Lifespan Healthcare System Uses GPT-4 to Improve Patient Health Literacy
Lifespan, Rhode Island’s largest healthcare system, is utilizing GPT-4 to transform dense medical-legal jargon in surgical consent forms into accessible text. This initiative aims to improve health literacy by ensuring patients can understand the procedures they are consenting to, thereby reducing uncertainty and improving patient outcomes.
Simplifying Surgical Consent Forms
Lifespan has successfully reduced the complexity of its surgical consent forms from a college reading level to approximately a 6th grade reading level. This transition was driven by the fact that over half of Americans read at or below the 6th grade level, while traditional surgical consent forms have historically been written at a college level—a problem identified as early as 1980 by the New England Journal of Medicine.
To achieve this, medical residents Dr. Rohaid Ali and Dr. Fatima Mirza used GPT-4 with the following prompt: –’‘While preserving content and meaning, convert this consent form to the average American reading level.’’
Key outcomes of the simplification process include:
- Reduction in length: Consent forms were reduced from three pages to one page.
- Word count reduction: There was a 25 percent reduction in overall word count.
- High accuracy: Clinicians only required one modification to the GPT-4 output, adding the term —‘‘sleep medicine’— next to the word ‘‘anesthesia’.
Human-in-the-Loop Safety Framework
To mitigate the risks of AI hallucinations and bias, Lifespan implemented a rigorous review system. GPT-4 performed the initial draft of the simplified text, which was then subjected to a review by both legal and medical professionals. This human-in-the-loop approach ensured that the simplified forms remained legally sound and medically accurate while becoming more accessible.
Patient and Physician Impact
The deployment of simplified forms began in September 2023, and the response has been overwhelmingly positive from both patients and patients' providers.
Patients have reported that the one-page, understandable forms provide comfort during emotionally charged and overwhelming surgical consent conversations. Dr. Fatima Mirza noted:
‘‘Surgical consent conversations can be very overwhelming and emotionally charged for patients... Since we’ve implemented the simplified consent forms, countless patients have expressed how meaningful it is for them to have a one-page form they can understand.’’
Physicians have also supported the initiative because the conciseness of the forms makes them more accessible for patients, which facilitates the doctor-patient conversation.
Scaling the AI-Assisted Documentation Process
Following the success of surgical consent forms, Lifespan has expanded the use of GPT-4 to simplify other types of medical documentation across its healthcare system. This includes:
- Patient intake forms
- Chemotherapy consent forms
This effort has been published in NEJM AI, a journal from the publishers of The New England Journal of Medicine, highlighting the potential for AI to solve long-standing problems in health literacy that have persisted for decades.