GP survey raises patient consent concerns over AI scribe use

NEWS - eHealthNews.nz editor Rebecca McBeth

Less than two thirds of Kiwi GPs ask for patient consent before using an AI scribe during consultations, a new survey has found.

The Otago University survey was conducted from February to March and nearly 200 GPs provided insights into their experiences with GenAI scribe tools used for clinical notes. 

Bioethicist and lawyer Rochelle Style helped conduct the survey with Tony Dowell, Angela Ballantyne and Maria Stubbe from Otago University. 

The survey revealed concerns about patient consent and data privacy as critical issues. 

Just under 60 percent of GPs had asked for patient consent before using an AI scribe and only 65 percent said they had thoroughly reviewed the terms and conditions of the tools.

“If you have not read the critical terms and conditions you cannot properly consent a patient,” Style says.

She tells eHealthNews the AI scribes in wide use by GPs in New Zealand, such as Nabla and Heidi, are based overseas, raising issues of data sovereignty and how that data could be used to train the model.

“New Zealand has very poor health literacy, and probably even poorer AI health literacy. so there is an issue about being able to first know what you are consenting to and giving patients real choice as once these tools become embedded, what will happen if people do not want their consultations recorded and summarised?” she asks.

The survey uncovered mixed levels of acceptance, with roughly 40 percent of respondents having tried these tools. 

This aligns closely with a similar survey by the AI in Primary Care Group, which found just over half of GPs had engaged with AI in some form by August 2024.

Style tells eHealthNews she was surprised that adoption was not higher because of the widely reported claims around the potential time-saving benefits for clinicians. 

"I hear a lot from people who just love these tools and you get the feeling everyone is using them, but actually they are not," she says. 

Style is sceptical about advertised claims of time savings as the survey found 70 percent of users were saving at most an hour or less.

“I still think there is a bit of puffery in what some of the platforms are claiming in terms of how much time GPs are going to save per day, because they will be checking the outputs,” she says, adding that there are potential legal risks if they do not review.

The survey also showed an impact on clinical consultations, with over half of the respondents saying that the use of an AI scribe had changed how they interact with patients, such as improving their ability to engage with patients and vocalising examinations.

Style argues that that any deployment of these tools should be paired with training for healthcare providers to understand both the risks and practical adjustments needed.

GP at Island Bay Medical Centre Richard Medlicott has tried Nabla and Heidi AI scribes and is helping to develop IntelliTek Health’s ‘clinical virtual assistant’.

His practice took the approach of consenting 1000 people and everyone said yes so they started using it across the practice, including some nurses. A link is also on their website and on all appointment text reminders letting people know that an AI tool will be used.

“We felt that that was enough notification, but other practices have to come to their own conclusions on this. There are no formal rules, just advice, and I have a slightly different opinion to others because the conversation is not linked to a person’s name or any identifiable information,” he tells eHealthNews.

“The other really important policy we have is that you have got to review the notes.”

Medlicott says the AI tools are saving significant amounts of time for staff and he had a comment from a patient that the notes available via the patient portal were much better since he started using a scribe.

The survey of GPs released by the AI in Primary Care group looked more broadly at use of AI tools in general practice and attracted more than 300 responses during July and August.

Spokesperson for the group and specialist GP in Mount Wellington Janine Bycroft says over half of the people surveyed were looking at AI-driven solutions to support inbox management, notetaking, and the automation of routine tasks, “mainly driven by a desire to free up time to focus more on patient care”.

“A common theme we hear in patient feedback is how much more they are enjoying and valuing interaction with their GP, they really feel the difference of the eye contact being with them instead of the screen and the keyboard.” 

Despite the potential benefits, concerns around data privacy, security, and the accuracy of AI-generated outputs are still challenges to overcome. 

“The survey findings point to a missing key ingredient to ‘unblock’ implementation. People are really looking for some sort of endorsement or framework from our national authorities – that could be a gamechanger in terms of trust and acceptance for people,” says Bycroft. 

WellSouth Primary Health Network has developed a comprehensive guide for general practices which they have made available nationwide through the AI working group, which can be accessed on the GPNZ website.

Hear Rochelle Style speak at Digital Health Week this dec 2-5 in Hamilton – view the programme online.

Image: Bioethicist and lawyer, Rochelle Style

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