Robbie Price, a nurse practitioner at Centra Health in Bedford County, has experienced an array of note-taking methods throughout his two decades in healthcare. From traditional pen and paper to advanced voice recognition systems, he has seen it all. Recently, a groundbreaking innovation has emerged: an artificial intelligence-driven "ambient digital scribe." Price notes that this technology has been “transformational on the clinical end.”
This innovative tool, installed on a physician's smartphone, listens to conversations between providers and patients, converting these discussions into comprehensive clinical notes. Centra, located in Lynchburg, introduced this app in July. By utilizing the scribe, healthcare professionals can dedicate their attention to patients rather than jotting down notes. The software intelligently filters out casual dialogue, like discussions about pets or sports.
Within minutes after a consultation concludes, the app generates a complete clinical note, according to Price, who also holds the position of director of advanced practice provider operations at Centra. He explained, “This technology essentially shifts providers from the role of note creators to that of editors.”
Similarly, Carilion Clinic in Roanoke began incorporating AI-powered documentation tools, such as digital scribes, into its clinical workflows in 2023. The integration of these tools has expanded across various care teams since their adoption.
Dr. Maruf Haider, the associate chief medical information officer at Carilion, pointed out that being more engaged with patients during appointments enables clinicians to remember details more accurately when reviewing and finalizing notes later. Patients have the option to view their notes during appointments, enhancing transparency.
The advantages of employing such technology are clear. Many healthcare providers, as Price describes, often devote “pajama time”—hours spent after work—on documentation. With automation, these providers can complete their records more efficiently, allowing them to return home sooner. This exemplifies the rapid advancement of artificial intelligence in healthcare, alongside tools enhancing imaging speed, streamlining communications, and boosting clinician efficiency.
However, these developments have raised concerns about data security, patient privacy, and the evolving roles of healthcare professionals as technology advances. Dr. Maxim Topaz, an authority on AI technologies to enhance patient-provider interactions from the Columbia School of Nursing, highlighted that the accuracy of AI can vary widely across clinical environments. He emphasized that legal and ethical guidelines have not kept pace with this adoption, raising issues regarding transparency in the use of such tools.
A 2026 American Medical Association survey found that around 81% of physicians utilize AI for various tasks, from conducting research to documenting patient visits. Many healthcare leaders see this shift positively, citing increased efficiency, reduced administrative burdens, and mitigation of clinician burnout as key benefits, according to Beth Bortz, president and CEO of the Virginia Center for Health Innovation.
Nevertheless, some patients, particularly younger individuals, express hesitation. Bortz noted that many inquire about the storage and use of their personal information, with concerns often centered around third-party vendors providing AI services. These external developers come with their own set of data access, accountability, and risk issues. Gurkan Akalin, executive director of the Institute for Applied Data Analytics at the University of Virginia’s College at Wise, pointed out that strong cybersecurity measures and responsible data handling are crucial.
The reliance on third-party AI tools raises significant security and data privacy questions, necessitating clear communication between healthcare systems and their vendors to safeguard patient information. Hospitals are bound to comply with HIPAA regulations, which dictate how protected health information is electronically stored and transferred. The law requires comprehensive safeguards to ensure patient privacy.
At LewisGale Medical Center in Salem, technology implementation is guided by support from its parent company, HCA Healthcare. Its electronic health records system, built on MEDITECH Expanse, has been uniquely developed for HCA. In comparison, Carilion often develops AI tools through long-standing vendor relationships, such as utilizing Epic for its MyChart patient portal.
Dr. Stephen Morgan, Carilion's senior vice president and chief medical information officer, mentioned that the health system receives countless proposals from vendors each year, offering new AI solutions. "Buyer beware," he cautioned, highlighting that while some vendors provide reliable data, others lack peer-reviewed information or credibility.
Hospital administrators agree that regardless of the technology's classification, all new tools must undergo rigorous evaluation concerning security and patient privacy prior to their integration. This thorough vetting process may slow down adoption, a point made by Jen Halikman, Centra’s vice president of applications information technology.
Carilion's Haider remarked that patients commonly share substantial personal data via everyday technology, and similar transparency regarding AI must be maintained across the board. Centra ensures patient consent for AI usage and renews it each year, informing patients when conversations are recorded. If patients opt out, traditional consultation methods remain available.
In some cases, there's still apprehension about AI, particularly in clinical settings where patients feel more secure. Topaz pointed out that not all health systems are forthcoming about their AI tool usage. While no federal mandate exists for disclosure, he believes patients deserve to know and often should be allowed to opt out.
Price emphasized the vitality of human oversight in any AI application, particularly regarding potential errors in automated notes. He stated, "Ultimately, the provider is still accountable for the note they sign." Although most providers have reported few errors concerning the digital scribe, Price reassured that the AI will continue to improve with utilization.
This partnership between AI and human practitioners doesn’t mean the former assumes control over critical medical decisions. As healthcare continues to adopt more AI technologies, advocacy organizations, like the Patient Advocate Foundation, are examining the interface between AI and patient care. According to Gwen Darien, executive vice president of advocacy and education at the foundation, patient engagement in the conversation surrounding AI and its applications is paramount.
Spearheaded by advancements like those at Centra, where an AI framework speeds up stroke diagnostics, the emphasis remains on human involvement. In stroke care, where every second is crucial, this platform has halved the time from “door to read” for brain scans. However, human radiologists maintain the final authority on interpretations regarding conditions.
As technology evolves, healthcare leaders are pondering the implications of greater autonomy for AI systems. Haider indicated that this transformation could significantly influence future medical training, as students who grow up with AI may prioritize decision-making over mere knowledge retention.
Undeniably, the demand for knowledgeable clinicians who can adeptly navigate AI tools is essential. Dr. Zachary Williams, emergency department medical director at LewisGale, emphasized the current balancing act medical educators face: nurturing strong clinical reasoning skills alongside a comprehensive understanding of AI technologies.
Additionally, hospitals are leveraging AI within patient portals, streamlining communications between patients and care teams. AI assists in triaging messages based on urgency, dramatically reducing the workload for nursing staff. According to Bortz, the integration of AI in these processes highlights how efficient they can improve communication flows.
As healthcare systems gear up to expand their use of AI technologies, Centra is exploring creating AI-generated patient summaries based on information derived from digital scribes and other tools. In line with these advancements, Carilion aims to integrate AI into nursing workflows, thereby enhancing overall operational efficiency.
Ultimately, as the integration of AI advances within healthcare, the focus continues to be on boosting efficiency and supporting clinical decision-making while balancing patient privacy and safety. Hospital leaders foresee a future where autonomous AI systems will play an increasingly crucial role in patient care, though such a transformation will occur gradually.
