“The doctor did not take any notes and kept her attention permanently on me,” says Fernando Egido, general director at Singular Bank, after a medical visit in December to the Jiménez Díaz Foundation, in Madrid. That day he saw for the first time an artificial intelligence (AI) system that the hospital group has been testing since the summer. “He looked at me more, it was a feeling of closeness and attention greater than other times, when he had to alternate between looking at the computer screen and at me,” he adds.
The system between doctor and patient creates the medical report in understandable language and proposes a treatment, which the doctor must confirm. “It saves doctors from low-value tasks, allows them to focus on the patient, and AI generates all the administrative part that they would otherwise have to introduce,” adds Egido.
First medical consultation in which my doctor is accompanied by an AI that summarizes the consultation, prepares the report, fills out the medication and even notes the appointment in the system.
— Fernando Egido Egaña (@fegido)
The Quirónsalud group calls the system Mobility Scribe and it is its own project, according to the company. In a conference they gave some details of their plan: “It is the star project within the house,” said Daniel Blanco, head of Assistance Applications. “The resident doctor or the secretaries have served as scribe, note taker, administrative part, we take advantage of the power of AI to assume these roles,” Blanco added.
Scribe is also a generic name for this type of doctor consultation application. There are dozens of providers around the world that offer this type of service. The American insurer Kaiser since October 2023. The Catalan public system has announced that it will be implemented in 2025, although there is hardly any information on its details. The Ministry of Health is considering a similar system for 2027.
Streamlining these types of tasks is an ideal example of how generative AI will impact the world of work. “One of the main current problems in medical consultations is that the doctor had become a “data inputter” who only looked you in the eye two or three times, if you were lucky,” says Jorge García Herrero, a corporate lawyer specialized in data protection. “In view of the advances, it was logical that the exchange of information between doctor and patient be processed by a language model,” he adds, so that the system summarizes the conversation, submits the data to the professional’s criteria before recording it in the clinical history and provide better access for the patient, who can review the diagnosis without analyzing the dreaded doctor’s handwriting.
But AI is not perfect for now. Transcriptions of complex words continue to be a challenge: “The doctor had to review each of the sections to ensure that she had transcribed it correctly,” says Egido of her consultation. “From what he told me, since they started using it two months ago the system has greatly improved the reliability of the transcription,” he adds.
A doctor from a Quirónsalud hospital who attended a preparatory course this fall tells EL PAÍS that the company already warned about it. “They have tested it and they say that you have to be careful with the spell checker. A word may appear that you do not understand and it turns out that it is a word that the corrector does not have in his dictionary, but we use words that are not in the usual dictionaries,” he explains, and points to the word “heparin” as a source of confusion, a anticoagulant medication.
In the Quirónsalud presentation published on YouTube there is a slide where they covertly point to linguistic problems: “Common global lexicon (adequate semantic environment).” Kaiser’s English examples work well, but with Spanish and its dialect variants in Spain and Latin America it can be more complex. Quirónsalud is testing the system at least in Madrid, Galician and Catalan hospitals.
Daniel Blanco, from Quirónsalud, admitted to some extent that these AIs may have difficulties with more complex specialties: “They say this works better for knee pain than for cardiology,” he admitted. Company sources point out that “in all specialties there are simpler and more complex consultations, and, in fact, cardiology is one of the specialties where it is most used in some of the centers.” The same sources add three comments about these risks: ”One, the doctor and the patient decide when to use Scribe, nothing is going to be 100% universal; two, the Scribe transcription and actions are reviewed, validated and shared with the patient; and three, the system learns every day and improves with use.”
The processing of such sensitive data can be delicate, but García Herrero believes that its limited capacity could exempt this system. The Spanish Data Protection Agency (AEPD), consulted by this newspaper, says it has not yet received any cases. “That it is configured with such a narrow purpose circumvents the main limitations of the European Artificial Intelligence Regulation, because it is a pure assistant subject to human judgment,” he says.
In an AI, but in which one?
The AI model that this Scribe uses is also a detail that is currently unknown: “We have relied on an AI. We try to make it agnostic of the AI engine on the other side,” said Blanco, from Quirónsalud, in his talk. If this engine were one of the famous ones based in the United States, a problem could arise: “The interesting and complex thing would be to know if the tool is just a customization layer for an AI system like ChatGPT, because this would imply the transfer of the processed data to a multinational in another non-European state. It is necessary to know which companies are present in the subcontracting chain,” says García Herrero.
There are more difficult questions to answer: the voice is biometric data. For Egido, who did not have to sign anything, his doctor “emphasized” that “once the recording was transcribed, it was deleted by the system.” The company says that “the conversation is not recorded and is only used to generate the report and the actions of protocols, test requests, prescriptions, appointment requests that arise from the medical act.”
Regarding patient data, , responsible for Digitalization of the UGT union, has other doubts: “The mechanization of data by a healthcare provider on a company platform is not the same as if said data can be used for other purposes. , like the training of the model itself,” he says. The company states that “express consent is requested from the patient.” Egido confirms that it is a permit without signing anything specifically: “At a certain time [la doctora] “They told me that they were starting to use an application with artificial intelligence and asked my permission as a previous step to start using it.”
The Quirónsalud project aims to go as far as renovating the hospital space: “From a consultation room full of gadgets to a warmer setting and more personal attention,” according to Blanco, who showed images similar to the current physical bank offices, with brown seats and low tables.
If you have more information on this topic you can write to jordipc@elpais.es
