Artificial intelligence systems that record conversations between patients and doctors, produce written summaries and help physicians make diagnoses and recommend next steps are already a reality in a number of hospitals.
Confido CEO Edvard Garder told ERR that the company began testing AI solutions last year, making it one of the first in Estonia to do so.
"The solution is now in use in several departments and we plan to roll it out across the entire organization. Patients have responded positively to the solution because doctors have more time to spend with them," Garder said.
Narva Hospital is currently seeking Estonian-language speech recognition and transcription software through a public procurement process. The software would convert conversations between doctors or nurses and patients into electronic text that can be processed, automatically translated, played back and stored.
Narva Hospital also wants the AI assistant to suggest medical codes and support doctors in making decisions. However, the procurement requirements emphasize that doctors must remain the decision-makers in all processes. AI-generated content that has not been reviewed and approved by a healthcare professional must not be entered into patients' medical records.
Tartu University Hospital began testing AI in its emergency department in mid-October and plans to continue the trial for three months. If the technology proves useful, the hospital will extend the trial period to obtain definitive confirmation of the application's benefits.
"The aim of using the EMO24 application is to reduce the time doctors and nurses spend on documentation. It also helps eliminate duplication where patients have to describe their condition to different staff members multiple times," said Aime Keis, head of the hospital's emergency department.
Heba Clinic also uses AI to compile patients' medical histories before appointments, document conversations during visits and subsequently prepare summaries and explanations for patients.
Heba Clinic CEO Ain Aaviksoo noted in an opinion article (in Estonian — ed.) published by ERR last week that AI cannot make decisions on behalf of doctors but should support solutions that help people manage their own health and enable doctors to assist them in doing so.
Every hospital looking for its own AI assistant
The Ministry of Social Affairs has not conducted a comprehensive assessment of the current use of artificial intelligence solutions across all hospitals, said Nele Labi, the ministry's deputy secretary general for innovation. However, the ministry is aware of several initiatives.
"We see that private hospitals have generally made the fastest progress in testing new solutions," Labi added.
According to Labi, there is no unified nationwide system to help hospitals streamline their work using AI and hospitals are largely seeking solutions independently based on their own needs.
"At the national level, however, two major AI-based solutions are currently under development: a transcription tool for family medicine and a transcription tool for the electronic ambulance system. The state has several other AI projects, but these two are expected to have the greatest impact on healthcare professionals' administrative workload in the near future," the deputy secretary general said.
Confido's CEO noted that healthcare professionals welcome the opportunities offered by AI and that skepticism is relatively rare. According to Garder, there is no significant difference between medical specialties in terms of the potential benefits as automated transcription tools and clinical decision support systems can reduce the documentation burden in virtually every field.
"This gives doctors more time for direct interaction with patients and also means that discharge summaries and other medical reports reach the national health portal more quickly," he said.
However, adopting AI does not mean immediate cost savings for hospitals, as initial investments are required. Garder nevertheless believes the technology will help reduce workloads and burnout among doctors and nurses, although the financial benefits of improved employee well-being cannot always be measured precisely.
The Ministry of Social Affairs also confirmed that projects in other European countries have clearly demonstrated the positive impact of such solutions in reducing administrative workloads.
"Estonia's approach is to seamlessly integrate general-purpose tools such as speech recognition and transcription into our hospitals' workflows so that medical professionals can spend their time on patients rather than paperwork," the deputy secretary general said.
Patients must be notified of AI involvement
A separate question is how to ensure that information exchanged between patients and doctors remains confidential and does not fall into the wrong hands.
According to Garder, Confido considers the solutions it currently uses to be secure and continues to do everything possible to mitigate potential risks. Nevertheless, Confido patients have the option to decline the use of AI during their appointments.
Tartu University Hospital also said participation in its AI pilot project is voluntary. If an emergency department patient does not wish to use the application, information gathering, diagnosis and treatment will proceed as before.
The Ministry of Social Affairs' deputy secretary general confirmed that strict data protection rules apply to the processing of such information and that patients must be informed about recordings and their purpose.
"However, because the technology is developing very rapidly, we need greater legal clarity and must ensure that patients understand how it is used and that the process is transparent. Working groups have already been established at the ministry to address this issue," Labi said.
Confido's CEO believes the state should develop a standard for security criteria. However, Garder does not consider it necessary for the state to develop a single AI solution for all healthcare institutions.
"Especially since tying all healthcare providers to a single system would create a monopoly and stifle innovation. Moreover, I'm not sure that would be the most efficient use of public funds," Garder said.
Instead, he believes the state should focus on ensuring that all data in the national health portal can be processed by AI, which would in turn speed up preparations for medical appointments.
"At present, the state is clearly moving far too slowly in adopting AI," the Confido CEO said.
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