There's currently a big focus on using artificial intelligence to reduce administrative burdens for clinicians, especially with medical note-taking and clinical summaries. But, there also are opportunities to use generative AI to make it easier for patients to understand their medical notes.
OpenNotes, a health transparency research group that is part of Beth Israel Deaconess Medical Center (BIDMC) in Boston, is partnering with Abridge to evaluate AI-generated patient visit summaries, but from a patient-centric lens.
The six-month study will investigate how AI solutions like Abridge can help enhance the value of the information shared with patients following a visit to better meet patients' needs, according to the organizations.
The partnership is part of BIDMC’s new OpenNotes Lab, an initiative fostering collaboration between patients and clinicians in developing AI-powered tools designed to advance transparency and digital health equity.
The OpenNotes initiative began in 2010 as a pilot program to give patients online access to their medical records. By 2020, more than 50 million patients in the U.S. and Canada gained access to their notes. As of April 5, 2021, all U.S. healthcare systems are required to electronically share clinicians’ visit notes with patients at no charge, as required as part of the 21st Century Cures Act's provisions on interoperability and information blocking.
While the OpenNotes movement and interoperability regulations are making medical information more accessible to patients, that information can be difficult for patients to find and understand, clinicians say.
"We were watching what was happening with the rapid integration of generative AI into the electronic health records, focused on important issues like documentation burden. As we were seeing this happen, reflecting back on our own work to spread OpenNotes and thinking about things that we heard from healthcare organizations like, "My patients won't understand the note.' 'This isn't for my patients. The note is full of jargon. It's not useful for patients.' A technology like generative AI can help to solve some of those problems," said Catherine DesRoches, executive director of OpenNotes and an associate professor of medicine at Harvard Medical School, in an interview.
"[Generative AI] also has tremendous potential to help patients to engage with their information which is, really, what the goal of OpenNotes is, to understand how data transparency and information transparency can help patients engage in their information. Generative AI adds a layer on top of that to enable clinicians to meet patients where they are in terms of how they understand their information," DesRoches said.
In the initial phase of the study, focus groups of patients who have been given Abridge visit summaries will evaluate them for usefulness, accessibility and other measures of effectiveness. For this phase, there will be no use of patient data, the organizations said.
The project can help bring the patients’ voices directly into the design of health AI tools, DesRoches noted.
"We are starting with a patient-centric and care partner-centric lens to look at what patients would want in something like a visit summary," DesRoches said. "Many patients already get an after-visit summary and it has information in it like the medications they're taking, their vital signs and it might have some canned information about what they went in for, such as 'You came in for a sore throat. Here's how to treat it at home.' But it doesn't capture the conversation that happened between the patient and the clinician."
"With Abridge's technology that starts with that conversation, we will be using a patient-centered lens to understand if there was an artifact that came out of that conversation that was designed specifically for patients. What would patients want it to contain? Would they care about the tone? Would they want the next steps right up at the top. Would they even want it to be text, or could it be something else? We're trying to bring the views and the diverse needs of patients and families into the development of patient-facing AI tools," she noted.
This work could also help establish new standards for responsible and transparent use of AI in clinical documentation, executives at the organizations said.
Pittsburgh-based Abridge uses AI to increase the speed and accuracy of medical note-taking, leveraging a proprietary data set derived from more than 1.5 million medical encounters. The company's AI converts a patient-clinician conversation into a structured clinical note draft in real time and integrates it seamlessly into the electronic health record system.
The technology also creates a visit summary for the patient, which is written at an eighth-grade reading level and provides information like new diagnoses, medications and next steps.
The study will be used to improve Abridge’s patient visit summaries.
"This research collaboration with OpenNotes will harness the power of actual patient conversations in informing the next generation of visit summaries, an invaluable tool in keeping doctors and patients on the same page," said Shiv Rao, M.D., CEO and founder of Abridge.
Katie McCurdy, founder of Pictal Health, patient advocate and user experience designer, noted that visit summaries are "overdue for a refresh," as the documents became widely used only after the widespread adoption of EHRs in the early 2000s.
"The potential impact of clearer, more user-friendly visit summaries is huge. OpenNotes and Abridge are the ideal teams to tackle this challenge, and patient advocates will be paying close attention," said McCurdy, who also serves on the OpenNotes Lab Advisory Board.
The partnership with Abridge marks OpenNotes' first sponsored study.
"This is the first time that our group has done industry-related work, and we're really excited about it. We feel like there's just so much innovation that's happening in the private market at this time that we needed to step out of our traditional comfort zone of foundation grants and federal grants because, in a lot of ways, that world is moving too slowly for what's happening on the private side," DesRoches said.