Augmented Intelligence in Primary Care (Mendoza 1/6/2021)

Many thanks to Dr. Emmanuel Mendoza for his Grand Rounds tour of the current state of technology in primary care and the emerging role of artificial intelligence (or as he reframed as "augmented intelligence") in primary care.

Dr. Mendoza reminded us that the transition in medicine to electronic medical records (EMR) has happened intensively and quickly over the last decade, leading to a great change in how we deliver healthcare and affecting our experience as clinicians caring for patients. Dr. Mendoza recommends three books on this transition for your pleasure reading: Deep Medicine, The Patient Will See You Now, and The Digital Doctor (see image below).

While the transition to the  EMR was touted as something that would be helpful and advantageous to physicians and healthcare delivery, many providers have felt professionally burdened and by the EMR. 

• 70% of clinicians report that the EMR increases their work hours
• 70% of clinicians believe that the EMR is contributing to burn out
• 70% of clinicians say that the EMR takes time away from patients

Are machines going to replace doctors?

Dr. Mendoza thinks not. He thinks, in fact, that computers and AI and machines should be thought of as tools that are designed to enable us to practice better medicine. Physicians are still needed because medicine is not just a set of algorithms. This includes a wide range of evolving AI technologies:

• Image processing

e.g. benign vs. malignant lesions

e.g. radiology (cxr reading)

e.g. diabetic retinopathy

• Patient engagement

via APPS

via Health trackers

via E-health programs

Dr. Mendoza covered a long list of different technologies and AI programs, and he reminded us that many of these technologies are works in progress; some will be raging successes and are more effective and more applicable than others. In fact, many will ultimately fail. Be aware of where the product is in its natural evolution (see image below).

Dr. Mendoza encouraged us to engage with the technology and explore them as they are being developed. Here are a few programs/apps/ideas for you to try in your spare time:

Technology you should play round with!

1. Patient symptom checker:  Symptomate: https://symptomate.com/

2. Preventive health via Facebook Preventive health: https://preventivehealth.facebook.com/

3. Chronic disease management via Omada: https://www.omadahealth.com/

4. Clinical Decision support: https://www.ibm.com/products/micromedex-with-watson

5. Medical education: FOAM: https://litfl.com/foam-free-open-access-medical-education/

6. Diagnosis: Human Diagnosis project: https://www.humandx.org/

7. EMR Voice Assistant: https://www.epic.com/epic/post/hey-epic-tell-voice-assistant-clinicians

8. Digital assistant for physicians: https://www.suki.ai/

Finally, Dr. Mendoza encouraged us to check out the AAFP innovation lab, where you can sign up to trial many of these technologies and give direct feedback.

https://www.aafp.org/family-physician/practice-and-career/managing-your-practice/health-it/innovation-lab.html