How physicians actually use AI: Christi Siedlecki, MSN, RN

Christi Siedlecki, MSN, RN

As the CEO of a multispecialty practice in southern Oregon, Christi Siedlecki was keenly aware of how documentation demands had contributed to burnout among her staff. When she spearheaded a trial of an AI-powered scribe, she hoped it would be a game changer.

“Our biggest interest at the time was an AI scribe, with the chart note being written, or at least partially written, to help decrease the burnout in our physicians,” Siedlecki says. “We’re just so concerned about all the administrative burden, which is mostly uncompensated time. We’re primary care, so our payment keeps going down, and our costs keep going up.”

Siedlecki and her team had been cautious, observing how other practices in their area implemented similar technology before committing to a trial themselves. After reviewing multiple demos, they selected a platform and rolled it out to the providers. The feedback was mixed.

One of the earliest challenges was patient consent. “When we rolled it out, we also created a consent form, so we were getting patients’ consent to use it,” she says. “And after just a couple of weeks, we realized there were problems. Like in pediatrics, if the mother brings in a child and consents, but then the grandmother or father brings them in later and doesn’t, how do we verify we have the right consent from the right people in the room?”

Siedlecki reached out to the Oregon Medical Association and a risk management attorney from the practice’s malpractice insurance carrier. The responses she received were contradictory. “The Oregon Medical Association said we didn’t have to have signed consent, that we could do disclosure instead. They provided examples of organizations that were using disclosure successfully. We were really excited about that — disclosure would eliminate a lot of the burden.”

But then the risk manager weighed in. “She said no, it has to be consent because AI scribes record. Even if it’s temporary and the recording disappears after the physician signs off, it’s still legally considered a recording under Oregon law. So, we were on the hook for that.”

The lack of clarity left Siedlecki and her team in a gray area, navigating an evolving regulatory landscape that hasn’t kept up with technology. “The bottom line is, there’s just not clear legislation or regulation,” she says.

Despite the challenges, the clinic is continuing with the trial, refining its consent and disclosure process while monitoring how AI scribes impact work flow.

Although the technology shows promise, it also has its limitations. “One of our pediatric providers was really excited about using this and wanted us to dive in a year ago. But in one of the first cases he used it for, the AI misinterpreted a simple diaper rash as an anaphylactic reaction. There was no anaphylactic reaction. That really highlighted the importance of providers thoroughly reviewing every note.”

This raised a critical question for some clinicians: If they had to spend so much time correcting the AI’s mistakes, was it saving them any time?

In addition, Siedlecki’s clinic has also explored AI for phone call triage, another area where technology could alleviate staff workload. The system uses a natural-sounding AI-generated voice to guide patients through scheduling appointments. “It looked promising,” she says. “It could take some of that triage burden off our switchboard and schedulers.” But she said until they get the scribe software worked out, she doesn’t want to take on any more technology changes.

Reflecting on the scribe experience, Siedlecki says she underestimated the difficulty of implementation. “I should have known,” she says. “I’ve been with this clinic a long time. But I was thinking, ‘Everyone is jumping in on AI scribes; let’s help our providers.’ I knew there would be complications getting it integrated, but the legislation wasn’t in place to help guide us.”

Still, she remains optimistic about the future of AI in health care. “I think the kinks are going to get worked out, and these tools will be incredibly helpful. We have shortages in both staff and providers, and the administrative burdens in primary care have gone through the roof. We need these tools.”

For Siedlecki, AI isn’t about replacing people — it’s about filling gaps where there aren’t enough workers. “I frequently hear concerns about technology replacing people’s jobs. But we’re taking open job positions that nobody wants to do and filling them with technology. We’re not kicking people out with technology.”

As her clinic continues fine-tuning its AI strategy, Siedlecki remains hopeful that the technology will evolve into a reliable support system for health care professionals. “I think it’s very promising,” she says. “I’ve been thinking about this AI scribe for a couple of years now, and I was hoping that others would have worked out the glitches before we got here. It just surprises me that we’ve had this technology for a couple of years, and it still requires some work to make it safe and to make it accurate.”