ProCare chief executive and Health Accelerator co-chair Bindi Norwell. Photo / Mike Scott
Four PHOs band together in an AI alliance; Health NZ starts an AI trial; Pharmac and Medsafet get the green light to use AI tools; and a GP gives her verdict after trialling an AI scribe.
Four healthcare providers running general practice clinics around the country have created a joint venture to help their doctors adopt new technologies, with a heavy focus on artificial intelligence.
Health Accelerator, registered as a new company, is owned by four Primary Health Organisations (PHOs): Pegasus, Pinnacle, ProCare and the non-profit Tū Ora Compass Health, which collectively own or support more than 500 general practices, or around half of those in New Zealand.
They serve more than two million patients between them.
As PHOs, each of the four companies receives public funding toward their general practice (GP) services.
But Health Accelerator co-chair Bindi Norwell says it is paid for purely from private funds. The amount hasn’t been disclosed.
With a heavy initial focus on digital and artificial intelligence (AI) innovations, the suite of tools already includes “digital assistants and robots” used for a variety of clinical and administrative tasks.
Norwell is also chief executive at ProCare, which is trialling AI transcription software from Australia’s Heidi Health.
She says an AI taking notes can save a GP seven minutes per 15-minute consultation.
The technology, and what ProCare has learned about it, will now be shared with the other providers in the Health Accelerator joint venture.
Of course, there’s been peril in the past as pharmacists and others have struggled to decipher doctors’ famously bad handwriting.
AI can have its own drawbacks, including hallucinations or mistakes.
Norwell says results are being reviewed by a clinical governance committee, which also has a brief to make sure privacy is tightly buttoned down.
“We’re going to innovate in a very protected way,” Norwell says.
Privacy risks were minimised by everything being in closed systems. Enterprise AIs only interrogate an organisation’s own data, and don’t share queries or results with the big tech firms (who use responses from their free, consumer version to train their large language models).
“We’ve already built quite a few robots to automate repetitive tasks,” Norwell says. “But it’s really just the start.”
Is there a danger of jobs being lost to AI?
“We’re already workforce constrained,” Norwell says.
“This is complementary. It’s relieving healthcare professionals and doctors of some of their administrative work and enabling them to spend more time with patients.”
Health Accelerator co-chair and Compass CEO Justine Thorpe says, “Through Health Accelerator, we’re partnering closely with practices, start-ups, researchers, and government agencies to identify real-world problems and co-design scalable solutions that can benefit the entire sector.
“The first innovation we rolled out across the country was robots which are aimed at supporting cardiovascular disease risk assessments, ensuring all ACC funding is claimed by practices where applicable.”
The Accelerator has also released two AI tools for managing inboxes.
“We are now looking at what other opportunities it will be able to announce soon, with AI scribes likely to be high on the list,” Thorpe says.
In the broader landscape, on July 1, Associate Minister of Health David Seymour gave Pharmac and Medsafe the green light to explore the use of AI to speed up their testing and approval processes.
And this week, Health New Zealand Te Whatu Ora gave the go-ahead for clinicians to use AI scribes – or using voice-to-text technology to turn patient conversations into ready-to-use medical notes.
The agency’s National Artificial Intelligence and Algorithm Expert Advisory Group, working with national privacy and security experts, has endorsed two “ambient AI scribe tools” for trial from iMedX and Heidi Health.
Both firms are from Australian start-ups, but the advisory group is open to expanding the trial to include others.
“We are seeking input from clinicians on any other products that should be considered,” says its chairwoman, Robyn Whittaker.
Wellington GP Dr Emily Cavana told the Herald she had tried out Nabla, a European rival to Heidi and iMedX.
“For every two to three minutes I might take to write notes, the AI took about 15 seconds [to transcribe the same amount of text] – and I can touch type,” she said.
Cavana, who also does medical education work for the Royal New Zealand College of General Practitioners (RNZCGP) and is a senior lecturer at the University of Otago’s Wellington campus, says she’s talked to numerous GPs about their use of AI tools.
She says doctors’ general take is that it “doesn’t save them tonnes of time overall”, because they have to check the AI’s notes, “and add things or take them out”.
“But it reduces the mental load. If you’re seeing 24 or 26 patients a day, it can be hard to keep everything in your head. It gives you a baseline to work from.”
GPs were telling her they no longer spent their tea or lunch breaks writing up notes because of the time saved by the AI.
Another major benefit: “You can look at the patient, not your keyboard.”
But, personally, she found she remembered more when she wrote up a patient’s notes herself.
Accuracy was generally good, she says. She cautions it also depends on not just the AI’s software smarts, but the ability of a GP to make sure a microphone is picking up a patient’s voice okay, and some doctors, like her, “are a bit old-school”, she says.
Reading through the AI-taken notes was a must. “With one transgender patient, the AI hallucinated they were thinking about joining the military,” Cavana says. The patient’s desired profession hadn’t even been discussed.
Elsewhere, it was not a matter of the AI getting things wrong, but more leaving things out when it seemed to lose track. A specific example was a woman’s health consult, where Cavana asked the patient about heavy menstrual flow and how many pads and tampons she used. “It didn’t pick up any of that.”
In another instance, the AI scribe did not include a warning she’d given a patient to go to an emergency department if their condition deteriorated – something that could have caused legal problems down the track, she says.
Given that AI was a new technology, it was important to get a patient’s consent, Cavana said. She didn’t find that a problem. “Patients were really interested and generally very happy for me to use it,” she says.
Cavana spoke to the Herald during a break at the RNZCGP annual conference in Christchurch, where AI was a hot topic. All GPs are talking about it, but not all are on board with artificial intelligence, she says.
“Not everyone loves it, and not everyone always uses it all the time. Uptake is still variable.”
Chris Keall is an Auckland-based member of the Herald’s business team. He joined the Herald in 2018 and is the technology editor and a senior business writer.