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Dr. Abbas Zavar, Simon Ling 

In the not-so-distant future, artificial intelligence (AI) tools will become standard features of patient visits with their doctors. A wave of advancements in AI is already beginning to reshape the health care landscape. This article addresses the art of the possible from the patient’s and doctor’s perspectives, however, it does not exhaustively catalogue commercial technology offerings for any market/area referenced.

The Patient’s View  

Before the Visit 

Meet Stuart, a concerned individual who’s been feeling unusually fatigued lately. Eager to discuss this with his family doctor, he turns to his innovative “AI Patient Companion,” “Chandi.” Initiating an interactive dialogue, “Chandi” systematically collects essential details about Stuart’s symptoms, recent medical history, and pressing concerns. This intelligent preliminary assessment is designed to guide Stuart toward understanding his situation better. 

However, there are additional activities taking place in the background. Through a seamless collaboration between “Sapien,” the AI solutions package used by Stuart’s doctor, and Stuart’s “Chandi” AI solutions package, the tools work discreetly, using Stuart’s Electronic Medical Record (EMR) data to comprehend his recent medical info, e.g., lab test results, and overall health status. By conducting meticulous analysis, the AI identifies potential areas that might necessitate a more thorough evaluation and recommends that Stuart complete a more detailed checklist or assessment survey before scheduling the appointment. 

Stuart’s health care journey is now guided by “Chandi,” which also acts as an expert health chatbot. “Chandi” uses Stuart’s newly provided information and existing EMR data to triage him. It answers Stuart’s health-related queries and smartly schedules an appointment, considering the urgency of his situation. Simultaneously, the AI’s unique ability to assess symptoms, medical history, and risk factors ensures urgent cases like Stuart’s are prioritized. 

“Chandi” considers Stuart’s condition (after triaging), his doctor’s availability, and personal preferences to schedule the best available appointment time. As the visit draws closer, “Chandi” prepares Stuart for the appointment with educational content customized to his health condition, potential treatment plans, and any upcoming procedures, enhancing his understanding and efficiency of the visit. Should new information arise, this system promptly reschedules appointments, ensuring patients in critical need are always cared for. 

“Chandi” also offers personalized reminders through Stuart’s preferred communication channel to ensure he is well-prepared for the visit. These reminders keep him on top of appointment schedules and vital pre-visit preparations. 

During the Visit 

Upon arrival at his doctor’s office, Stuart experiences the brilliance of AI integration in the in-visit stage. The AI Voice Assistant (one of “Sapien’s” features) records the entire consultation, creating detailed clinical notes as a Clinical Ambient AI Scribe. This allows his doctor to concentrate entirely on Stuart during the visit, enhancing the quality of compassionate care. 

Simultaneously, “Sapien,” which is integrated with the EMR system, interprets the dialogue, and cross-references the medical history, lab results, and latest medical research to propose a personalized care plan. If medications are prescribed, “Sapien” scrutinizes them for potential drug interactions and allergies, ensuring a safe treatment plan for Stuart. 

As the consultation concludes, Stuart’s post-visit journey begins. “Sapien” meticulously handles documentation, tracking, and coding of patient encounters, allowing the doctor’s office to prioritize patient care over administrative tasks. 

After the Visit 

Following the appointment, Stuart interacts with “Chandi,” receiving timely reminders and follow-ups. “Chandi” now acts as an Integrated Patient Communication & Empowerment tool, keeping Stuart well-informed about his medications, self-care, and overall health plan. “Chandi” also offers personalized educational materials and self-management tools, promoting adherence to treatment recommendations. 

In situations that require it, “Chandi” offers an additional feature known as Remote Patient Monitoring, which enhances Stuart’s health care experience. This advanced system uses wearable devices and medical equipment to continuously monitor Stuart’s health in real time, promptly notifying health care providers and caregivers of any alarming patterns or indicators. As a result, it ensures a complete view of Stuart’s health while continually improving accuracy and effectiveness through ongoing data analysis. 

The Doctor’s View  

Before the Visit 

Stuart’s journey to Dr. Razi’s clinic begins long before he steps through her door, guided by his interaction with “Chandi” which plays a critical role in the pre-visit stage. At the doctor’s end, Dr. Razi starts her day by reviewing her schedule and the pre-visit summaries provided by “Sapien” (an innovative AI solutions package for doctors), which integrates seamlessly with her EMR system for each patient to help Dr. Razi to deliver enhanced patient care. 

As Stuart’s appointment draws closer, Dr. Razi employs “Sapien” to provide her with a comprehensive overview of Stuart’s symptoms, health history, and immediate concerns. This data, collected through “Chandi,” and wearable devices before the visit, is cross-referenced with Stuart’s most recent EMR data. Equipped with this rich health data narrative, Dr. Razi can plan her consultation more effectively and anticipate potential diagnosis paths and risk factors for Stuart. 

“Sapien” also supports Dr. Razi in preparing for upcoming appointments, and she meticulously reviews recent medical documents, including lab results and specialist consultation reports. By focusing on critical details, the assistant saves Dr. Razi’s valuable time and ensures that no vital information goes unnoticed. 

During the Visit 

During Stuart’s doctor visit, Dr. Razi is aided by the Clinical Ambient AI Scribe (a feature of “Sapien”) to take intensive notes and enter data, capturing and transcribing real-time interactions. This frees up Dr. Razi to devote her full attention to Stuart, leading to a more compassionate, patient-centred interaction. Simultaneously, the AI interface provides voice-activated access to the EMR, permitting Dr. Razi to pull up relevant information or input new data through simple voice commands. This feature facilitates a more human-centric encounter, eliminating the distractions of keyboarding. 

“Sapien” offers Dr. Razi a range of support functionalities during Stuart’s consultation. It helps generate referral letters, proposes evidence-based treatment suggestions, designs and offers personalized care plans, and recommends follow-up plans. This suite of capabilities ensures Stuart’s consistent and efficient care journey, perfectly tailored to his unique health profile. 

After the Visit 

Post-visit, “Sapien” steps in, ensuring accurate coding for the patient encounter and streamlining the billing process. This helps to reduce Dr. Razi’s administrative burden enabling her to focus more on direct patient care. 

After the consultation, “Chandi” engages with Stuart, providing reminders, coordinating follow-up appointments, and dispensing tailored health advice. These features foster compliance with treatment protocols, fortifying Stuart’s active involvement in his health journey. Furthermore, it collects updated data on Stuart’s’ health status through wearables, surveys, and chatbots, updating his EMR profile accordingly. Meanwhile, “Sapien” continuously monitors Stuart’s health data, identifying significant changes and alerting Dr. Razi promptly. This ability for swift intervention dramatically improves Stuart’s overall care and enables a rapid response to any urgent situation. 

Finally, the AI-Enhanced Quality and Outcomes Management System monitors and optimizes Stuart’s care, tracks patient outcomes data, identifies areas requiring improvement, and ensures that Dr. Razi’s practice adheres to the highest standards of care. It also updates Dr. Razi with the latest medical research relevant to her practice or specific patient cases, contributing to continual learning and growth. 

Bringing the Patient and Doctor Views Together 

AI-IntegratedCare, as exemplified through Stuart’s and Dr. Razi’s experiences, depicts a compelling vision of the future of primary health care. This narrative isn’t just about novel technology but an anticipated transformation that deepens the patient-physician relationship, fostering a compassionate and patient-centred approach to care. AI-IntegratedCare facilitates the seamless transition of patient information from pre-visit assessments to in-visit diagnostics and post-visit follow-ups. AI-IntegratedCare ensures a smooth flow of patient information, encouraging patients to take an active role in their health care while assisting doctors by reducing administrative burdens. This potent synergy boosts treatment adherence and outcomes and fortifies the human essence in patient care. 

The fusion of AI into health care aims to enrich, not replace, the human touch in care delivery. It evolves into a data-rich platform, driving continuous learning, improved quality of care, and better patient outcomes. 

Undoubtedly, there are significant barriers and gaps that must be navigated in the quest to achieve this fully AI-integrated health care workflow. Policy-making will play a crucial role in shaping the path forward, as numerous regulatory, ethical, and practical issues need to be thoroughly addressed. For AI solutions to be widely adopted, they must be rigorously tested to ensure they operate with minimal bias and uphold the highest ethical standards. Data access, interoperability, privacy, and security are critical concerns that must not be overlooked; they are fundamental to establishing a robust and reliable AI-IntegratedCare. It is paramount to ensure that AI systems are transparent and that their decisions can be understood and trusted by health care professionals and patients alike. As we move toward this promising future, we must proceed with diligence and intention, striking a balance that prioritizes both technological innovation and the preservation of the deeply human aspect of health care. 

Interestingly, some of these AI concepts are not visions. They are under development or already available in the market, steering primary care toward being more efficient, personalized, and patient-centred. OntarioMD champions this revolution, supporting the development and integration of AI solutions in primary care practices. 

OntarioMD’s goal is not just to envisage an AI-powered primary care landscape but to implement it. We strive to support Ontario doctors to enhance care quality, patient experiences, and health outcomes. With a strategy that encourages AI development to bring innovative solutions to life, we aspire to make this future a reality. In this dawn of this new era, we stand on the brink of transforming health care into a more accessible, efficient, and personalized experience, seamlessly weaving compassion, and technology. 

Appendix: A Summary of AI-enabled Solutions 

“Chandi,” the “AI Patient Companion” for patients and “Sapien,” the “AI Clinical Assistant” for doctors, encompass a suite of advanced AI features that aim to enhance patient care and reduce the administrative burden on doctors before, during, and after visits.  

What’s in the AI Patient Companion (Chandi): 

• AI-Enabled Health Assessments and EMR Analysis: Patients take an initial health assessment and input symptoms that leverage the patient’s Electronic Medical Record (EMR) data for more comprehensive evaluation. 
• Intelligent Virtual Health Aides: Possibly an AI-powered chatbot that collects patient data, facilitates in-depth clinical evaluations, responds to patient inquiries, offers health-related education, and manages appointment scheduling. 
• AI-Supported Patient Triage: Evaluates patients based on their symptoms, medical history, and risk factors to prioritize urgent cases. 
• Tailored AI Education (pre-visit): Provides patients with AI-generated educational content specific to their conditions and potential treatments. 

• Intelligent Appointment Management: Enhances appointment scheduling and rescheduling by considering factors like visit urgency and doctor availability. 
• Personalized Appointment Reminders: Generates reminders for upcoming appointments and medication timings, delivered via the patient’s preferred method. 
• AI-Powered Remote Monitoring: Uses wearable devices to track vital health parameters and uses AI for real-time data analysis to detect patterns, trends, and anomalies. Upon identifying potential health concerns, it alerts doctors in a timely manner, enabling early interventions. It also personalizes patient monitoring plans, integrates with medical devices and wearables, and provides insightful health recommendations based on real-time data. 
• AI-Customized Post-Care Management: Tracks follow-up appointments, sends reminders, and identifies patients needing extra care using predictive analytics and previous interaction data. 
• Unified Patient Communication & Engagement: An AI chatbot that answers common patient inquiries, provides medication reminders, and offers personalized health advice to improve patient engagement and treatment adherence. 

• AI-Supported Self-Care Education: A tool that uses data from previous patient interactions to generate personalized educational materials, care plans, and self-management tools. 
• AI-Enhanced Quality & Outcome Management: Harnesses AI to track patient outcomes, analyze care components, ensure compliance, and keep doctors informed with the latest medical research. 

What’s in the AI Clinical Assistant (Sapien): 
Most of these features are integrated into the EMR system. 

• Document Analysis and Review: Conducts AI-enabled review of patient EMRs, summarizing past medical issues and examining the latest information provided by the patient. 

• Clinical Ambient AI Scribe: Converts real-time patient-doctor conversations into written clinical notes, ensuring all key details and observations are accurately recorded. 
• Voice-Activated EMR Interface: Allows health care providers to interact with EMR systems using voice commands, enhancing efficiency, and reducing errors. 
• Automated Referral Management: Assists in creating referral letters to specialists, simplifying, and speeding up the referral process. 
• AI-Assisted Diagnostic Tool: This smart Clinical Decision Support System (CDSS) uses patient symptoms, medical history, lab results, and the latest research to recommend evidence-based treatment plans. It facilitates collaborative decision-making by considering top-tier clinical evidence and the patient’s values and preferences. It also anticipates potential health risks and proposes relevant clinical interventions. 
• Personalized Care Plan Generation: Generates tailor-made care plans by analyzing the patient’s information gathered before and during the visit, ensuring alignment with each patient’s specific requirements. Using patient data and clinical guidelines creates unique care plans for each patient, contributing to improved patient results. 

• AI-Facilitated Treatment Follow-Up Plans: Suggests a follow-up plan based on the diagnosis, providing a continuous care path for patients. 
• In-Visit Health Assessments: Suggests relevant checklists or surveys if needed during the visit and uses an interactive chatbot to conduct these assessments. 
• AI-Powered Prescription Management: Assists in prescribing medications, checking for potential drug interactions, allergies, and patient-specific considerations. 
• AI-Enhanced Patient Communication: Provides real-time translation services for patients with language barriers to improve communication during visits. 
• AI-Informed Procedural Mentor: Offers real-time guidance during complex clinical procedures, enhancing safety and improving patient outcomes. 

• AI-Optimized Medical Coding and Billing: As a post-visit functionality, ensures accurate coding for patient encounters and procedures, reduces errors, and enhances revenue management, allowing doctors to focus more on patient care. 
• Real-Time Physician Alert System: Provides continuous monitoring of patient data, alerting doctors to any significant changes that require immediate attention. 
• AI-Assisted Imaging Interpretation: Helps in the real-time interpretation of imaging studies, delivering valuable insights for clinical decision-making. 
• AI-Driven Medical Literature Updates: Uses AI to continuously scan and summarize the latest medical research, helping doctors stay current with evidence-based practices to benefit their patients’ treatment plans. 
• AI-Driven Quality Assurance: Employs AI to evaluate various aspects of patient care and interactions, identifying areas for enhancement or potential regulatory concerns. Considering metrics and patient feedback, it offers a comprehensive performance overview to promote high-quality care and patient satisfaction. 

Disclaimer: This article is intended for informational purposes only and does not constitute professional advice and none of the products/services referenced herein are a substitute for medical judgement, or an opinion on any issue. This article does not exhaustively catalogue commercial technology offerings for any market/area referenced. References to third parties and/or commercial products/solutions do not constitute an endorsement by OntarioMD Inc. (“OMD”) and may not be current. Use of the information in this article and/or any of the products/services referenced is at your own risk. For permission to republish this content, please contact the OMD Communications & Marketing Department at info@ontariomd.com.  

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