Health care in the AI era

Three perspectives on the risks and benefits of new digital technologies 

Melanie Irwin, Primary Times Managing Editor 

Many primary health care organisations have been quick to adopt new tools powered by artificial intelligence (AI). The benefits of these tools include improved efficiency and better conversations with patients. However, as with any kind of new technology, there are also risks. Three healthcare professionals share the impact of AI technology and other digital tools on their day-to-day work. What’s working well? And how can nurses adapt to these changes?  

How have recent developments in digital technology impacted your role in health care? 

Tracey Johnson: Significantly! Our team at Inala Primary Care uses Lyrebird to scribe consultations, Samantha to acquire incoming correspondence for our medical records and various other systems to help us prepare documents, meeting summaries and so much more.  

AI has also meant big changes to how our chronic disease care processes work. Our doctors consult with patients and use AI tools to generate plans for health coaching and patient-support visits throughout the remainder of the year. Our nurses then follow up with the patients to do that work. The quality, efficiency and cost-effectiveness of this process have improved a lot.  

Our nurses have a growing interest in health coaching, and AI tools help us schedule reminders, track goals and embed education in ways that improve the continuity of care and the relevance of conversations with patients.  

Anju Thakur: Next Practice Deakin cares for a large number of patients, including many in aged care, and we are using AI-powered tools to streamline our processes. My colleagues and I use Heidi for documentation of patient consultations and Cubiko to identify patients who need recalls or chronic disease follow-up. The practice’s administrative team and patient advocates also use AI tools for managing patient records.  

Patricia Jones: As an educator at Griffith College, generative AI (GenAI) has improved efficiency in developing teaching materials, and with practice and understanding of the importance of the prompts used, my GenAI skills are improving. 

Significantly though, since 2023 when Open AI released ChatGPT, I have seen a decline in independent critical thinking and clinical reasoning among some learners. This has caused increased workloads for educators in assessing academic integrity, and concerns around valid education outcomes.  

With the rapid growth of the technology, though, we now have new AI tools to support student learning. We have implemented a GenAI tool specifically developed for students that responds much like a tutor would do. The system responds to student prompts and provides clear guidance but does not do the work for them. This type of evolution gives great possibilities in the safe and effective use of AI in healthcare education. 

Many healthcare workplaces now encourage the use of specific GenAI platforms. There are increasing issues to safeguard the business, though, so it is important for employees to comply when at work. 

What kind of benefits do AI technology and other digital tools provide for primary health care clinicians and patients? 

Patricia: The Royal Australian College of General Practitioners (RACGP), APNA, and the Australian Health Practitioner Regulation Agency (AHPRA) see great potential for AI use to increase efficiency around administrative tasks, access to a patient's preferred language, improving diagnostics and even personalising care. AI scribes, such as Lyrebird and Heidi, allow GPs and nurses to spend more time in patient care and less time at the computer. They meet Australian privacy laws and integrate with medical software. Many other forms of medical technology, such as wearable technology and virtual reality, are also AI integrated and will improve access and efficiencies.  

Anju: My colleagues and I appreciate the way that these tools can save time, reduce our workload and improve continuity and coordination of care. Before a patient consultation, I will check Cubiko to see if there are any extra measures I can offer. The tool analyses patients’ medical records and provides prompts for different types of care, such as preventative care and care plan reviews. In a busy clinic, we might not always remember to offer these extra measures and Cubiko ensures these opportunities are not missed. 

During consultations, Heidi transcribes our conversations with patients and automatically formats the information according to its built-in templates. Afterwards, I check the information and save the template. It saves me so much time and mental load! This allows me to focus on the patient and our conversation. The quality of those conversations has improved a lot thanks to this technology. Eye contact is so important for building rapport, and I can’t make eye contact if I’m constantly taking notes. Using Heidi, I can focus on what the patient is saying and they feel heard.  

Tracey: Lyrebird saves our GPs time with note taking and makes the consultations more personal. Patients love that the clinicians are interacting with them. They find the discussions more conversational and less structured, which makes for easier participation. The AI tools manage to take from the more organic conversation the most remarkable insights, goals and actions and organise them into excellent plans. Key actions can then be delegated to our nursing team and scheduled via our Chronic Conditions Coordinator. 

AI also provides a fabulous tool for summarising key information and digesting the latest and greatest. We have done so many literature reviews in recent months using AI. It has brought much more current information to our team as they discuss changes to protocols and emerging evidence … and we don’t need to spend days collating the evidence! 

We have also used AI to generate procedures, event checklists, blogs we are releasing to patients and so many other written forms of communication. We pair such things with our organisation’s tone-of-voice document, which took many of us some time to develop. Each type of document we generate fits the style and standard we have set and simplifies and streamlines the creation of new content. 

What are the risks associated with AI tools in health care and how can nurses mitigate these risks? 

Patricia: Key risks include privacy breaches, inaccurate or biased outputs, erosion of clinical reasoning, and overdependence on technology. Nurses can mitigate these risks by maintaining strong clinical judgment, questioning AI recommendations, safeguarding patient data, following organisational policies, and promoting responsible, transparent use of AI in practice. Consideration must be given to ethical use and ensuring transparency by advising the patient that an AI tool will be used. 

It is critical that nurses and other healthcare providers learn what AI is and what GenAI is and how we should interact with each type. This requires specialised AI platforms and with this comes a financial consideration and time factor for staff education. 

Tracey: We are very aware of privacy concerns. Any care needs to comply with privacy standards and confidentiality. We always use the right sort of AI tool for the task so that we do not breach patient privacy or organisationally commercial-in-confidence information. 

Using off-the-shelf tools not developed in Australia for medically specific applications is a risk. Your data will be pooled, shared and used in ways that do not fit our legislative environment. Lyrebird and Samantha have been developed to comply and embed well with systems like Best Practice [medical software], so we are happy with the adoption. 

Also, AI makes mistakes. Reviewing all the plans generated by AI is a must. Your notes must be edited too. Even so, the time savings are so good that reviewing notes and tweaking them is still a good use of time. 

Anju: We need to form good habits and remain vigilant. I always obtain informed consent from patients before using AI tools during consultations. Technical disruptions are another risk. I’ve learnt from experience to check that the technology is working. I always try to have my laptop fully charged. And I check and edit my documents at the end of every day. We can’t let the tools replace our clinical judgement. We need to use AI as a support tool, rather than a substitute for professional reasoning. We also need to stay up to date with training to ensure safe and effective use. 

Patricia: Clinicians should also understand the benefits and limitations of AI in relation to how their patients are using it. Some nurses I’ve spoken with have seen an increase in patient use of ChatGPT and Claude, rather than the appropriate health websites. These general-purpose GenAI tools are quick and accessible, but they might provide incorrect or non-personalised information, which is a risk for patients with low health literacy. This indicates a need to educate our patients about health literacy in the AI era. Safe use depends heavily on clinical oversight and judgement. 

Looking ahead: Advice for nurses 

Anju: At first, I wasn’t confident about using these tools. I remember thinking that I would prefer to take my own notes! I’ve gotten used to them now, though. My advice to other nurses is to give it a try and feel the difference. I’m sure you’ll recognise the benefits.  

Tracey: Recent surveys show that many GPs have been quick to adopt AI scribes. Dedicated scribes for psychologists and other mental health professionals are already on the market. Sometime soon, dedicated attention will turn to general practice nurses too, so keep an eye out for more nursing-specific AI tools.  

Clearly, AI is increasingly going to be used in diagnosis, by replacing radiologists reading images, pathologists analysing samples and so many other diagnostic activities. It will increasingly be used in analysing all sorts of data and helping us understand trends, good and bad. 

Patricia: Nurses should educate themselves on what AI is, how it is used and, importantly, review the guidelines of our governing bodies, such as AHPRA, the Nursing and Midwifery Board of Australia and other leading health and nursing organisations, such as the RACGP, the Australian College of Nurses and, of course, APNA. 

Anju: Heidi has just released a new clip-on wireless microphone that can record a whole day’s worth of consultations. This looks like a great tool and we’re thinking of trying it soon. I will keep building on this experience with AI tools as I work towards my NP qualification. It’s the best way to ensure that I can give that extra time and attention to my patients.