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Scripps Health Tests AI for Patient Messages

AI: Addressing Clinician Burnout

In an effort to curb clinician burnout and optimize time spent doing hands-on care, Scripps Health is initiating a pilot program using generative AI to help doctors respond to patients’ messages.

The responses will be drafted using AI large language model systems – similar to Chat GPT – that’ll craft messages based on patients’ messages, current medications, recent results and other clinical data.

Dr. David Wetherhold, MD
CMO for Ambulatory Systems
Scripps Health

“This technology is not designed to predict treatments or provide evidence-based decision support. Rather, it serves to make the initial drafting process more efficient, all while upholding stringent security measures that protect patient health information,” said Dr. David Wetherhold, MD, Scripps Health CMO for Ambulatory Systems and physician at Scripps Clinic Anderson Medical Pavilion in La Jolla.

To ensure that safety is paramount, all messages will be reviewed by a human before they’re sent. Scripps Health, though, has elected to not indicate that the responses are drafted by AI.

“The reason for this is that all responses are reviewed and often edited or modified slightly by a physician or member of the care team, prior to being released. This technology is a decision aid to ensure efficient turn-around time of patient requests and to allow the physician and care team to spend more time on direct care activities,” said Shane Thielman, corporate senior vice president and CIO for Scripps Health.

“If we get to the point where some responses are fully automated, we will be transparent that it was an AI-automated response,” Wetherhold added.

Fatigue Leads to Burnout

Scripps Health reports a 50% uptick in messaging since the onset of COVID-19. “There are 44 messages per day received on average, with some physicians receiving over 100 per day,” Wetherhold said. “Each message takes 30 to 120 seconds to review and complete. This has some physicians spending an hour per day just on messages.” This often happens after hours – an unreimbursed activity that’s cutting into physicians’ personal time. “Here is an example I see often. A physician sees patients from 8 a.m. to 5 p.m. and finishes up by 6 p.m. before going home to eat with [their] family, but then spends the rest of the night doing in basket messages.”

The effect is burnout. Wetherhold said the extra work is one of the top five complaints that his physicians express. “Some [situations] are even worse, where they are doing in basket messages until 2 a.m., only to get up a few hours later and repeat the process.”

Shane Thielman
Corporate Senior VP, CIO
Scripps Health

The Rollout

The pilot is taking place at the Scripps Clinic Anderson Medical Pavilion (AMP) with one physician to start but will expand to all five of its primary care physicians and two advanced healthcare providers in the next month.

“The initial implementation is focused on primary care,” shared Thielman. “Primary care is most impacted by in basket messages…We are in an initial adoption phase and learning and adapting to the technology in a controlled manner so that we can expand to additional care teams.” The hospital network will collaborate with healthcare software provider Epic Systems to continue to refine the AI tool through weekly check-ins and clinician feedback.

Earlier this year, UC San Diego Health launched a similar program, using operationalized AI to draft messages to patients.

Scripps Health

FOUNDED: 1924 by philanthropist Ellen Browning Scripps
HEADQUARTERS: San Diego

BUSINESS: Healthcare
VALUATION: $4.3 billion

EMPLOYEES: almost 17,000
WEBSITE:  scripps.org
CONTACT: 1-800-SCRIPPS
NOTABLE: Recently ranked #5 on the “Fortune Best Workplaces in Health Care 2023” list.

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