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Ontario family doctor says new AI notetaking saved her job

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Re: Ontario family doctor says new AI notetaking saved her job

#151

Post by adzm »

benmanns wrote: post #139
chimeracoder wrote: post #118

Earlier quoted context omitted.

> The HIPPA rules on health data are fairly strict Depends on how you define "strict". They're pretty onerous to comply with, but they don't really provide patients with anywhere near the level of protection that most people think. It's better than nothing, but in reality, your data is being legally shared with an arbitrary number of entities, without your consent, and without any way for you to even know who has acc…

And what is your recourse? There's no private cause of action for HIPAA violations.

Finally someone uses the correct acronym

Re: Ontario family doctor says new AI notetaking saved her job

#152

Post by IG_Semmelweiss »

lotsofpulp wrote: post #136
IG_Semmelweiss wrote: post #123

Earlier quoted context omitted.

>> Documenting it so that it can be billed appropriately is also crucial. This is literally the only reason why scribes, or pretty much any EMR exist. EMRs are an accounting tool. To avoid "down coding" and legal exposure . Plain and simple. There's a reason that doctors would not adopt EMRs for the longest time (at least in the US, don't know other nations) until actual legislation was passed to force them to do so,…

> The EMR, and therefore most note-taking, is not as value add to the patient Since patient’s medical histories are relevant to treating medical issues, having quick access to accurate medical histories is a value add for the patient. Just the simple fact a pharmacist does not have to decipher chicken scratch to get people the right medicine is a value add for patients. My family chooses to frequent doctor groups tha…

That can be easily solved without an EMR. In fact, that's a good AI use case

Re: Ontario family doctor says new AI notetaking saved her job

#153

Post by tiahura »

andsens wrote: post #144
technofiend wrote: post #122

Earlier quoted context omitted.

HIPPA rules are easily circumvented unless you as a patient are paying attention: I can't tell you how many forms I've opted out of that wanted to explicitly export my data to third parties and partners that are not HIPPA compliant. And at least for my healthcare providers that use MyCharts, they like to make it part of the echeckin workflow, with no option to refuse. So you're forced to go up to the desk to check in…

The fact that it is even legal to ask patients to sign away their right to privacy boggles the mind.

In the US, adults are generally considered competent to make their own decisions.

Re: Ontario family doctor says new AI notetaking saved her job

#154

Post by alsetmusic »

hollerith wrote: post #147
andsens wrote: post #144

Earlier quoted context omitted.

The fact that it is even legal to ask patients to sign away their right to privacy boggles the mind.

There are already too many restrictive law and rules in the US around healthcare, and here you want to add another restriction.

Ok, I’ll bite. List some concrete examples. Otherwise, I have to land on the default that regulation is good and works better than a free-for-all.

Re: Ontario family doctor says new AI notetaking saved her job

#155

Post by adzm »

robrenaud wrote: post #145
IG_Semmelweiss wrote: post #132

Earlier quoted context omitted.

OK, but you need to clarify your statement. As you said, >>> note taking and documentation is required by law. So then, the EMR not a value add, which is also what I wrote. It just so happens that in the US the primary reason is to get paid, and its also why some doctors still eke out a living without an EMR (but still with some kind of paper medical files)

Do EMRs improve the standard of care?

Absolutely. They can allow providers to easily track their adherence to Patient Quality measures which directly affects their income.

Re: Ontario family doctor says new AI notetaking saved her job

#156

Post by IG_Semmelweiss »

swader999 wrote: post #126
IG_Semmelweiss wrote: post #123

Earlier quoted context omitted.

>> Documenting it so that it can be billed appropriately is also crucial. This is literally the only reason why scribes, or pretty much any EMR exist. EMRs are an accounting tool. To avoid "down coding" and legal exposure . Plain and simple. There's a reason that doctors would not adopt EMRs for the longest time (at least in the US, don't know other nations) until actual legislation was passed to force them to do so,…

My wife is a vet where the legal penalties are far less but she contends that proper medical records are critical, one of her most important asks of colleagues.

A medical record can be paper or electronic. The key question, is whether that record is proper or not.

Most EMRs have copy pastes of staff paid $15 per hour and of doctors completing e-notes in under 3 mins for each pt the night after the encounter happened. That's hardly proper records.

Re: Ontario family doctor says new AI notetaking saved her job

#157

Post by sxg »

technofiend wrote: post #122
tim333 wrote: post #113

Earlier quoted context omitted.

The HIPPA rules on health data are fairly strict, otherwise your doctor, hospital and so on could already be doing wrong. Personally I have a dumb TV, car, doorbell and fridge so not much spying there. The phone I'm less sure of.

HIPPA rules are easily circumvented unless you as a patient are paying attention: I can't tell you how many forms I've opted out of that wanted to explicitly export my data to third parties and partners that are not HIPPA compliant. And at least for my healthcare providers that use MyCharts, they like to make it part of the echeckin workflow, with no option to refuse. So you're forced to go up to the desk to check in…

Wait—this doesn't make any sense. I'm a physician and have a lot of experience dealing with protected health information. Third parties are required to sign a HIPAA BAA and obligated to uphold privacy/security standards equal to that of your physician and hospital. Can you provide some specific examples of the third parties you're talking about?

MyChart itself is a component of Epic (the EMR) and is absolutely HIPAA compliant. Every healthcare institution I've worked with has taken HIPAA and privacy/security regarding patient data extremely seriously. Non-HIPAA compliant vendors are an immediate non-starter and don't even enter discussions when looking at new products.

Re: Ontario family doctor says new AI notetaking saved her job

#158

Post by IG_Semmelweiss »

adzm wrote: post #155
robrenaud wrote: post #145

Earlier quoted context omitted.

Do EMRs improve the standard of care?

Absolutely. They can allow providers to easily track their adherence to Patient Quality measures which directly affects their income.

The question is whether they improve the standard of care.

Quality measures produce numbers so bean-counters are satisfied at CMS.

For example: Before i was not submitting any quality measures, but my patient satisfaction was sky high, and i had the lowest complications for years.

Now i report quality measures, but as a result of documentation requisites and reporting requirements, i have less time to see patients , and therefore make more mistakes.

My quality measures are good because I'm talking to patients about quitting smoking and getting leaner - but i was already doing that previously. Now objectively, since I now have less time due to EMR requisites, my patients are worse off than before and it shows with slightly more complications my patient's aren't as happy as their waiting times are longer (and getting worse too).

Re: Ontario family doctor says new AI notetaking saved her job

#159

Post by penjelly »

im from Ontario and see resident physicians regularly. The problem isnt that they dont have time to take notes.. its that they dont have time period. The first thing the supervisor doctor will say to me when theyre invited in is "i havent got much time...". Most likely your diagnosis goes like this, you describe symptoms, resident doctor disappears to the supervising doctor and returns with an action. Usually no longterm plan is given, just a medication or recommendation. Its hard to negotiate the action because youre negotiating with the resident, but the decision is authorized by the supervisor. The problem is systemic and automatic note taking isnt going to solve it. Despite this success story for the doctor, I suspect the patients themselves wont have the same success in Ontario.

Re: Ontario family doctor says new AI notetaking saved her job

#160

Post by tiahura »

benmanns wrote: post #139
chimeracoder wrote: post #118

Earlier quoted context omitted.

> The HIPPA rules on health data are fairly strict Depends on how you define "strict". They're pretty onerous to comply with, but they don't really provide patients with anywhere near the level of protection that most people think. It's better than nothing, but in reality, your data is being legally shared with an arbitrary number of entities, without your consent, and without any way for you to even know who has acc…

And what is your recourse? There's no private cause of action for HIPAA violations.

Bingo. As a new ambulance chaser, I was having some real difficulty getting the medical records for a client - no response for weeks and weeks and weeks.

Aha! I thought. HIPAA gives them 30 days(sortof). We'll sue, and surely there's an attorney fee provision in there. Easy money. GOOGLE Wait what? No private cause of action! All I can do is file a complaint with HHS!

That said, depending on your state, you may be able to make some sort of colorable common-law claim.

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