AI scribes used by doctors may miss vital body language cues, study warns
AI scribes used by doctors may miss body language and other non-verbal cues that can contain clinically important information, a review has warned.
The technology converts spoken consultations into text and generates summaries, but researchers said it cannot capture gestures, facial expressions, movement or emotional cues.
Academics at the University of Edinburgh raised the concerns after reviewing 27 articles examining the adoption of AI scribes and the implications of their use.
Around four in ten GPs now use AI scribes. Also known as ambient voice technology, the systems are designed to reduce paperwork and allow doctors to focus more on patients during consultations.
Researchers described the technology as having a “written language bias” because it processes consultations as textual records.
They said: “They convert spoken consultations into text and then process the interaction as a textual record.
“Ambient scribes cannot capture the potentially vital information a clinician can glean from gestures, facial expressions, movement and emotional affect.”
The review also raised concerns that patients could change their behaviour when AI is present and disclose less sensitive information, including details about substance abuse, domestic abuse or mental health difficulties.
Researchers said AI-generated summaries may prioritise clinical information over patients’ accounts and experiences of illness.
They also identified a potential risk of “deskilling” if clinicians have fewer opportunities to maintain their clinical reasoning skills.
Lucas Seuren, research fellow at the University of Edinburgh’s Centre for Biomedicine, Self and Society, said: “Many clinicians are excited about ambient AI scribes, because they promise to cut down on paperwork.
“But the experiences of patients are poorly considered, and there are real risks that the patients’ stories are lost.
“This can further disadvantage people who already face marginalisation in health and social care services.”
NHS England has told hospitals they should “deploy ambient voice technology (AVT) at pace”, while stressing that doctors must review generated notes and seek patients’ permission before using the technology during appointments.
The researchers said most existing studies have focused on productivity and technological performance, while the socio-technical dimensions of adoption have received less attention.
They said: “Ambient scribes are complex interventions with the potential to reshape clinical work, documentation practices and the organisation of care.
“Before pursuing large-scale spread, it is important to develop a robust evidence base of the impacts of early deployment and develop a comprehensive understanding of how care with ambient scribes could and should be designed to support patients, clinicians and care systems.”
Some doctors have reported not recognising their own notes generated by AI and finding it harder to remember patients when they see them again.
Sarah Townley, deputy medical director at Medical Protection, said: “Doctors frequently tell us about the burden of excessive administration tasks and their concerns about how this impacts patient care.
“We welcome AI scribe tools that are helping to minimise this element of their work but recognise the important risks highlighted by this review.
“Gestures, facial expressions and the tone of speech are key features when assessing patients and documentation of these details can also assist doctors with recall when patients return.
“Failure to capture this illustrates the limitations of this technology and the importance of a clear framework for practitioners to utilise AI safely.
“Our advice to doctors is that they are responsible for ensuring medical notes produced by transcription software are clear, legible, accurately reflect the consultation and do not omit potentially relevant information.
“When using AI scribe tools – particularly those requiring the sharing of personal data with a third party – informed consent should be sought from patients before use, and this should be documented.
“Doctors should also receive appropriate training on AI scribes so they understand their limitations and data protection implications and can reassure patients about how their personal information is being used and stored.”
