Forget about replacing doctors with AI—just get our computers to work

Much of the excitement around using artificial intelligence (AI) in healthcare lies in the promise that machines will be able to make sophisticated clinical judgments, such as diagnosing disease and making treatment decisions. In the past year the UK government has invested in AI in the hope that it can speed up diagnosis and tackle NHS waiting times. The former health and social care secretary Steve Barclay boasted that “more cutting edge AI technology across the NHS” will help with “quicker, more accurate diagnosis of lung cancer.”1 Similar hopes have been echoed by other healthcare leaders and commentators.2

AI will undoubtedly revolutionise radiology interpretation, even if the evidence supporting plans to procure the technology for English hospitals is currently lacking.23 Other applications touted for AI include acting as “virtual nurses” for patients with chronic diseases and predicting cancer metastases.4 Such technology may well prove useful in time, but the most exciting and plausible near term promise of AI isn’t that it could replace doctors with computers—it’s that doctors might be freed from the drudgery imposed by our current computer systems.

People who rhapsodise about AI driven healthcare often seem to have little appreciation of how the functionality and user experience of our present systems lags decades behind consumer technology that we take for granted. Systems that are notionally paperless are actually a mishmash of digital and analogue, with vital information trapped in non-searchable PDFs and scanned letters. For example, GPs receive discharge letters electronically, but in my case this hasn’t made the task of reconciling medicines any easier and usually requires me to print off a copy to tally the changes manually, one by one. Finding out a patient’s diagnosis or working out why a hazardous medication was started often requires slowly loading different pages of scanned detritus before finding the one document that holds the explanation.

An NHS with an IT infrastructure that would “work” in the ways we wanted could transform clinicians’ working lives and bring some joy back to the job, allowing doctors to stop squinting at screens and spend our time talking to patients instead. In primary care many GPs have highlighted the administrative burden they contend with, and in one survey of GP trainees they cited this “hidden” workload as one of the top reasons they wouldn’t want to work full time.5 These administrative tasks are made considerably worse for doctors by having to use systems that aren’t fit for purpose and leave us struggling with innumerable fiddly annoyances that we have to fit around patient care.