Artificial Intelligence Proves to be an Effective Tool for Documenting Orthopaedic Encounters in Hand Surgery
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LAS VEGAS, March 7, 2023 ~ A new study presented at the 2023 American Academy of Orthopaedic Surgeons (AAOS) Annual Meeting has revealed that while Electronic Health Records improve access to patient information, charting increases the clerical burden on physicians. Medical documentation has been identified as a contributing factor to burnout, and the study sought to analyze the use of documentation modalities including artificial intelligence (AI)-based virtual scribe services to determine the overall quality and time it takes to capture a patient encounter.

Michael Rivlin, MD, FAAOS, orthopaedic surgeon at Rothman Institute and associate professor at Thomas Jefferson University in Philadelphia, explained that "in our practice, we created a task force to better understand and correct physician burnout to study what we know to be the top reason for burnout ­– patient documentation. We wanted to look at ways to maximize the physician's workload at the maximum level of their license and remove burdens that can lead to burnout by finding methods to outsource certain tasks, such as documentation, as this can be time consuming and redundant."

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The team compared the quality and time spent documenting common orthopaedic encounters in hand surgery using four different modalities during a patient visit: AI-based virtual scribe service; medical scribe; transcription service; and voice recognition mobile (VRM) application. Three fellowship-trained orthopaedic hand surgeons evaluated 10 standardized patients with prewritten clinical vignettes. Clinical documentation was performed during the clinical encounter using AI-based scribe and medical scribe, and then afterwards using VRM and transcription service.

The results showed that all modalities performed well with similar documentation outputs between each. The AI scribe scored significantly lower than other modalities for one specific question: "Is the plan correct?" – whereas AI was able to get most of verbalized narrative throughout entire encounter for accurate documentation; however manual edit of plan section was required. Documenting clinical encounters through transcription services and VRM applications requires substantial time compared to auto-populated AI-based notes. The average time per note for VRM and transcription service was 3.48 min and 3.22 min respectively.

Dr Rivlin concluded that "the AI-based virtual scribe service is a promising tool to help decrease documentation burden without significantly lowering quality of documentation compared to transcription and voice recognition software services." He added that while AI has some limitations, it continues to improve as technology advances, providing physicians with a palette of options for comparison should they want explore new modalities."
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