Dataset Information

Development and Validation of an Artificial Intelligence System to Optimize Clinician Review of Patient Records.

ABSTRACT:

Importance

Physicians are required to work with rapidly growing amounts of medical data. Approximately 62% of time per patient is devoted to reviewing electronic health records (EHRs), with clinical data review being the most time-consuming portion.

Objective

To determine whether an artificial intelligence (AI) system developed to organize and display new patient referral records would improve a clinician's ability to extract patient information compared with the current standard of care.

Design, setting, and participants

In this prognostic study, an AI system was created to organize patient records and improve data retrieval. To evaluate the system on time and accuracy, a nonblinded, prospective study was conducted at a single academic medical center. Recruitment emails were sent to all physicians in the gastroenterology division, and 12 clinicians agreed to participate. Each of the clinicians participating in the study received 2 referral records: 1 AI-optimized patient record and 1 standard (non-AI-optimized) patient record. For each record, clinicians were asked 22 questions requiring them to search the assigned record for clinically relevant information. Clinicians reviewed records from June 1 to August 30, 2020.

Main outcomes and measures

The time required to answer each question, along with accuracy, was measured for both records, with and without AI optimization. Participants were asked to assess overall satisfaction with the AI system, their preferred review method (AI-optimized vs standard), and other topics to assess clinical utility.

Results

Twelve gastroenterology physicians/fellows completed the study. Compared with standard (non-AI-optimized) patient record review, the AI system saved first-time physician users 18% of the time used to answer the clinical questions (10.5 [95% CI, 8.5-12.6] vs 12.8 [95% CI, 9.4-16.2] minutes; P = .02). There was no significant decrease in accuracy when physicians retrieved important patient information (83.7% [95% CI, 79.3%-88.2%] with the AI-optimized vs 86.0% [95% CI, 81.8%-90.2%] without the AI-optimized record; P = .81). Survey responses from physicians were generally positive across all questions. Eleven of 12 physicians (92%) preferred the AI-optimized record review to standard review. Despite a learning curve pointed out by respondents, 11 of 12 physicians believed that the technology would save them time to assess new patient records and were interested in using this technology in their clinic.

Conclusions and relevance

In this prognostic study, an AI system helped physicians extract relevant patient information in a shorter time while maintaining high accuracy. This finding is particularly germane to the ever-increasing amounts of medical data and increased stressors on clinicians. Increased user familiarity with the AI system, along with further enhancements in the system itself, hold promise to further improve physician data extraction from large quantities of patient health records.

SUBMITTER: Chi EA

PROVIDER: S-EPMC8303101 | biostudies-literature |

REPOSITORIES: biostudies-literature

ACCESS DATA

Similar Datasets

Project description:BackgroundThe use of patient health and treatment information captured in structured and unstructured formats in computerized electronic health record (EHR) repositories could potentially augment the detection of safety signals for drug products regulated by the US Food and Drug Administration (FDA). Natural language processing and other artificial intelligence (AI) techniques provide novel methodologies that could be leveraged to extract clinically useful information from EHR resources.ObjectiveOur aim is to develop a novel AI-enabled software prototype to identify adverse drug event (ADE) safety signals from free-text discharge summaries in EHRs to enhance opioid drug safety and research activities at the FDA.MethodsWe developed a prototype for web-based software that leverages keyword and trigger-phrase searching with rule-based algorithms and deep learning to extract candidate ADEs for specific opioid drugs from discharge summaries in the Medical Information Mart for Intensive Care III (MIMIC III) database. The prototype uses MedSpacy components to identify relevant sections of discharge summaries and a pretrained natural language processing (NLP) model, Spark NLP for Healthcare, for named entity recognition. Fifteen FDA staff members provided feedback on the prototype's features and functionalities.ResultsUsing the prototype, we were able to identify known, labeled, opioid-related adverse drug reactions from text in EHRs. The AI-enabled model achieved accuracy, recall, precision, and F1-scores of 0.66, 0.69, 0.64, and 0.67, respectively. FDA participants assessed the prototype as highly desirable in user satisfaction, visualizations, and in the potential to support drug safety signal detection for opioid drugs from EHR data while saving time and manual effort. Actionable design recommendations included (1) enlarging the tabs and visualizations; (2) enabling more flexibility and customizations to fit end users' individual needs; (3) providing additional instructional resources; (4) adding multiple graph export functionality; and (5) adding project summaries.ConclusionsThe novel prototype uses innovative AI-based techniques to automate searching for, extracting, and analyzing clinically useful information captured in unstructured text in EHRs. It increases efficiency in harnessing real-world data for opioid drug safety and increases the usability of the data to support regulatory review while decreasing the manual research burden.