Live data from Hacker News

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

localnewsmatters.org

361–370 of 401 posts

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

#361

Earlier quoted context omitted.

"My pushback is that now is not the time for both-sides-ism" Of course, and that line of reasoning has consistently failed at the polls since it was deployed as a readguard attempt to bolster Clinton's failed presidential campaign. Like, how many times does the DNC have to stick a fork in this particular outlet before it becomes transparent that this line of rhetoric simply doesn't produce the desired results? Not on…

Let me try this again. A two party system is a rigged game. Period. The Democratic party absolutely needs to be taken to task and none of their bullshit should be tolerated or defended, ever, except one small exception: election day, in the general election -- because we can't fix the government if it's no longer a democracy.

Thank you for clarifying your position.

We are in violent agreement in all but this: I refuse to reward the Democratic party for putting a gun to my head. If they as a political organization are willing to literally risk our democracy when the alternative is assembling reforms that clearly address the imbalances in our society then we can all burn together because I refuse to continue to reward their brinksmanship.

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

#362

I RFTA and the majority of the complaints are about call center metrics and the pressure to ration care. These are real concerns about misuse of metrics, but not AI. The AI empathy thing was a 2024 pilot that was discontinued. FWIW my wife works for Kaiser and finds a lot of value in the the medical LLM tools available to her. She tells me being able to do live translation, summarize notes, and quickly get comprehens…

Being close relative for several med and care workers we have discussed it a lot and consensus is that it really depends. For example relying on LLM summaries sounds great until it doesn't. It doesn't matter whether you misunderstand LLM summary or LLM "misunderstands" you – there are real risks involved, and you wouldn't want them to weigh on your conscience if they were to materialize. Relying on LLM to summarize t…

> It doesn't matter whether you misunderstand LLM summary or LLM "misunderstands" you – there are real risks involved, and you wouldn't want them to weigh on your conscience if they were to materialize.

"fun" fact, a number (some? many? all?) of the LLM speech to text models will editorialize or hallucinate words for you, to make your speech fit the pattern it expects.

I don't think it's appropriate to use a model that can editorialize in a medical transcription setting. I feel that crosses a huge number of ethical lines.

> At the moment consensus is that it must not be banned, but also not mandated in any way - people must take responsibility, and they must be able to decide for themselves where and when the LLM use is justified and where it is not.

I have a really hard time understanding how supposed experts in their field, have been taken in so perfectly and so completely. You're a trained and certified medical/healthcare worker, responsible for the health, safety and well being of other humans, and yet willingly turn over parts of the process that exists to protect the safety and health of others, to a machine that you know can and will make mistakes you wouldn't or even couldn't ever reasonably make. You're supposed to make sure it works and is safe for everyone you're responsible for before you start using it... but then, I prefer healthcare that doesn't move fast, and break humans.

I'm sure someone will try to play devil's advocate and suggest it's a good thing to ration care, and that you have to acknowledge that you can't save everybody, faster is better after all But no, I'm angry enough about it that if a licensed person suggests that, I'll gladly complain to your licensing board (rhetorically speaking, I'm not gonna try to doxx anyone). You can't ethically argue for rationing care, and letting a machine known to make errors in ethics or care decisions, that you have been trained not to make. (Advocating for a reduction in the standard of care in order to increase profits.) (Yes, you're correct, if you're in a state of triage, you're required to, and in those cases, using an imperfect machine is possibly preferable, and probably ethical, but still objectionable. I currently refuse to believe that the US is in a state of emergency, but perhaps that's where I'm wrong) Part of your licensure you promised to prioritize patient care above personal gain. You can't then make decisions to experiment with systems you cant prove are safe.

I can understand in when SWEs ignore the best interests of the humans they're working for. But Doctors and Nurses? I guess I expected better from my former colleagues?

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

#363

Earlier quoted context omitted.

Being close relative for several med and care workers we have discussed it a lot and consensus is that it really depends. For example relying on LLM summaries sounds great until it doesn't. It doesn't matter whether you misunderstand LLM summary or LLM "misunderstands" you – there are real risks involved, and you wouldn't want them to weigh on your conscience if they were to materialize. Relying on LLM to summarize t…

> It doesn't matter whether you misunderstand LLM summary or LLM "misunderstands" you – there are real risks involved, and you wouldn't want them to weigh on your conscience if they were to materialize. "fun" fact, a number (some? many? all?) of the LLM speech to text models will editorialize or hallucinate words for you, to make your speech fit the pattern it expects. I don't think it's appropriate to use a model th…

> I have a really hard time understanding how supposed experts in their field, have been taken in so perfectly and so completely.

Yes, surely it’s not you. It’s all the experts that are wrong and being hoodwinked. Why can’t they just see what you can?

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

#364
post #331

Earlier quoted context omitted.

everyone is very thirsty for AI hate, so its not unexpected. Today its a mixed bag of corpo hate, anxiety about the future, inequality and traditional class warfare, combined with the typical technical ignorance. I would expect companies to blend shit metrics with AI systems, if not at Kaiser then at other places. People lack imagination and using AI to monitor your workforce has to be one of the possibly worst ways…

> Today its a mixed bag of corpo hate, anxiety about the future, inequality and traditional class warfare, combined with the typical technical ignorance. Are there no actual problems with what it promises/how we're expected to use it at work/how it is used against us by people who use it at work? Is it just anxieties and feelings, that aren't actually grounded in anything? Everything's getting better for everyone, no…

In this case it seems to me that LLMs in medicine pretty much are just better for everyone with no real downsides. Im not a doctor but have 2 in my family I speak with regularly and from how they talk about it care is pretty much just unequivocally better now because they dont have to be sitting at the computer taking notes all the time. It removed a huge part of the process that neither patients nor doctors enjoyed.

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

#365

Earlier quoted context omitted.

> It doesn't matter whether you misunderstand LLM summary or LLM "misunderstands" you – there are real risks involved, and you wouldn't want them to weigh on your conscience if they were to materialize. "fun" fact, a number (some? many? all?) of the LLM speech to text models will editorialize or hallucinate words for you, to make your speech fit the pattern it expects. I don't think it's appropriate to use a model th…

> I have a really hard time understanding how supposed experts in their field, have been taken in so perfectly and so completely. Yes, surely it’s not you. It’s all the experts that are wrong and being hoodwinked. Why can’t they just see what you can?

> Why can’t they just see what you can?

Most humans use a default trust model for life; they've been lied to. That's part of why I'm angry, if you trust other people; why would you look for it? This entire article is about the fallout from not looking for it, and the resulting harms to pt care. So, it turns out, it was a mistake to adopt the new tech quickly; you know, as evidenced by the harms to patients?

So I don't know, why do you think they couldn't they predict the harms that I thought were obviously predictable, and then happened?

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

#366
post #141

Earlier quoted context omitted.

You're seriously saying it's surprising that your PCP had a different response to AI that is presumably not mandatory for him to use? Cmon dude.

you're frowning on a verbatim experience, considering it a presumption _while_ making another presumption? Come on, dude.

I'm frowning upon your use of a good experience that one person had in a completely different context to overshadow a bad use of AI that affects hundreds of thousands of people. They both happened in healthcare, but other than that, they are different situations with different outcomes.

I made a single presumption: that the PCP's use of AI for this situation is not mandatory. Is it mandatory or is it not?

In 2024 when the AI empathy snakeoil machine was inflicted on the nurses, the nurses had no choice in the matter. And management has already established that they may do something like this again.

Your situation is completely different. It's a doctor overseeing their own tool. If the AI makes a mistake, the doctor is responsible and would presumably take responsibility. Who is responsible if an AI tool makes a mistake in a performance evaluation of an employee? The employee! The employee is guilty until proven innocent. But the employee gets no choice in whether that AI tool is used against them (absent a union agreement which dictates how AI tools can be used).

The reason I fear the misuse of AI is because it is so useful.

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

#367

Earlier quoted context omitted.

The older the doctor the more experience they have, but also their knowledge is more outdated (how many keep up with medical journals?) and their brain is worse at learning and connecting dots so I'm not sure I'd choose the oldest I could find.

The human body is the same as it was before your doctor was born.

Our knowledge of it very much is not

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

#368
post #81
post #33

Earlier quoted context omitted.

Not sure if you’re serious but just search the name Kaiser in any research search engine. https://pmc.ncbi.nlm.nih.gov/articles/PMC8032167/ Their secret sauce is their ability to standardize protocols throughout their entire organization.

Well then their protocols suck. I have many anecdotal data points about them fumbling in major ways when it matters (missed major pathologies, messed up surgeries, etc.). If you have a choice of hospital networks, research carefully. Kaiser might be fine for many people's needs, it's not fine when it comes to intensive care.

Correct. There’s no uniform healthcare solution that works for everyone.

But it doesn’t change the fact their protocols are top notch as reflected by their quality metrics.

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

#369
post #47
post #33

Earlier quoted context omitted.

Not sure if you’re serious but just search the name Kaiser in any research search engine. https://pmc.ncbi.nlm.nih.gov/articles/PMC8032167/ Their secret sauce is their ability to standardize protocols throughout their entire organization.

Study is from 2000-2013, their care has deteriorated significantly since then. I know because I've been a patient the whole time.

Their quality metrics have increased steadily over the last 10 years

https://healthy.kaiserpermanente.org/northern-california/pag...

There’s no best healthcare for everyone but that doesn’t change the fact that Kaiser is objectively one of the best.

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

#370

Earlier quoted context omitted.

It made no sense that he targeted an underling instead of UNH’s head honcho.

How is the CEO not a head honcho?

The guy that was murdered was not the CEO of UNH, he had a boss. There is 1 head giving orders, and it was not the guy that was murdered. Kind of funny if title inflation got him murdered in error.
Post reply on HN