-up actions like lab tests and prescription orders…

It has also unshackled doctors from staring into a computer or scribbling notes rather than being present with the patient… [end quote]

This is a “killer app” for AI – a potentially transformative improvement in efficiency and efficacy. Of course, the doctor will have to review AI’s comments and use personal judgment.

Many doctors hate patients who use “Doctor Google.” But I have spent many hours consulting Google Gemini, Chat GPT and Perplexity about DH’s complex problems. Their inputs come with references to original research to support their advice. They are not identical but they converge on important points.

Doctors have knowledge and experience but they are all-too-human. As a pre-med college student I spent years in classes with people who are today’s doctors. They are under tremendous stress from directions that have nothing to do with diagnosis. It’s also impossible for them to know everything. Not only about diagnosis but also advances in treatments. There simply isn’t time or mental bandwidth.

I often say to doctors, “You have 1,000 patients but I only have one ME.” I have the time, motivation and knowledge to delve in depth.

I think that AI in medical practices will be tremendously advantageous for patients and doctors. Microsoft dominates this market which is only just beginning.

Wendy

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At the end of my career electronic medical records were the norm. Supposed to be great. All this information with the stroke of a key. The biggest problem, like most software, written for software developers and not users. Not intuitive. So, I wind up wading through 1000 negative answers to try to find what is important. No where was there a “pertinent positive” list. So the flood of information made it even easier to miss things, not find things. From what I’ve seen of AI so far, more of the same.

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Let me “fix” this comment.

“Like most software, written for bean counters, middlemen, and legal liability avoidance” and NOT for actual delivery of healthcare, these “notes and records” will only be available in heavily redacted and summarized form to the patient.

HTH
:medical_symbol:
ralph

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Meanwhile, in Spain, I have seen their (different) software rise rapidly in popularity with both doctors and patients. I saw a friend who had lived for some time near Madrid show up (with me) on a medical emergency in Mallorca, and Kaboom, with a few stroked the Mallorcan doc KNEW the ctucial complex details about my friend. Can be done.

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Sounds like the system in Spain was designed with patient care as the priority. The American system, while touted that way, has been more of a sophisticated billing system designed to capture every last penny. Plus each institution, clinic, urgent care has their own EMR and they often don’t communicate with each other. In most cases instead of streamlining patient care it has added drag to it. (retired doc here)

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Yes, yes, yes! I keep up now with at least three separate records systems. Each has its own unique name and password, which is bad enough. But, as you say, they do not communicate with each other and so either (a) one has to duplicate records - if possible - in each system or (b) operate with one’s own memory of everything, which engenders an inevitable amount of incompleteness.

A royal pain in the posterior apart from all of the other challenges of actually getting the health care one needs.

Pete

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I keep a 3-ring binder for health “projects.” Test results organized on paper. Doctors really like this!
Wendy

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@rainphakir by law, the patient can see every single record. I requested my surgical record from the records department. They put it into MyChart at no charge. I was able to see every detail down to the lot numbers of my implanted aortic valve and aorta.

Just need to know how to look. Seek and ye shall find.
Wendy

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I’ve used the local hospital, now regional system group, all my life
20 years ago, I looked into getting my records
The response was “We OWN the data. By law we’re required to provide it to you. It’s a couple thousand pages. Pay us $1.30/page and it’s yours.”

The “data” I see on my “health portal” is arranged different, and is MUCH LESS DETAILED, than what the doc sees on the computer screen in the exam room.

Just cause it’s required by law doesn’t mean the health care system will WILLINGLY make the data available.

The system claims to OWN the data, and they want to control it. And monetize it.
(I can NOT imagine they are not selling data to insurance companies, and anyone else who’ll pay for it.)

BTW. The system/group is divided into regions. Clinics n hospital facilities in one group do NOT “like” to communicate with other “regions” of the SAME SYSTEM.
Getting data shared works fine.
It’s getting access to treatment n facilities in a different “region” that’s difficult.
Once “pushed” they grudgingly do their jobs.

Yeah. I think service at this Central Texas “non profit” regional health care system sucks.
They have a rumor reputation, also, for “anticompetitive” practices that run competitors out of business.

:disguised_face:
ralph

FWIW, Toyota collects driving data on me - a recently introduced message that appears on the screen, tells me how my driving was, and offers tips to improve!

I can NOT imagine Toyota does not sell this data to insurance companies.

“Data is the new oil”.

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There is the problem. Healthcare in Spain is primarily Public Health, although the wealthy can and do pay more for private care.

In Spain they look at costs wholesale across the entire system to see what strategies to take or change to get the most health for the euros spent. Huge difference,

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Regarding medical records, I was VERY impressed with the doctor/surgeon that repaired my shoulder a few years ago. He had an iPad with him for all visits, and he had his assistant in the room with their own iPad for all visits. While examining me, he would dictate his noted into his iPad, and in real-time (LIVE!), his assistant would correct the content as necessary on their own iPad. It was incredible. And if I wanted, he would send me a copy, but I only did that once just to see what it looked like.

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I loved patients like this, informed and invested in their own healthcare. A total 180 of the too often answer to a question “I don’t know, its in my medical records somewhere”.

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Meanwhile I have a TON of potentially useful data* in my Apple Health App, and Apple has a way to share the data with doctors … and I have yet to find a single doctor that has a way to accept the shared data.

* For example, I have blood pressure data for the last 4+ years. When my former doc (sadly now retired) told me I may have elevated BP, he said to take my BP three times a day. At first I recorded it on paper, then I transcribed it into the health app. But that became tedious so I bought a BP device with bluetooth, and it transfers all the data to the phone by itself. I don’t take it 3 times a day anymore, my new doc said to take it once a day instead. The app also has a record of all my bloodwork for the last few years. It hs my estimated fitness level, my HR throughout the day and night and during exercise, my weight for the last 4 years, my workouts, my sleep patterns, my average environmental sound levels, and a bunch of other stuff.

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Last time I was at my sleep doctor the AI was in charge of scheduling.

Appointments were canceled while people were sitting there in the waiting room. Scratching the surface, eh.

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I complained up thread about “my” local healthcare provider.

Let me recount yesterday me watching a doctor interact with an older relative in a rehab facility.
The doctor asked my cousin to approve her use of an app that would record her interactions with him. He did.
She proceeded to open the app, got his approval and then went about interviewing him.
I have no idea how the notes came out. As an observer, the raw conversation seemed very … Disjointed.

He has a CGM.
The healthcare provider’s system will not interact with the CGM. I’ve been with him several times when he’s asked about it and he always gets a non-answer.

Ie. My local provider apparently now offers the recording app to it’s providers.
Slowly, the provider is adopting the tech.

:man_scientist:t4:
rslph

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I gave my gp permission to record my annual visit with some sort of ai ap which apparently was used to help compose my patient summary which contributed in some way to my mychart. It was a good summary and the act of reading it and comparing it to my prior visit caused me to notice that my doctor forgot to order a t3/t4 test despite my perennially high tsh readings. So I called, left a message, and she responded with an apology and ordered the t3/t4.

So at this point I am still the only one keeping an eye on all of my treatment records. I know I miss things because of forgetfulness and large gaps in my knowledge, but I am not counting on my insurance driven medical care to take a holistic approach to my healthcare care any time soon.

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Ralph,

The AI is in the learning phase. Rest assured nothing will be learnt.

Medicine is an open system. It is not a dice roll classical odds.

BTW Ralph, My Dad was on the licensing board for eight years during his earliest retirement. He had two retirements. He surprised me, I did not know until the other day, he was chairman of the licensing board for the eight years.

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Remember, the doctor has thousands of patients but you only have one YOU.

Doctors don’t have the time or bandwidth to do this.

I have similar data from my Fitbit. It took me hours to distill it into two charts which I printed out and mailed to my cardiologist.

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Chart #1 shows my steps per minute from 12/22/24 through 3/30/25 as recorded by my Fitbit watch. The Fitbit has a motion sensor so it only records steps when I’m moving and then it records a data point every minute. I do Zumba dancing three times a week for about 40 minutes per class. The steps are fast. Typically when I’m dancing that fast my sustained pulse rate is 120 - 130 bpm as shown on Chart #2.

I also do a daily walk for about ½ hour. My pulse rate is lower than Zumba – 110 bpm. The trail is partly uphill. You can see the walks in Chart #1 since they are about 20 - 40 steps per minute. That’s why Chart #1 has a 2-tier appearance. I typically do 5,000 steps a day including my exercise class, walk and general housekeeping and gardening activities.

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I mailed this to my cardiologist with a message that if he needs to see me soon he should let me know. Otherwise, I pushed back my next appointment to September.

I think it’s reasonable for a doctor to be able to read a chart of my data. I don’t think it’s reasonable to expect them to figure out how to process the raw data so they can include it in their clinical picture.

I’m doing the prescribed cardiac rehab class now…6 months after my open-heart surgery. If I hadn’t taken my exercise program into my own hands right after returning home from surgery (when I was literally too weak to take a shower standing up) I never would have regained my conditioning.

I am beginning to feel more like myself again but it has taken 6 months of working out 5 days a week.
Wendy

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Call me cynical. I suspect that since ‘data is the new oil’, the CGM company does NOT want to give up the raw data.
And, my Healthcare Industry provider does not want to pay.

Hence my broken record that I want an AI that is my personal health care assistant.
@intercst says he doesn’t want an Insurance Exec between him and his health care.
I don’t want any kind of ‘bean counter exec’ between me and my health care.
The docs, nurses and staff are superb.

The INDUSTRY - bean counting aspect is not so ‘superb’.

:flexed_biceps:
ralph

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I do not understand where that assumption is coming from. We are talking the class overachievers in their specialty.

One booooob on the radio today said, “..and doctors have to follow dosing requirements”. He was talking about freedom to decide with your doctor and political dogmas.

There are things the doctor can see such as this data and their textbooks and reference library. There are things the doctor can work with that s/he can’t see such as dictated dosing schedules and then how it affects the patient.

Specialists get a lot more than 15 minutes with the patient. :wink: