A project at Beth Israel Deaconess Medical Center's new OpenNotes Lab aims to explore the opportunities and challenges of using artificial intelligence to generate patient visit summaries.

WHY IT MATTERS
The initiative, which will see OpenNotes collaborate with clinical genAI developer Abridge, will study how AI can enable collaboration between patients and clinicians, while advancing transparency and promoting health equity, they say.

BIDMC-based OpenNotes has long been a leader in patient access and empowerment. By working with Abridge and its AI-powered clinical documentation platform, the goal is to explore how patient-clinician conversations can improve notes at the point of care and enable more useful visit summaries.

Abridge offers real-time automation with the aim of reducing documentation burden and administrative tasks for clinicians. After patient visits, its AI technology creates both a structured clinical note and a visit summary for the patient, "written at an 8th-grade reading level and [providing] information like new diagnoses, medications and next steps," the company says.

The OpenNotes Lab at BIDMC will help evaluate Abridge's AI-generated patient notes and help them to be enhanced to better meet patient needs. In the first phase, focus groups of patients will be given Abridge visit summaries and asked to evaluate them for accuracy, usefulness, accessibility and other efficacy measures. In that phase there won't be any use of actual patient data, the health system says.

"We are excited to lead this project that brings patients' voices directly into the design of health AI tools," said Harvard Medical School professor Cait DesRoches, executive director of OpenNotes at BIDMC. "By centering patients and their care partners in the process, we aim to establish new standards for responsible and transparent use of AI in clinical documentation, and ensuring these technologies serve patients, care partners, and clinicians."

THE LARGER TREND
OpenNotes has transformed patient engagement and clinician experience worldwide since it was launched in 2010 as a pilot collaboration between Beth Israel Deaconess, Geisinger and Seattle-based Harborview Medical Center, enabling more open and transparent communication among patients, their families and care teams.

"This is a movement," said OpenNotes cofounder Tom Delbanco, former chief of the Division of General Medicine and Primary Care at BIDMC, when we first interviewed him a decade ago.

In 2015, OpenNotes had enabled around five patients to have full access to their clinical notes via secure electronic portals. In the years since, as hundreds of other health systems signed on with the patient empowerment movement, that number has grown enormously. By 2020, that number was 50 million.

And now, of course, thanks in part to the clear benefit shown by the OpenNotes initiative, the 21st Century Cures Act now mandates that providers electronically share clinical visit notes with patients at no charge.

The project has always been driven by the conviction that such free and transparent access is a key driver of safer and higher quality care.

"I've always thought the medical record is the hub of the wheel, the way to bring patients much closer to those who care for them," Delbanco has said.

Now, with the advent of generative AI, there are new avenues to explore.

We spoke in Boston this past month with Dr. Chethan Sarabu, director of clinical innovation at Cornell Health Tech Hub and AI and informatics strategist at OpenNotes.

Beyond the patient encounter, he said he's encouraged by large language models' ability to enable "a new level of patient empowerment" by helping healthcare consumers understand clinical notes, navigate insurance claims and much more.

ON THE RECORD
"This research collaboration with OpenNotes will harness the power of actual patient conversations in informing the next generation of visit summaries, an invaluable tool in keeping doctors and patients on the same page," said Abridge founder and CEO Dr. Shiv Rao. "We are excited to continue exploring ways to enrich the Abridge platform with insights from the research we will conduct with OpenNotes."

"The visit summary came about with the widespread adoption of electronic health records in the early 2000s, and it's overdue for a refresh," added Katie McCurdy, a patient advocate and UX designer at Pictal Health who serves on the OpenNotes Lab Advisory Board. "The potential impact of clearer, more user-friendly visit summaries is huge."

Mike Miliard is executive editor of Healthcare IT News
Email the writer: mike.miliard@himssmedia.com
Healthcare IT News is a HIMSS publication.