AI workflows for serious illness conversations in ED

Serious illness conversations—discussions about values and care preferences—can align medical care with what matters most to patients, yet they rarely happen in Emergency Departments. Barriers include fragmented information, time pressure, and documentation burden, leaving clinicians to make decisions without knowing what patients want. With collaborators from Harvard Medical School, we investigated how AI might support these conversations without displacing human connection. 

We identified opportunities for AI—synthesizing information, supporting dialogue, automating documentation—while recognizing concerns about preserving autonomy and interpersonal care. Simultaneously, we developed and evaluated ED GOAL-AI, a voice-based agent for brief values discussions with older adults in the ED. Most patients found the interaction acceptable and felt heard. Ongoing work refines the system with clinicians to establish boundaries and principles for AI that enhances rather than replaces human care.