7/26/2023 0 Comments Digital scribe![]() ![]() The digital scribe only considers the provider's speech when generating notes. Verbal cues for summaries and section names can be customized by the provider. For example, to document family history, she asks, “Could you tell me about your family history?” Then, after collecting relevant information, she summarizes, and the digital scribe adds the note-ready summary to the family history section. To document other history sections, the provider signposts with a section name. It feels worse when he walks and climbs the stairs.” The digital scribe adds information to the history of present illness section by default. Is that right?” The digital scribe parses the summary, expands contractions, and inflects the second person to the third person so that the note-ready summary reads, “He has been having chest pain for about a month. It feels worse when you walk and climb the stairs. For example, she says, “To recap, you've been having chest pain for about a month. As the provider talks to the patient, she periodically recaps information to confirm her understanding and to allow the patient to correct any mistakes. To illustrate how patient-centered communication can facilitate automatic medical documentation, imagine an adult male patient who is presenting to his primary care provider with complaints of chest pain. Incorporating patient-centered communication into a digital scribe may mitigate longer visit times by reducing documentation times while facilitating effective provider–patient communication. ![]() 23–29 Epstein et al 30 demonstrated that patient-centered communication may be associated with lower diagnostic testing expenses but also increased visit times. 7, 8, 14–22 Other studies showed that physicians with higher malpractice rates had twice as many patient complaints about communication, and physicians with poor communication scores on the Canadian medical licensing exam had higher malpractice claims however, physicians with fewer malpractice claims encouraged patients to talk, checked patients’ understanding, and solicited patients’ opinions. 3–13 Another group of studies showed a positive association between patient-centered communication and patient recall, patient understanding, and patients’ adherence to therapy. One group of studies showed a positive association between patient-centered communication and patient satisfaction. King and Hoppe 2 reviewed multiple studies that support the use of patient-centered communication. ![]() The provider repeats the process of summarizing and signposting to confirm and obtain important information. After discussing a topic, the provider summarizes the relevant information, then transitions to another topic by signposting. These discussions also begin with open-ended questions but may later be clarified with closed-ended questions. ![]() After listing and prioritizing all the patient’s concerns, the provider discusses each item in more detail. 1 The provider then elicits the patient’s agenda with open-ended questions. Patient-centered medical interviewing begins with the provider introducing everyone present and, in nonurgent situations, making small talk to build rapport. We conclude that the patient-centered digital scribe may be an effective tool for automatic medical documentation. Patient-centered communication also enabled our system to overcome the challenges of relying solely on machine learning. By relying on patient-centered communication, our system allowed providers to simultaneously talk to patients and document information. Both participants required minimal training to use the digital scribe and improved at using the system over the course of the study. Our study showed that documenting visits with the digital scribe was at least two times faster than typing and dictation. We tested the system with two medical students, who took turns acting as the physician and the patient. The system requires physicians use patient-centered communication, a style of interaction that minimizes miscommunication and improves patient satisfaction. To help reduce physician burnout, we developed a digital scribe capable of automatically generating medical documentation by listening to physician–patient conversations. including increased risk of medical errors, malpractice lawsuits, and physician suicide. It has consequences for both physicians and patients. Burnout is affecting physicians at epidemic levels, largely due to excessive time spent documenting patient visits. ![]()
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