AI Comes to the Medical Exam Room

AI is making healthcare easier to navigate for everyone involved. / Photograph by Tima Miroshnichenko

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Imagine being able to instantly grasp the results of an MRI that your family physician ordered after you complained of lower back pain. Instead of “mild facet arthropathy is noted bilaterally at L4-L5 and L5-S1,” the message in your patient portal reads, “There’s also some mild wear-and-tear in the joints around that area, which is common with age.” That translation from medical-ese will be brought to you by artificial intelligence.

AI regularly makes healthcare headlines for diagnosing rare neuromuscular disorders, spotting breast cancer risk, and catching brain tumors early. (A woman in Delaware County even credits AI for helping to get her insurance to pay for a critical medicine.) But we’re increasingly likely to encounter AI in routine primary care, too. Advocates say, if implemented correctly, the technology can make doctors and patients happier — reducing the amount of time doctors spend on administrative tasks, strengthening their relationships with patients, and generally making healthcare easier to navigate for everyone involved.

Less Note-Taking, More Face Time

You may have already encountered a popular AI tool at a doctor’s visit. Over the last two years, the Philadelphia region’s major health systems expanded the use of recording and transcribing appointments with AI.

Since testing so-called “AI medical scribes” in 2024, Main Line Health has widely adopted the approach, according to John S. Potts, the system’s vice president and chief medical information officer (who is also a family physician with patients at Broomall Internal Medicine). He says that 86 percent of Main Line Health clinicians using the tool are “thrilled.”

Why such high satisfaction? Studies show that primary care physicians can spend less time on documentation and reduce after-hours work thanks to AI. In the long run, this could lower burnout for Philadelphia-area doctors — good news in a region where primary care appointments are increasingly harder to get.

Patients can benefit, too: Penn Medicine researchers found the tool allows doctors to directly talk to patients more because they don’t have to constantly type notes on a keyboard. An added bonus, Potts says: Patients get “far more detailed and easy to understand” visit summaries in their charts.

Checking Up on AI

Worried about mixing sensitive health information and AI? Understandable. Here are a few things to consider if your doctor asks if you’re okay with your appointment being recorded.

Main Line Health keeps recordings for 30 days and then deletes them. They’re stored on a secure server, not in the cloud — “so there’s very low risk that it will be compromised, say, by a cyber attack,” Potts says. They’ve also prohibited their AI scribe vendor from selling patient data, even if it’s anonymized.

There isn’t currently any federal regulation of AI healthcare tools, so patients must rely on whatever security protocols exist at their doctor’s office. In Pennsylvania, the law already requires consent for recording, but Harrisburg legislators are working on a bill that would address safety concerns more broadly. Meanwhile, the American Osteopathic Association and the American Medical Association are pushing for federal regulation to ensure that AI tools support but don’t replace doctors.

The tools aren’t 100 percent error-free, and best practice is for providers to review transcriptions and make any necessary corrections before they go into health records. But, says Potts, patients can, and should, check.

“If something is wrong in the medical record, it’s possible that another physician may see that and think that it’s true and therefore make a medical decision based on that erroneous information,” Potts says.

At Main Line Health, patients who spot an error should start by notifying their doctor’s office, he says. In cases where the physician and patient disagree, the patient can still have a note added through the health information management office.

What’s Next for AI and Primary Care

Physician use of AI across the country has gone from 38 percent in 2023 to 81 percent today, a recent AMA survey found. But the Philadelphia region’s providers are thinking well beyond AI medical scribes, and patients should expect to keep seeing shifts in the primary health care space, even if subtle.

For example, Jefferson Health aims to use AI tools systemwide to save clinicians more than 10 million hours by 2028. Virtua Health in South Jersey has partnered with Microsoft on AI tools. Penn Medicine is set to open a clinic in Montgomeryville next year where doctors won’t need to hit record on a smartphone because ambient recording is built into the exam room. According to Srinath Adusumalli, a cardiologist and chief health information officer at Penn Medicine, another feature would be a screen on the wall that displays the reasons the patient says they’ve come in for the appointment and next steps, like prescriptions or test orders, that the doctor and patient could review together. “The space is organized so it prioritizes face-to-face. But then the technology is there to support information review and delivery,” Adusumalli says.

Penn also wants to use technology to guide patients to the exit — welcome news to anyone who has ever left an exam room and wondered, now how do I get out of this maze?

Adusumalli says Penn Medicine is testing a variety of patient-facing AI tools. Among them, a pre-appointment conversational chatbot that goes beyond a standardized questionnaire to get to the heart of a patient’s health concerns with the aim of maximizing the time that doctor and patient get together. Another would deliver test results to patients in plain, easy-to-understand language. And Penn’s in-house-designed Chart Hero enables doctors to get the information they need from a patient’s chart more quickly. For example, the tool can summarize a patient’s history of antibiotic prescriptions at chatbot-speed. Patients won’t see that in action, but they may feel the difference if the tool makes physicians more content.

Potts of Main Line Health says doctor satisfaction is central to AI implementation in the Main Line system. Next up, a tool that reduces the hassle of getting insurance companies to give prior authorization for prescriptions: He anticipates a 96 percent reduction in time completing the necessary electronic forms.

“You hear all the time how clinicians are exhausted, overwhelmed with the amount of [electronic] paperwork that they have to do. They’re constantly being bombarded with information. And I’ll be honest, it’s exhausting,” Potts says. “We’re looking to roll out tools to help bring back the joy of practicing medicine.”

This primary-care health series is made possible by a generous donation from PCOM.