Patients, physicians see promise for AI in eVisits — but only with a human in the loop

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As artificial intelligence (AI) continues its rapid advance into seemingly all aspects of health care, patients and physicians are, albeit cautiously, warming up to its potential.

A new study published in The Annals of Family Medicine suggests that AI could play a supportive role in primary care electronic visits (eVisits) — asynchronous online consultations — by assisting practices in triaging requests, responding more quickly and reducing administrative strain.

But acceptance hinges on the preservation of the human clinician’s role in care.

“Patients and staff welcomed the use of AI,” researchers wrote, “if it were used as an adjunct to (not replacement for) clinical judgment” and included appropriate safety checks and communication.

The study was conducted in the U.K., including interviews and focus groups with 16 primary care practice staff members and 37 patients from 14 practices in northwest England and London. All of the practices use the Patchs Health eVisit system.

Participants were asked about their understanding of AI, its potential risks and benefits and how it might improve, or complicate, the way care is delivered online.

Misconceptions run deep

At the outset, both patients and staff admitted they weren’t quite sure what AI was capable of — or what it might be used for.

Some patients envisioned science fiction. “Something like ET I think, twiddling a finger and thinking, what shall I tell this human? No, I just, no. I just … no,” said one 75-year-old woman.

Other respondents were concerned that AI might bypass the clinician entirely. “My concern would be, if it’s possible for the bot to straight away prescribe you medication or make a diagnosis,” said a 38-year-old woman.

Primary care staff had their own uncertainties. “I suppose, I mean I don’t really know, I’m not entirely sure kind of what the ability is going to be,” said one staff member.

A shift after explanation

Once researchers provided a clear, plain-English description of how AI might be used in eVisits — namely, to support staff by handling routine tasks — attitudes softened.

“I’m extremely comfortable with it,” said a 69-year-old male patient. “I recognize the benefits of it, because we are an aging population, and health care is becoming more and more expensive, and it is eventually going to become unaffordable unless we introduce technologies like AI.”

Several general practitioners (GPs) echoed that sentiment, particularly around managing demand.

“I think it’s good that patients can access GPs a bit easier,” said one female GP. “But hopefully … you’re dealing with the stuff that needs to be dealt with rather than wasting your time dealing with trivial stuff.”

Seven ways AI could help

The study identified seven opportunities where AI could assist during eVisits — most of which were met with approval when described to participants.

1. Workflow routing: Directing requests to the right person more efficiently.
2. Emergency directing: Flagging life-threatening symptoms and routing them to emergency services.
3. Prioritization: Identifying urgent concerns so clinicians can address them first.
4. Asking questions: Asking for more information, photos or questionnaires to complete the eVisit.
5. Writing assistance: Suggesting templates clinicians can edit for common issues.
6. Self-help information: Automatically sharing trusted educational resources when appropriate.
7. Face-to-face booking: Scheduling in-person appointments when physical exams are needed.

“If it could automatically triage things that definitely need [a face-to-face] appointment,” said one male GP. “Because actually that could be one way in which it could save some time … could it direct them to an appointment where we have some certain slots for the pill?”

The role of human oversight

Despite the enthusiasm, both groups emphasized that AI should not act alone.

“I wouldn’t want it to just do something automatically in the background and then close something off without a human taking a look at that request too at some point in the process,” said a male GP.

Others worry that patients might enter symptoms imprecisely, leading to missed cues or misdirected recommendations.

“If someone was having a heart attack, say, but didn’t express themselves very well, and the AI thought, oh, it’s nothing much that and said just rest at home or something,” said a 73-year-old patient.

Most patients expressed their trust in practice to safely implement AI. “Well, there’s the element of trust in everything, isn’t there? If you can’t trust your GP, you’re on a loser straight away,” said a 58-year-old man.

Physician acceptance is key

Practice staff voiced concerns that patients might initially resist automated features and revert to calling the office, but several said that the same thing happened with eVisits themselves — until patients got used to them.

“Initially, there … might be quite a lot of resistance from it,” said one female GP. “It might be extra work in the beginning, but once they start to spot a pattern — actually, no, the doctors are agreeing with what the AI is telling us — that might then disappear.”

Researchers emphasized that practices need to clearly communicate how AI is being used, what it can and can’t do, and that it will never completely replace face-to-face care when it’s necessary.

Ultimately, patients and physicians are open to using AI in primary care eVisits, especially if it helps them get care faster and makes workloads more manageable. But, they also want reassurance that AI will enhance care — not replace it.

“I feel uncomfortable if I’m being really honest,” said a 58-year-old patient. “Knee-jerk reaction is I feel uncomfortable [about] any kind of AI because it’s …I just think certain things — you still need some face-to-face interaction, some interaction with another human.”

The message is clear: if AI is going to become a part of primary care — and it sure seems like that’s the path we’re on — it needs to be built on trust, transparency and teamwork.