Balancing Efficiency and Empathy: Healthcare Providers' Perspectives on AI-Supported Workflows for Serious Illness Conversations in the Emergency Department

TL;DR

This study explores emergency department providers' perspectives on AI tools to support serious illness conversations, highlighting workflow stages, barriers, and design guidelines to balance efficiency with empathy.

Contribution

It identifies key challenges and opportunities for AI support in SICs, proposing design principles for ambient AI systems that preserve human connection.

Findings

Providers see AI as useful for information synthesis and documentation.

Barriers include fragmented info, time constraints, and documentation burdens.

Design guidelines emphasize supporting, not replacing, human interaction.

Abstract

Serious Illness Conversations (SICs), discussions about values and care preferences for patients with life-threatening illness, rarely occur in Emergency Departments (EDs), despite evidence that early conversations improve care alignment and reduce unnecessary interventions. We interviewed 11 ED providers to identify challenges in SICs and opportunities for technology support, with a focus on AI. Our analysis revealed a four-stage SIC workflow (identification, preparation, conduction, documentation) and barriers at each stage, including fragmented patient information, limited time and space, lack of conversational guidance, and burdensome documentation. Providers expressed interest in AI systems for synthesizing information, supporting real-time conversations, and automating documentation, but emphasized concerns about preserving human connection and clinical autonomy. This tension highlights the need for technologies that enhance efficiency without undermining the interpersonal nature of SICs. We propose design guidelines for ambient and peripheral AI systems to support providers while preserving the essential humanity of these conversations.