WORCESTER MEDICINE
A.I. In Medicine
Do Patients Want Artificial Intelligence or Human Intelligence? Larry Garber, MD
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ne thing that the COVID-19 pandemic taught us is that good healthcare does not mean a patient has to deal with traffic, parking, and waiting room issues. In fact, for some types of problems, patients have preferred video visits from their home over an in-person office visit [1]. Convenience and cost are major factors in that decision. But how far removed from direct contact with their healthcare provider are patients willing to go for the sake of convenience and cost? Are they willing to let artificial intelligence (AI) guide their medical care? The answer is a resounding “Yes!” Patients are accepting, and, in some cases, preferring the medical guidance that they can receive from AI. Reliant Medical Group first Figure 1. OpenAI’s test results on standardized exams (Source: https://openai.com/research/gpt-4) tested the waters of AI-assisted patient care with the development and implementation of a symptom checker in 2021. Unlike other symptom checkers available on the internet or offered by some electronic health record (EHR) vendors, this system leverages the patient’s known medical history to reduce the number of questions needed to give guidance on over 800 conditions that could be causing their symptoms. It provides education on what each condition is, how to undertake self-care if appropriate, and when to seek medical care if the condition gets worse. Patients love it because half of them use it after hours and on weekends when the offices aren’t open, and a quarter of them get enough self-care information that they do not need input from Reliant’s providers or staff. This frees up Reliant’s providers and staff to In the past year, a form of AI known as “Generative AI” has hit the help serve other patients who have more acute needs. headlines. One version known as GPT-4 by OpenAI has been able to surpass humans on many standardized tests [2] (Figure 1) and specifically outperform If patients do want to schedule a video visit, they can do most physicians in the United States Medical Licensing Exam [3]. that directly from the app. All the symptom history they Even more remarkable is that GPT-4 scored higher on communication already entered will be available to the clinician within the EHR, so they don’t need to give their history again. skills such as empathy and professionalism than the average physician The symptom checker has also potentially saved several [4,5]. This has indeed been the experience as EHRs such as Cerner lives, referring some patients to the ED who were and Epic have implemented GPT-4-generated draft responses to online originally planning to undertake self-care, resulting in patient portal questions. As these messages appear in the In Baskets admissions for serious conditions. of physicians and nurses, the EHR displays an optional draft response.
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…GPT-4 scored higher on communication skills such as empathy and professionalism than the average physician.
Winter 2023
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