On an average day, David Wetherhold, MD, engages with his patients through 47 to 100 electronic messages, dedicating upwards of one hour of his time to this increasingly important aspect of care. With the introduction of a new pilot program at Scripps Health this week, Dr. Wetherhold and other clinicians will have the opportunity to optimize this time, directing even more focus toward hands-on patient care.

Scripps Health is piloting an artificial intelligence (AI) tool aimed at streamlining physician-patient communications, allowing clinicians like Dr. Wetherhold to focus more on patient care while potentially reducing clinician burnout that is commonly associated with administrative tasks.

Physician responses to patient messages are generated through the use of a large language model (GPT models via Microsoft Azure OpenAI Services) that uses a simple query that includes the patient's message, current medications, and recent results, among other clinical data, and the AI tool crafts a draft reply that reads like natural language. 

"This technology is not designed to predict treatments or provide evidence-based decision support. Rather, it serves to make the initial drafting process more efficient, all while upholding stringent security measures that protect patient health information," according to Dr. Wetherhold, who is the chief medical information officer for ambulatory systems at Scripps Health and also an internal medicine physician at Scripps Clinic Anderson Medical Pavilion in La Jolla.

Human Oversight is Paramount

The AI tool is not designed to predict treatments, provide evidence-based decision support, diagnose, or prescribe treatment. It serves to assist clinicians, and the AI-generated, HIPAA-compliant drafts must always be reviewed by a provider for accuracy and appropriateness. 

"It's a virtual assistant that tees up messages for clinicians to review, allowing us more time for direct patient care," said Dr. Wetherhold. "Clinicians remain an irreplaceable part of the communication loop with patients. This AI tool is an assistant, not a substitute." 

Addressing Clinician Burnout

By simplifying the administrative aspects of patient communications, the tool aims to alleviate clinician burnout — a growing concern in health care. Dr. Wetherhold notes that the volume of patient messages arriving in physicians’ in-baskets has seen a roughly 50% uptick since the onset of COVID-19, thereby cutting into the time available for face-to-face patient interactions.

"We hope that by easing some of the administrative load, physicians can focus more on the personalized care that attracted them to medicine in the first place," said Dr. Wetherhold.

Future Development and Collaboration

Scripps Health, in collaboration with Epic Systems, will continue to refine the AI tool through weekly check-ins and clinician feedback. Currently, there is one Scripps primary care location involved in the initial pilot, and the plan is to gradually roll out the feature to a broader range of healthcare providers in the coming months.