How AI is Transforming Telemedicine

Our telehealth infrastructure is continuing to advance, with AI poised to transform appointment duration, quality of care, and physician retention. Although telehealth surged specifically in response to the pandemic, remote appointment options have proven to increase access to healthcare—particularly for those in rural areas with provider shortages, those who cannot take time off work, and those who cannot afford a hospital visit. While telemedicine already reduces waiting time, travel requirements, and associated expenses, the integration of AI is likely to expedite processes through automated vital sign collection and clinical documentation and even elevate quality of care by, for example, detecting neurobehavioral symptoms (3).

One company making waves in the sector is binah.ai, whose slogan, health checks anywhere, touts the convenience of its video-based vital sign screening. The software takes a video through your mobile phone or computer webcam and, by detecting the changes in red, green, and blue light reflected from the skin, measures blood pressure, heart rate, heart rate variability, oxygen saturation, breathing rate, sympathetic stress, parasympathetic activity and pulse-respiration quotient (5). The company is currently working to add hemoglobin levels to their metrics, which would help eliminate the need to draw blood. When integrated into a telemedicine video platform, binah.ai's technology bypasses the need for any in-person vital collection.

Another application of AI video analysis aims to track neurobehavioral symptoms associated with psychiatric and neurological health to screen for possible CNS disorders. For example, deliberate.ai’s technology uses metrics such as speech prosody, facial expression, linguistic analysis, vital signs, and eye movement, and compares them to their database of neurobehavioral symptoms to generate diagnosis predictions and flag high-risk behavior (7). While mental health professionals are trained in observing and detecting some symptoms of these indications, many are invisible to the human eye. Thus, deliberate.ai’s technology ensures that early signs of neurobehavioral conditions don’t go unnoticed. Importantly, this technology could also aid in other care settings. For instance, if these screenings were to be run in the background of primary care appointments, mental health disorders could be detected and diagnosed earlier.

Lastly, AI programs can expedite the appointment process by automating clinical documentation. Healthcare providers face an immense administrative burden—on average, physicians spend two hours on electronic health records and administrative work for every hour of direct patient care (8). Automatic documentation technology records patient information and details about the visit—information that would normally be entered manually—making it ready for final review and signoff by clinicians as soon as they finish direct patient care. Last month, this possibility became a reality when Teladoc Health, a leading telemedicine provider, partnered with Microsoft to use their Nuance Dragon Ambient eXperience software for AI-powered, voice-enabled, automatic patient encounter documentation (3). Just under a week after the partnership was announced, Amazon unveiled AWS HealthScribe, which, similarly, will generate clinical notes from patient-clinician conversations (11). According to Teladoc’s chief medical officer, "administrative burden and staff shortages are major reasons why clinicians are leaving the professions" (9), suggesting that automated clinical documentation technology could increase clinician retention rate while increasing the amount of time clinicians are able to spend with patients.

These advancements, however, are developing under the risk of healthcare privacy violations and AI hallucination (the generation of false information by AI) 10). While AI/ML-based software-as-a-medical device is currently not regulated by the FDA, the agency released an action plan in 2021 that aims to develop a regulatory framework with an emphasis on patient transparency (12). These barriers aside, the integration of this technology into our increasingly virtual healthcare system is inevitable and exciting given the immediate potential to increase convenience, quality of care, and clinician retention.

Sources

1. The Case for Video AI in Telemedicine

2. Can A.I.-Driven Voice Analysis Help Identify Mental Disorders?

3. Teladoc expands Microsoft tie-up to document patient visits with AI

4. AI-enabled remote monitoring of vital signs for COVID-19: methods, prospects and challenges

5. Binah.ai: Health checks anywhere

6. Vital sign AI: Remote symptom monitoring for COVID

7. Deliberate.ai

8. Administrative burdens – Massachusetts Medical Society

9. Teladoc, Microsoft Expand AI Collaboration

10. Health Care’s AI Embrace Boosts Workforce Despite Privacy Risks

11. AWS Healthscribe

12. Artificial Intelligence/Machine Learning-Based Software as a Medical Device Action Plan