Batman and Robin in Healthcare Knowledge Work: Human-AI Collaboration by Clinical Documentation Integrity Specialists

TY - JOUR

T1 - Batman and Robin in Healthcare Knowledge Work: Human-AI Collaboration by Clinical Documentation Integrity Specialists

AU - Bossen, Claus

AU - Pine, Kathleen H.

PY - 2023/4

Y1 - 2023/4

N2 - This article describes the successful collaboration "in the wild"between Clinical Documentation Integrity Specialists (CDIS) and an Artificial Intelligence (AI)-embedded software to conduct knowledge work. CDIS review patient charts in near real-time to improve clinicians' documentation, with the goal to make medical documentation more accurate, consistent and complete. CDIS collaborate with an AI-embedded "Computer Assisted Coding"(CAC) system that scans records from the Electronic Healthcare Record and auto-suggests codes based on natural language processing. CDIS find the CAC's suggestions are often inaccurate - often humorously so. Still, they find the CAC to be a useful helper, like Robin is to Batman. This human-AI collaboration is contingent on several factors: the flexible integration of the AI into the workflow similar to the notion of unremarkable AI; supporting the CDIS' sensemaking; the CDIS' knowledge about the CAC being predictably unreliable, an experience by the CDIS of the AI's value; humans remaining in control; and ability to experiment with the AI, which spurs reflection and learning for these knowledge workers.

AB - This article describes the successful collaboration "in the wild"between Clinical Documentation Integrity Specialists (CDIS) and an Artificial Intelligence (AI)-embedded software to conduct knowledge work. CDIS review patient charts in near real-time to improve clinicians' documentation, with the goal to make medical documentation more accurate, consistent and complete. CDIS collaborate with an AI-embedded "Computer Assisted Coding"(CAC) system that scans records from the Electronic Healthcare Record and auto-suggests codes based on natural language processing. CDIS find the CAC's suggestions are often inaccurate - often humorously so. Still, they find the CAC to be a useful helper, like Robin is to Batman. This human-AI collaboration is contingent on several factors: the flexible integration of the AI into the workflow similar to the notion of unremarkable AI; supporting the CDIS' sensemaking; the CDIS' knowledge about the CAC being predictably unreliable, an experience by the CDIS of the AI's value; humans remaining in control; and ability to experiment with the AI, which spurs reflection and learning for these knowledge workers.

KW - Artificial intelligence

KW - clinical documentation

KW - data work

KW - ethnography

KW - healthcare

KW - in the wild

KW - Knowledge work

KW - Artificial Intelligence

KW - knowledge work

U2 - 10.1145/3569892

DO - 10.1145/3569892

M3 - Journal article

SN - 1073-0516

VL - 30

JO - ACM Transactions on Computer-Human Interaction

JF - ACM Transactions on Computer-Human Interaction

IS - 2

M1 - 26

ER -