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In JMIR medical informatics ; h5-index 23.0

BACKGROUND : Patient waiting time at outpatient departments is directly related to patient satisfaction and quality of care, particularly in patients visiting the general internal medicine outpatient departments for the first time. Moreover, reducing wait time from arrival in the clinic to the initiation of an examination is key to reducing patients' anxiety. The use of automated medical history-taking systems in general internal medicine outpatient departments is a promising strategy to reduce waiting times. Recently, Ubie Inc in Japan developed AI Monshin, an artificial intelligence-based, automated medical history-taking system for general internal medicine outpatient departments.

OBJECTIVE : We hypothesized that replacing the use of handwritten self-administered questionnaires with the use of AI Monshin would reduce waiting times in general internal medicine outpatient departments. Therefore, we conducted this study to examine whether the use of AI Monshin reduced patient waiting times.

METHODS : We retrospectively analyzed the waiting times of patients visiting the general internal medicine outpatient department at a Japanese community hospital without an appointment from April 2017 to April 2020. AI Monshin was implemented in April 2019. We compared the median waiting time before and after implementation by conducting an interrupted time-series analysis of the median waiting time per month. We also conducted supplementary analyses to explain the main results.

RESULTS : We analyzed 21,615 visits. The median waiting time after AI Monshin implementation (74.4 minutes, IQR 57.1) was not significantly different from that before AI Monshin implementation (74.3 minutes, IQR 63.7) (P=.12). In the interrupted time-series analysis, the underlying linear time trend (-0.4 minutes per month; P=.06; 95% CI -0.9 to 0.02), level change (40.6 minutes; P=.09; 95% CI -5.8 to 87.0), and slope change (-1.1 minutes per month; P=.16; 95% CI -2.7 to 0.4) were not statistically significant. In a supplemental analysis of data from 9054 of 21,615 visits (41.9%), the median examination time after AI Monshin implementation (6.0 minutes, IQR 5.2) was slightly but significantly longer than that before AI Monshin implementation (5.7 minutes, IQR 5.0) (P=.003).

CONCLUSIONS : The implementation of an artificial intelligence-based, automated medical history-taking system did not reduce waiting time for patients visiting the general internal medicine outpatient department without an appointment, and there was a slight increase in the examination time after implementation; however, the system may have enhanced the quality of care by supporting the optimization of staff assignments.

Harada Yukinori, Shimizu Taro

2020-Aug-31

artificial intelligence, automated medical history taking system, eHealth, interrupted time-series analysis, waiting time