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Join us as we delve into the transformative potential of AI medical scribes in health care with family nurse practitioner Erica Dorn. Discover how this technology is reshaping clinical workflows, improving work-life balance, and addressing burnout while exploring its benefits, challenges, and ethical considerations.
Erica D, the NP Charting Coach, is a family nurse practitioner and the creator of The Nurse Practitioner Charting School.
She discussed the KevinMD article, “AI medical scribes: Boosting efficiency or risking over-reliance?”
Our presenting sponsor is DAX Copilot by Microsoft.
DAX Copilot, by Microsoft, is your AI assistant for automated clinical documentation and workflows. DAX Copilot allows physicians to do more with less and turn their words into a powerful productivity tool. DAX Copilot automates clinical documentation—making it available in the EHR within minutes—and clinical workflows, including referral letters, after-visit summaries, style and formatting customizations, and more.
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Transcript
Kevin Pho: Hi, and welcome to the show. Subscribe at KevinMD.com/podcast. Today, we welcome back Erica Dorn. She’s a family nurse practitioner, and she’s the creator of the Nurse Practitioner Charting School. Today’s KevinMD article is “AI Medical Scribes: Boosting Efficiency or Risking Over Reliance.” Erica Dorn, welcome back to the show.
Erica Dorn: Thank you for having me.
Kevin Pho: All right. So tell us what this latest article is about for those who didn’t get a chance to read it.
Erica Dorn: Yes, so AI medical scribes have definitely become popular in the last few months. There’s a lot of buzz going around using AI medical scribes. And so, you know, kind of the question comes up: should you be using an AI medical scribe in your practice or should you not? So that’s kind of what the article discusses.
Kevin Pho: All right. And for those who may not be familiar with AI medical scribes, and full disclosure, this podcast is sponsored by one of those, DaxCopilot. How does it work? What does it look like?
Erica Dorn: Yeah, so there’s a lot of different AI scribe companies out there, but most of them, you know, are similar in how they work. So they use natural language processing to, you know, abstract information. So you have it, you know, open when you are seeing a patient, and it listens to the conversation between the provider and the patient. And then it uses that AI technology to abstract the important information. And then it can populate it into usually, you know, like a SOAP note, chart note format with your subjective, objective, assessment, and plan.
Erica Dorn: And then depending on, you know, which one you’re using, some of them you have to copy and paste into your own EHR. Some of them do integrate into your own specific EHR, and then it creates that chart note for you. So it can save a ton of time. You are not having to, you know, type out or dictate your chart notes. It is using the AI technology to write your chart notes for you.
Kevin Pho: And have you used one before? And if so, how does that impact your workflow?
Erica Dorn: Yeah. So I’ve been using Freed AI medical scribe for about a year now in my own practice, and I love it. So before I was using it, I would take my computer into the room and then, you know, sit with a patient, trying to have that conversation, trying to listen to everything that they are telling me and type it out, you know, so I don’t forget anything and so I can stay caught up with my charting. And so that was just very distracting for me and for the patient. I wasn’t, you know, able to make eye contact. They didn’t feel like I was truly listening. So that’s my favorite thing about using an AI medical scribe is that the technology is doing the hard work for me. So then I can focus on talking to the patient, listening to what they’re actually saying. And then, you know, not to mention that it helps save a ton of time.
Erica Dorn: So as soon as I’m done seeing that patient, the chart note is populated within a few minutes. So then I can just, like I said, either copy and paste or integrate into my EHR, sign it off, you know, review it, of course, and then sign it off. So it really helps to stay caught up with charting. So I’m not having to bring my charts home, you know, stay late at the office to catch up.
Kevin Pho: And you said that after that patient encounter is finished, your note is more or less done. How does it work for the assessment and plan?
Erica Dorn: Yeah. So a lot of the subjective, you know, as you’re talking to the patient, they’re stating their signs and symptoms, that sort of thing. The objective, you would have to verbalize, you know, your physical exam, vital signs, you know, diagnostic data, etc. There are some of the AI scribe companies that have like templates. So you could have, you know, kind of your normal physical exam and then pull that through. And then, yeah, for the assessment and plan, some of the AI companies kind of help you create that.
Erica Dorn: So, for example, you know, with Freed AI, if I was seeing a patient with chest pain, I wouldn’t necessarily have to say, “You’re diagnosed with chest pain.” I mean, the AI would pick up on that. And then, you know, as I’m telling the patient, “OK, we’re going to draw some labs, we’re going to get an EKG,” it is helping to write that plan for me.
Kevin Pho: And you mentioned that this is life-changing. How much time does it save for each encounter, if you had to guess?
Erica Dorn: Oh, I don’t know for sure. I would say it can save you, you know, fifteen to thirty minutes per patient. Because if you were having to, you know, type out the whole chart note or dictate, it is doing that work for you. So it can save you a ton of time.
Kevin Pho: And any issues with accuracy, because I know that there are a lot of dictation systems where accuracy was an issue, but with these large language models, how does that address the accuracy issue?
Erica Dorn: Yeah, absolutely. I always recommend that providers review their note and check for, you know, accuracy. When I’m using Freed AI, though, I’ve been very impressed with just like the spelling of the medical terminology and what kind of information it is abstracting. So it is way more accurate. I was blown away by that, but also, you know, recommend reviewing it before you sign it.
Kevin Pho: So, in terms of the patient, do you ever let them know that this encounter is being listened to by the large language model? So, what kind of consent do you need before using this in a patient encounter?
Erica Dorn: Yeah. It’s always good to get at least, you know, verbal consent just to utilize the technology. All the, you know, AI medical scribes are HIPAA compliant. So that is, you know, reassuring, but it is good to get the patient’s consent before you use an AI medical scribe.
Kevin Pho: And from a cost standpoint, I’m not sure what your practice is like, but from a cost standpoint, do you have to see more patients in order to make up for the cost of the AI scribe?
Erica Dorn: Yeah, so with the different technologies or different companies, they can range, you know, Freed AI is ninety-nine a month, so that’s something that, you know, is pretty reasonably affordable for just a practitioner to start using right away. The ones that integrate within the EHR are, you know, maybe one thousand five hundred with like some setup fees. I mean, they are more, and so you would have to, you know, get permission from your clinic manager, you know, help to integrate. So the price range does vary, but, you know, with using the ones that are just a separate website browser, those are reasonably affordable. And like I said, you can start using it right away. You don’t have to wait for it to integrate.
Kevin Pho: Any downsides to using these scribes that you can imagine or have you encountered?
Erica Dorn: Yeah, so we talked a little bit, you know, cost. There is a cost, so that is one downside. Just making sure that it is HIPAA compliant and, you know, security and safety and compliance and everything. And then one thing, I never want providers to over-rely on using the technology. You still need to learn how to write a chart note, you know, what needs to go in your chart note in case that technology does not work that day, you know, you can still know how to do your job. So I stress, you know, new providers still learn how to write a chart note, but then you can also use the AI technology to help speed up that process.
Kevin Pho: So tell me some other stories from your nurse practitioner colleagues about using these AI scribes for better or for worse. What have you heard from your colleagues?
Erica Dorn: Yeah, I have heard really good reviews about, you know, several different AI companies out there. A lot of nurse practitioners and providers, myself included, were just blown away by how accurate it is, how well it works, how easy it is to use, and how much time they can save writing their chart notes. So one of the concerns whenever this topic comes up on a podcast, especially if clinicians work for a large medical system, is that there is almost an expectation that they may need to see more patients because it saves time, but they have to make up the cost of these AI scribes. So what do you think about that from these administrators who see this improvement in efficiency leading to potentially clinicians seeing more patients?
Erica Dorn: Yeah, I mean, if the technology can help you to get your charting done, there are just so many benefits. I mean, yes, you could potentially see more patients, that would have to be a discussion between you and your employer, but I feel like, you know, you’re not having to sacrifice personal time. You’re not having to, you know, stay late to chart or bring your charting home, so it can really improve job satisfaction, improve your work-life balance.
Erica Dorn: You also think about, you know, timing of your charting, getting these chart notes signed and submitting to insurance. There’s usually, you know, that ninety-day window. So, of course, employers are wanting providers to get their chart notes signed sooner rather than later so that they can submit for insurance reimbursement. So I mean, those are some of the benefits, you know, some of the things that you could talk to your employer about as far as this is how the AI technology can help us solve these problems.
Kevin Pho: Just comment in terms of how those two areas of your life have improved.
Erica Dorn: Yeah, it, I’ve just been blown away by how much time it helps me to save. And, you know, as the Nurse Practitioner Charting Coach, I work specifically with these nurse practitioners who are struggling with the charting and that lack of work-life balance and starting to feel burned out because they’re spending so many hours charting. And so, you know, utilizing this technology has been a game changer. And so I’d strongly advocate, you know, lots of different charting and time management tips, but the AI technology is one that will definitely be the future of health care. And so I encourage, you know, providers to learn, you know, to discover and to, you know, utilize that technology.
Kevin Pho: Now, there are so many AI scribe companies that are out there. You, of course, talked about Freed. The presenting sponsor of this podcast is DAX Copilot by Microsoft. Those are just two, but there are so many out there. From your experience and what you’ve heard, are there major differences between scribe companies?
Erica Dorn: Yeah, they are very, very similar. And so, like we talked a little bit about, you know, some of them, a practitioner can start using right away. They don’t have to wait for the EHR integration. The formatting, you know, might be a little bit different. So there are some, there are some, you know, differences, but overall they all work the same. A lot of the companies are coming out with like templates so you can customize them more for your own charting preferences. So I just strongly encourage providers to trial a few different ones. A lot of companies offer, you know, a seven-day trial period. And so you can use that and see, you know, maybe which one you like better.
Kevin Pho: What do you see as the future for these AI scribe technologies? Because right now, from my vantage point, it’s kind of like the Wild West. There’s so many companies that are out there. I think eventually there’s going to be some consolidation, but it’s moving so quickly, right? So let’s say the next six to twelve months, just from your experience with AI scribes, where do you see this technology heading to?
Erica Dorn: Yeah, I think we’re going to see a lot of the EHRs have them integrated into their own system, and so, you know, it won’t be like a separate package, it won’t be a separate website. It’ll be all, you know, together. And if you think about when health care switched to utilizing an EHR, I mean, it kind of seemed like something new, something we had to learn. And so, you know, the AI scribes will, you know, eventually become familiar for providers and something that they use every day. And so, you know, I definitely encourage practitioners to learn for themselves and to give it a try and to know, you know, that AI will be used in health care even more than it is now.
Kevin Pho: And from your experience, are these primarily used in outpatient settings? Are you seeing AI scribes being used in inpatient settings at all?
Erica Dorn: I’ve seen more so outpatient settings. I think, you know, eventually it will increase into, you know, inpatient settings. I personally, I work in a critical access hospital, so I do clinic and ER, and so I’ve utilized it in the ER as well. So I think, you know, it’s mostly clinic outpatient-based right now, but we will see a lot more in the inpatient setting.
Kevin Pho: We’re talking to Erica Dorn. She’s a family nurse practitioner and creator of the Nurse Practitioner Charting School. Today’s KevinMD article is “AI Medical Scribes: Boosting Efficiency or Risking Over Reliance.” Erica, let’s end with some take-home messages that you want to leave with the KevinMD audience.
Erica Dorn: Yeah, I just encourage you to give AI medical scribes a try like I’ve said, you know, it’s been a game changer for me. If you are a nurse practitioner struggling with charting and want to learn more, you can go to my website NPChartingSchool.com. I’m on Instagram, Facebook, YouTube. So I offer tons of free charting and time management tips.
Kevin Pho: Erica Dorn, thank you so much for coming back on the show and sharing your perspective and insight.
Erica Dorn: Thanks for having me.
