为急诊科严重疾病对话设计智能辅助系统，平衡效率与人文关怀
Balancing Efficiency and Empathy: Healthcare Providers' Perspectives on AI-Supported Workflows for Serious Illness Conversations in the Emergency Department
- 构建四阶段对话工作流，识别信息碎片化等核心障碍
- 医生期待AI实时支持对话与自动记录，但担忧削弱人际连接
- 提出环境式AI设计指南，保障技术辅助中的人文温度
严重疾病对话（SICs）是针对危重病患价值观与照护偏好进行的沟通，虽能提升照护一致性并减少过度干预，但在急诊科（ED）极少开展。我们访谈了11位急诊科医生，分析其在SICs中的挑战与技术支持机会，聚焦人工智能（AI）。研究揭示了四阶段工作流程：识别、准备、实施与文档记录，各阶段存在患者信息分散、时间空间有限、缺乏对话引导及文书负担过重等障碍。医生对AI系统在整合信息、实时对话支持与自动化记录方面表现出兴趣，但强调必须保护医患间的人际联结与临床自主性。该矛盾凸显了需开发既能提升效率又不损害人际关系的AI技术。本文据此提出面向环境化与边缘化AI系统的设计准则，以支持医护人员同时保留对话的本质人文性。
原文摘要 · Abstract (English)
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.
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