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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

#131

Post by caturopath »

sarchertech wrote: post #119
caturopath wrote: post #103

Earlier quoted context omitted.

I'm not sure the for-profit approach is exactly what's to blame. HMOs like Kaiser are legally forced to spend a certain fraction (80% percent for the worst case, more for large group plans) of their premium revenue on medical services. They can't save and pocket the money like a traditional for-profit enterprise. This doesn't seem like a money-saving measure exactly. The main AIs the article talks about is making sur…

> spend a certain fraction (80% percent Increasingly health insurance companies and healthcare providers are intertwined. So they may spend 80% on healthcare, but then a big chunk of that could go to the urgent care clinics that they own. And even if they don’t own the provider, they don’t have much incentive to lower total cost because 20% of a larger number means more total profit.

> Increasingly health insurance companies and healthcare providers are intertwined.

Kaiser is an HMO. They are the insurer and try to have their employees, such as these nursing lines, perform almost all of their care. Shifting from one line of business to another is purely internal and can't game Medical Loss Ratio like your scenario.

> they don’t have much incentive to lower total cost because 20% of a larger number means more total profit

There is some bad incentive here for sure. That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Also, regulatory rate review can decide whether they can raise premiums a given amount.

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

#132

Post by terminal-bloom »

abeindoria wrote: post #100

That is surprising. My primary care provider had a different response. Basically he said something in line of "You wouldn't believe how much of a relief it has been. In your last visit, you saw me typing everything you were saying, right? I don't have to. I can listen to you and take very specific notes as necessary as opposed to focusing on both typing and listening to you at the same time. It has bought my stress l…

I’d be more willing to consent to these tools if I had confidence that the underlying software truly was built to honor my privacy.

Too many AI tools are built hastily for me to give my doctor’s (visibly awful) software the trust.

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

#133

Post by TheOtherHobbes »

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…

Classic "1 star review because UPS lost my delivery" metric.

I'd guess most people have had a situation where there's a corporate problem, the support person you talk to literally doesn't have the tools or the agency to fix it, but then you're asked to rate their performance on whether or not they solved the issue, with no option to say "Actually they did their best but this isn't their fault."

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

#134

Post by wrecked_em »

api wrote: post #118
derekdahmer wrote: post #115

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…

“AI” in title gets clicks. So “AI” must be in title.

[dead]

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

#135

Post by aaron695 »

derekdahmer wrote: post #115

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…

[dead]

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

#136

Post by ihsw »

derekdahmer wrote: post #115

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…

[dead]

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

#138

Post by sarchertech »

caturopath wrote: post #131
sarchertech wrote: post #119

Earlier quoted context omitted.

> spend a certain fraction (80% percent Increasingly health insurance companies and healthcare providers are intertwined. So they may spend 80% on healthcare, but then a big chunk of that could go to the urgent care clinics that they own. And even if they don’t own the provider, they don’t have much incentive to lower total cost because 20% of a larger number means more total profit.

> Increasingly health insurance companies and healthcare providers are intertwined. Kaiser is an HMO. They are the insurer and try to have their employees, such as these nursing lines, perform almost all of their care. Shifting from one line of business to another is purely internal and can't game Medical Loss Ratio like your scenario. > they don’t have much incentive to lower total cost because 20% of a larger numbe…

I’m not talking about Kaiser. I’m talking about companies like UnitedHealth Group Incorporated who own UnitedHealthcare the insurance company and Optum the healthcare provider.

> That being said, insurers do compete on price so they lose customers if they charge more than other insurers.

Yeah but that’s a second order effect. Most companies are incentivized to cut costs because they will directly realize the profit. Insurance companies are incentives to cut costs only to grow market share.

I understand the point of the profit limits, but I don’t think it works very well in practice. I think it would probably be better to just have private companies without that profit cap and add a government insurer to compete with them.

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

#139

Post by ACCount37 »

pydry wrote: post #89
9x39 wrote: post #74

It sucks because AI reduces call center costs in many toil tasks very effectively, regardless of whether you want to help or dissuade customers - it's just well-suited to the task and it's going to accelerate. It's a win for capital and the technology implementers, even if it's a loser for the call center employees and callers. Some of the tech is pretty scary. One big vendor's solution [0] can provide not just AI ag…

90% of the time when I call a call center I need a human to fix an organisational bug - e.g. faulty billing or some other kind of mixup. AI cannot help with this. If it's to do something normal you could do through the website there was no need for AI - a website or app suffices - provided it isnt terrible. Capital definitely thinks it can save costs here but capital is getting increasingly delusional these days.

Neither can an average call center human.

A good 90% of call center humans are flesh interpreters for support scripts. They are being paid to act like they don't have free will.

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

#140

Post by caturopath »

sarchertech wrote: post #138
caturopath wrote: post #131

Earlier quoted context omitted.

> Increasingly health insurance companies and healthcare providers are intertwined. Kaiser is an HMO. They are the insurer and try to have their employees, such as these nursing lines, perform almost all of their care. Shifting from one line of business to another is purely internal and can't game Medical Loss Ratio like your scenario. > they don’t have much incentive to lower total cost because 20% of a larger numbe…

I’m not talking about Kaiser. I’m talking about companies like UnitedHealth Group Incorporated who own UnitedHealthcare the insurance company and Optum the healthcare provider. > That being said, insurers do compete on price so they lose customers if they charge more than other insurers. Yeah but that’s a second order effect. Most companies are incentivized to cut costs because they will directly realize the profit.…

Right, but the article was about Kaiser and I was talking about the thing the article was about.
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