“Not All Bots Are Bad”: How digital tools are adding a more human touch to primary care

With over six million Canadians lacking access to a primary healthcare provider and wait times for specialist services at an all-time high, many are questioning if the healthcare system will ever recover.

The College of Family Physicians of Canada reports an “exodus” of family doctors leaving the profession, with fewer individuals entering the field. A primary concern among these professionals is administrative burnout. This type of burnout stems from the overwhelming volume of administrative tasks that divert clinicians from the very patients they intended to serve when they chose to become doctors.

The problem has worsened over the last five years due to increasingly complex health issues related to the COVID-19 pandemic, a growing aging population requiring more specialist care, and an aging physician workforce, with many doctors approaching retirement.

Today, the average family doctor spends 19 hours per week on administrative tasks—the equivalent of a part-time job, in addition to already demanding clinical hours. It’s no surprise that clinicians are reaching their breaking point.

Administrative burdens have a significant impact on the entire healthcare system

Dr. Mohamed Alarakhia, a family doctor and digital health and innovation faculty lead at McMaster Medical School in Waterloo, believes that reducing clinicians’ administrative burdens is essential to restoring the healthcare system.

“We know that a trusted relationship with a primary care physician reduces morbidity,” says Dr. Alarakhia. “It leads to fewer illnesses and a 20% reduction in ER visits for those who have a dedicated clinician. Primary care makes a real difference in patient outcomes. While access to primary care is challenging, there are models where it’s achievable. One very successful approach I’m involved with is the team-based model.”

Dr. Alarakhia describes team-based care as a collaborative effort involving professionals like doctors, nurse practitioners, nurses, pharmacists, dietitians, and social workers. While he’s grateful to work with supportive colleagues, he admits he could do much more if his administrative load were lighter.

“When you’re just trying to get through your day, it’s hard to be as proactive as you’d like with tasks like patient follow-ups, preventive care, and counselling. You lose the chance to hear a patient’s ‘life story,’ which can often reveal important insights into their medical situation.”

The Canadian Medical Association reports several key statistics highlighting the impact of administrative work on primary care clinicians:

• 38% of administrative tasks assigned to physicians do not require their expertise.
• 75% of physicians report an increase in time spent on administrative tasks over the past five years.
• 61% of general practitioners say the time they spend on Electronic Medical Records (EMRs) at home is “excessive” or “moderately high,” compared to 39% of specialists.
• 75% of physicians feel unnecessary administrative tasks negatively affect job satisfaction.
• 60% report that administrative burdens harm their mental health.
• 75% say that administrative demands hinder patient care.
• The time spent on non-essential administrative tasks equates to 55.6 million patient visits.

To reduce administrative burden for primary care clinicians, experts agree on a multifaceted approach, including improving recruitment and retention. Dr. Mohamed Alarakhia, who is also the CEO of the eHealth Centre of Excellence, is working on this issue through digital solutions. The eHealth Centre is a non-for-profit organization that co-develops solutions with clinicians, and Dr. Alarakhia and his team are focused on creating technology specifically designed to alleviate admin load.

“Our role is to be on the ground, helping family doctors, nurse practitioners, and admin staff adopt technology that makes their work easier and improves patient care,” says Dr. Alarakhia.

Currently, these tools are being implemented in Ontario, British Columbia, Nova Scotia, and Prince Edward Island, with plans to expand nationally across Canada.

Using digital tools to treat a human problem

While these issues extend beyond family practices, the eHealth Centre of Excellence is concentrating its efforts on primary care, hoping improvements will have a positive ripple effect across the healthcare system. Dr. Alarakhia describes the situation as “dire,” noting that many people end up in the ER due simply to a lack of access to primary care. Clinicians are doing their best to support patients but continue to struggle with administrative overload.

This is why his team is focused on creating digital tools to help clinicians dedicate more time to direct patient care. However, they are cautious not to deploy technology too hastily. As part of their approach, they regularly meet with clinicians to understand their on-the-ground challenges.

“We need to identify the actual problems we’re solving, which isn’t always easy,” explains Dr. Alarakhia. “It’s tempting to pursue shiny, easy solutions, but our goal is to determine the right issues to address.”

The aim of digital health is to enhance the flow of patient information, enabling more personalized care through technology that supports—not replaces—the human element. These tools are specifically designed to alleviate administrative burden, not to perform diagnostic functions.

Here are some of the tools the eHealth Centre of Excellence has helped implement:

• AI Scribe: Transcribes patient-physician conversations into medical notes, saving clinicians hours of documentation time.
• eReferral: Allows primary care to see real-time wait times for specialty services and refer patients efficiently to the appropriate services all the while preventing the back and forth faxes that often add time to the referral process.
• E-consults: Allows primary care physicians to consult specialists while the patient is still in the office. This can assist with symptom management and, in some cases, reduce the need for referrals altogether.
• Decision-support tools: Designed to integrate best practices directly into the medical record, these tools place the latest research and evidence at clinicians’ fingertips, often reducing the need for specialist referrals. Typically, it takes about 17 years for research findings to become standard practice; these tools are designed to bridge that gap.
• Bots: Software robots (virtual team members) take on repetitive administrative tasks, freeing up clinician time. Each bot has a human name to enhance relatability:
  • Bernie the Bot: Handles extensive administrative tasks to prevent physician burnout.
  • Sharon the Bot: Ensures seamless sharing of care plans across healthcare providers, so everyone in a patient’s care team has real-time access to the same information.
  • Cody the Bot: Standardizes and organizes patient data, helping clinicians use the information for more proactive care.
  • Poppy the Bot: Manages population health by identifying patients overdue for cancer screenings and initiating follow-up actions automatically.

The bots alone account for 20–30% of the time saved by clinicians using them. Another benefit of these digital tools is that they’re helping to make healthcare more equitable across the country. By using them, clinicians can leverage a nationwide approach, rather than being limited to resources available in their specific region.

“A patient with depression or heart issues in one part of the country should be treated the same as a patient with a similar condition in another,” asserts Dr. Alarakhia.

Will these bots save our healthcare system?

Dr. Alarakhia is optimistic about the future of the Canadian healthcare system. He acknowledges the time required to train new doctors, but notes that several new medical schools are in development across the country. In the meantime, provincial governments are becoming increasingly aware of the challenges and seem more open to innovative solutions, such as implementing digital tools developed by the eHealth Centre of Excellence.

Dr. Alarakhia commends provincial governments for recognizing the need for team-based care. Increased funding is now available for this model, and more medical homes are operating nationwide. Team-based models can help reduce wait times and free up space for patients who need it most. Inter-professional team-based care, particularly when combined with digital tools, has the potential to make a significant impact.

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What can we expect over the next five years?

Dr. Alarakhia admits that transitioning the system and convincing people to embrace innovative approaches will take time. Wait times will remain longer than desired, and many Canadians may still face limited access to a primary care provider. However, he believes that with patience, improvements will come.

While he remains optimistic, Dr. Alarakhia also urges the need for faster, bolder action to drive meaningful change. “Every few weeks, I hear of a physician deciding to quit due to the overwhelming administrative burden. But we have a suite of tools to help lighten that load, and these tools offer real hope.”

Though he stresses the urgency for “bold action,” Dr. Alarakhia is quick to clarify that the responsibility does not lie with the patient. “Patients are not responsible for doctor burnout. If you need to see a doctor, you should go. Our priority must be to facilitate access, not create more barriers.”

That said, the patient voice is powerful, and patients should feel empowered to advocate for a stronger healthcare system. “It’s a voice politicians listen to. Patients need to be included in the conversation on transforming the health system.”

This conversation must continue—and it’s essential that it does.