Australian Institute of Health Innovation, Macquarie University, Sydney, Australia.
Faculty of Engineering & IT, University of Technology Sydney, Sydney, Australia.
J Am Med Inform Assoc. 2020 Nov 1;27(11):1695-1704. doi: 10.1093/jamia/ocaa131.
The study sought to understand the potential roles of a future artificial intelligence (AI) documentation assistant in primary care consultations and to identify implications for doctors, patients, healthcare system, and technology design from the perspective of general practitioners.
Co-design workshops with general practitioners were conducted. The workshops focused on (1) understanding the current consultation context and identifying existing problems, (2) ideating future solutions to these problems, and (3) discussing future roles for AI in primary care. The workshop activities included affinity diagramming, brainwriting, and video prototyping methods. The workshops were audio-recorded and transcribed verbatim. Inductive thematic analysis of the transcripts of conversations was performed.
Two researchers facilitated 3 co-design workshops with 16 general practitioners. Three main themes emerged: professional autonomy, human-AI collaboration, and new models of care. Major implications identified within these themes included (1) concerns with medico-legal aspects arising from constant recording and accessibility of full consultation records, (2) future consultations taking place out of the exam rooms in a distributed system involving empowered patients, (3) human conversation and empathy remaining the core tasks of doctors in any future AI-enabled consultations, and (4) questioning the current focus of AI initiatives on improved efficiency as opposed to patient care.
AI documentation assistants will likely to be integral to the future primary care consultations. However, these technologies will still need to be supervised by a human until strong evidence for reliable autonomous performance is available. Therefore, different human-AI collaboration models will need to be designed and evaluated to ensure patient safety, quality of care, doctor safety, and doctor autonomy.
本研究旨在从全科医生的角度了解未来人工智能（AI）文档助手在基层医疗咨询中的潜在作用，并确定其对医生、患者、医疗体系和技术设计的影响。
与全科医生进行共同设计研讨会。研讨会的重点是：（1）了解当前的咨询背景并确定现有问题；（2）针对这些问题提出未来的解决方案；（3）讨论 AI 在基层医疗中的未来作用。研讨会活动包括亲和图、头脑风暴和视频原型制作方法。研讨会进行了录音并逐字记录。对对话记录的转录进行了归纳主题分析。
两位研究人员与 16 名全科医生共同主持了 3 次共同设计研讨会。出现了三个主要主题：专业自主权、人机协作和新的护理模式。在这些主题中确定了主要影响，包括：（1）由于完整咨询记录的持续记录和可访问性而引起的法律和医学方面的担忧；（2）未来的咨询将在一个分布式系统中在诊室之外进行，该系统涉及授权患者；（3）在任何未来的 AI 支持的咨询中，医患对话和同理心仍然是医生的核心任务；（4）质疑当前 AI 计划关注提高效率而不是患者护理的重点。
AI 文档助手很可能成为未来基层医疗咨询的重要组成部分。然而，在有可靠的自主性能的强大证据之前，这些技术仍需要由人类进行监督。因此，需要设计和评估不同的人机协作模型，以确保患者安全、护理质量、医生安全和医生自主权。
