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Kaiser nurses say AI, surveillance are making their jobs and patient care worse

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Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#61

Post by datsci_est_2015 »

inigyou wrote: post #21
neaden wrote: post #3

If you think using a machine to evaluate how well a human is showing empathy is a good idea, you probably shouldn't have any position of power.

Power is based on wealth extraction, not merit.

Increasingly true in Trump’s America.

It’s somewhat the point of democracy to maintain a limit on rent seekers’ and wealth extractors’ power on the political process. It should come as no surprise that the individuals who have grifted and extorted their way into power are also fiercely antidemocratic. The xenophobes and bigots that have hitched their wagons are equally deplorable.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#62

Post by BeetleB »

Broken_Hippo wrote: post #30
BeetleB wrote: post #8

Earlier quoted context omitted.

I have some inside information (but not much!) They claim they do not use average handle time, but it is very common to get called into meetings to discuss why they spent a lot of time on some calls. The nurses get defensive (by definition - they have to justify the time used - it is a defense). They also do get called into meetings if their average handle time is large. It may still be true they don't use it for eva…

It might not be a written metric, but do you actually believe that someone isn't being evaluated partially based on how many times they've had to talk to them about issues? I highly doubt it. If this is the reason your manager knows who you are, you are absolutely going to be judged on it. It doesn't really matter what the policy says. And the nurses absolutely feel like they are being punished for it. Just like havi…

> but do you actually believe that someone isn't being evaluated partially based on how many times they've had to talk to them about issues?

This is true for any job. I was unfairly fired from a job because somehow the manager got a perception of me being incompetent, because he often talked to me about problems in my work - most of those conversations ended with him saying "Oh, now I see why you did it that way."

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#63

Post by uhhhhwhaaaa »

Unpopular opinion: People want to be lazy and hate things that force them to work harder.

They will vocally rationalize it.

I did it. "I'm more productive work from home." But then I do dishes, take an hour break, paid.

Foucault says that when people are observing them, power is placed over them.

If you are a worker you should hate this.

If you are a customer or owner, you should like this.

But I certainly won't be automatically believing people under surveillance who make claims it makes their quality worse.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#64

Post by caycep »

uhhhhwhaaaa wrote: post #63

Unpopular opinion: People want to be lazy and hate things that force them to work harder. They will vocally rationalize it. I did it. "I'm more productive work from home." But then I do dishes, take an hour break, paid. Foucault says that when people are observing them, power is placed over them. If you are a worker you should hate this. If you are a customer or owner, you should like this. But I certainly won't be a…

clearly you have never been a floor nurse at a hospital...

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#65

Post by datsci_est_2015 »

munk-a wrote: post #41
lostlogin wrote: post #32

Earlier quoted context omitted.

> you can rely on the customers. Patient or customer? I even struggle with that, but I guess that’s what people are in a privatised healthcare system.

Most of the folks here on HN are dealing with customer feedback in systems automation in one form or another - it's pretty unavoidable in this age of LLM trendiness. The customers of healthcare (in both private and publicly funded systems) are the patients. So while the term might not be super natural it's an understandable one to use.

Patients are not customers, or at least I don’t want to live in a world where patients are considered customers. Customers and vendors are usually more of a symmetric relationship: price transparency, alternatives, lack of urgency. These are all characteristics of transactions that healthcare often lacks.

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#66

Post by cindyllm »

uhhhhwhaaaa wrote: post #63

Unpopular opinion: People want to be lazy and hate things that force them to work harder. They will vocally rationalize it. I did it. "I'm more productive work from home." But then I do dishes, take an hour break, paid. Foucault says that when people are observing them, power is placed over them. If you are a worker you should hate this. If you are a customer or owner, you should like this. But I certainly won't be a…

[dead]

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#67

Post by [deleted] »

BeetleB wrote: post #58
kulahan wrote: post #24

Earlier quoted context omitted.

"You can't ask people because the experience is so universally terrible they'll just tell you it's terrible" isn't really an argument against surveys, it just means you need more specific questions they'll be fired up to answer

Let me suggest the following: Ask the nurses if they want the customer to rate them. A significant fraction of the calls they answer are patients shouting at them because of: - Long wait times - They don't like their doctor - They don't like the advice they're given (sorry, but we're not going to book you as a high priority appointment if all you can tell me is you have a headache. Sorry, we're not going to prescribe…

[deleted]

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#68

Post by teachrdan »

doodlebugging wrote: post #45
inigyou wrote: post #23

Earlier quoted context omitted.

Isn't that the insurance company whose CEO was murdered because of the terrible quality of care they delivered?

Yes it is. Somehow that might appear to be incentive to improve quality of care but maybe their corporate culture is a bad fit for quality.

> that might appear to be incentive to improve quality

Their goal isn't to provide high quality care. Their goal is to increase profits. It's not hard to imagine how improved quality would lead them to spend more money. (faster diagnoses of serious illnesses and recommending expensive care)

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#69

Post by wilg »

ButlerianJihad wrote: post #46
arjie wrote: post #44

Earlier quoted context omitted.

Well, I suppose you can rest easy on that count. Kaiser is principally a non-profit.

> principally a non-profit. I hate to break it to you, but "non-profit" doesn't mean what you literally think it means. https://en.wikipedia.org/wiki/Kaiser_Permanente Also, KPMGs are indeed "for-profit" while Kaiser Permanente as a whole is constituted as a "consortium" of both types.

Do you suppose thats why they wrote "principally"?

Re: Kaiser nurses say AI, surveillance are making their jobs and patient care worse

#70

Post by BeetleB »

munk-a wrote: post #35
BeetleB wrote: post #8

Earlier quoted context omitted.

I have some inside information (but not much!) They claim they do not use average handle time, but it is very common to get called into meetings to discuss why they spent a lot of time on some calls. The nurses get defensive (by definition - they have to justify the time used - it is a defense). They also do get called into meetings if their average handle time is large. It may still be true they don't use it for eva…

Yeah, I didn't even want to lean out that far but I'm sure average handle time is incorporated in some manner. But, just purely semantically, the statement Kaiser gave in response was worded in a precise smug corporate America style to dodge the main concern raised. I think it's important to call out weasel words.

> the statement Kaiser gave in response was worded in a precise smug corporate America style to dodge the main concern raised

I know nurses. And I know their unions. Kaiser can be extremely clear and tell the truth, and they'll still say "We don't believe you!" without any evidence other than being called in to talk about it.

I'm not anti-unions - I've benefited from them. But it's well known that distrust goes up when you have (or need) unions. It typically degenerates from "We" to "Us vs them".

Let me ask you this: Are you saying they shouldn't monitor the time at all?

Again: A tidbit of inside information: A number of Kaiser patients get such long wait times that they're issue isn't addressed when they try to call (i.e. they are told they'll be called back, and they're called back some other day). I don't know the percentage - likely small - but from a healthcare standpoint, it's unacceptable.

Another bit of information (likely not inside): Kaiser has a serious budget problem. They already pay amongst the top salaries for nurses, and they can't simply solve the problem by hiring more.

So: How would you solve it?

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