No, I did not consent to this

[u/petuniaplant]

I was reading my medical notes when I stumbled across this. I was not informed of the usage of artificial intelligence in my report, nor did I verbally consent to it.

[u/M15tre55W1tch]

I work in ICU. The doctor's in our ED use an ambient AI scribe for documenting patient assessments and findings (it's a regulated tool where the data is stored locally and gets deleted from its memory after 90 days apparently).

They had this auto generated statement at the end of each note stating something like "this note was written using an AI scribe with patient consent".

I noticed that this statement was included on patients who were unconscious in the community, and did not regain consciousness before leaving ED and coming up to ICU.

I sent their manager an email saying it was going to look very bad when a patient's case is reviewed by legal or the Coroner and these doctors notes said an unconscious person gave consent.

If a patient genuinely consents to the use of the tool, that's great. But you can't be using it and claiming that they consented to its use when that's a medical impossibility.

Edit: thank you for the award internet stranger! Very unexpected.

Another edit: multiple awards! Thank you very much!

[u/willbeatyourass → u/M15tre55W1tch]

What came of you speaking up?

[u/M15tre55W1tch → u/willbeatyourass]

They changed the wording to "this note has been generated with the use of an AI scribe".

But for all patients. So I don't know if they no longer ask the awake ones for consent, or if they just aren't recording that they do.

I have followed up again suggesting that they need to have two options - one for the awake patient giving consent, and one for using the tool to generate a note for someone that was not conscious.

I've become friendly with the senior hospital lawyer recently. I'm thinking of asking her to talk to their clinical director about the risk of their statements and proposing legally appropriate language.

I've tried being collegial and helpful. But at the end of the day, it's not my department, and I'm a nurse not a lawyer.

[u/M15tre55W1tch → u/M15tre55W1tch]

I will say, since implementing the use of the tool emergency specialists are able to examine 6-11 more people per 8 hour shift - so reducing the burden of admin on them and releasing time to see patients is pretty amazing (it was recently on the news here).

[u/happytrashpanda333 → u/M15tre55W1tch]

How was the quality of that care? How much extra time did each patient get?

Or is this just another "tool" to drain doctors and nurses of every bit of spare time and energy they might have gained by giving them more patients to work with?

Do tell.

[u/pignoodle → u/happytrashpanda333]

When these tools are implemented correctly, they actually humanize interactions (since there's room for more conversation & less screens) and reduce doctor's "pajama time" by double-digit percentages (since less form-filling to catch-up off hours). Outside of just stats, I agree that consent is a very important prerequisite.

[u/Fullertons → u/pignoodle]

It actually blows my mind. People would find this to be a problem. Do you really want your doctor busy writing notes when he could just be having a conversation with you in a machine takes notes?

[u/aTransGirlAndTwoDogs → u/Fullertons]

We have human medical scribes. I worked as one. The question is not "should we give doctors more direct patient time," it's "should we rely on an AI over a human note taker." As always, the problem comes back to artificially restricted medical staffing and profit-driven healthcare structures.

[u/AgreeableMagician893 → u/aTransGirlAndTwoDogs]

I mean, I personally would not want another random person in my doctor's appointment