JMIR Publications

ABSTRACT

Background:

Whilst digital health innovations are increasingly being adopted by healthcare organisations, implementation is often carried out without considering the impacts on front line staff who will be using the technology and those who might be affected by its introduction. The enthusiasm surrounding the use of artificial intelligence (AI) enabled digital solutions in healthcare is tempered by uncertainty around how it will change the working lives and practices of clinicians and healthcare professionals. Digital enablement can be viewed as facilitating enhanced effectiveness and efficiency by improving services and automating cognitive labour, yet the implementation of AI comes with challenges related to changes in work practices brought by automation. This research explores staff experiences before and after care pathway automation with an autonomous clinical conversational assistant (Dora) that is able to automate routine clinical conversations.

Objective:

The primary objective is to examine the impact of digital automation on the wellbeing of doctors, nurses and allied health professionals (AHPs) who provide or facilitate healthcare to patients in high-volume low-complexity care pathways. In the process of transforming care pathways through automation of routine tasks, staff will increasingly work at the top of their licence. The impact of this fundamental change to the professional identity and work practices of the individual is poorly understood. We aim to focus on understanding how automation of routine tasks impacts staff wellbeing, specifically assessing whether it contributes to, or mitigates burnout. Investigating this will illuminate how the implementation of conversational agents such as Dora impacts work practices.

Methods:

A multiple case study approach will be adopted, combining qualitative and quantitative data collection methods, over two distinct phases: (a) pre-implementation/ adoption, and (b) post-implementation.

Results:

The analysis is expected to reveal the interrelationship between Dora and those directly or indirectly affected by its introduction. This will reveal how tasks and responsibilities have changed or shifted, current tensions and contradictions, ways of working, and challenges, benefits, and opportunities as perceived by those on the front line of the healthcare system.

Conclusions:

The implementation of AI in the healthcare sector, as well as the body of research on this topic, remain in their infancy. The project’s key contributions will be to understand the impact of AI enabled automation on clinician wellbeing and work practices.