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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

#161

Post by jorlow »

agentultra wrote: post #97

Privacy and hallucinations would concern me. It seems likely to me that relying on these tools will mean physicians will "trust" the output of these systems and stop checking the notes for accuracy. Checking the notes will become a burden too. Maybe the real solution is to lower the amount of administrative work required? Or hire people to do it?

I too feel a bit worried about AI making mistakes, but the thing is that a doctor rushing or an assistant can (and do) make mistakes too. These are all just cost vs quality of service tradeoffs. From my experience (having been in and out of hospitals a lot in the last year) it wouldn't surprise me if AI, even with occasional mistakes, would still be a net improvement in overall quality of care and outcomes.

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

#162

Post by pixl97 »

IG_Semmelweiss wrote: post #152
lotsofpulp wrote: post #136

Earlier quoted context omitted.

> 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

This doesn't make any sense... an AI is going to be reading the EMRs.

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

#163

Post by TacticalCoder »

xyst wrote: post #92

As a person that used to be a “human scribe” but for emergency dept doctors. I would say the ER doctors shared the same experience as the one depicted in the news story. For a doctor that was nearing the age of retirement or had very poor keyboard proficiency. scribes were a godsend. Doctors worried less about documentation and focused more on patient care. Of course they still wrote things like admission orders, pre…

> For a doctor that was nearing the age of retirement or had very poor keyboard proficiency...

I went to a doctor recently who was typing very fast. I did kid with her that she could type nearly as fast as I did and yet she was also using one of this automated note taking thinggamagic (holding some kind of microphone in her hand).

She'd type manually for stuff like email/subject, click click one sentence here, click, one word there: for that kind of stuff it's too slow to dictate one word, then click, etc.

But in that big empty text field? She'd dictate.

As a bonus as her patient I got to hear her report (or "my" report if you want) in real-time.

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

#164

Post by danielmarkbruce »

ceejayoz wrote: post #106
snoman wrote: post #78

Earlier quoted context omitted.

> …when they get to the point of only rarely making big dangerous mistakes. Are you intentionally rubbing FUD on that or am I mis-reading you? I don’t think we need to wait to rely on technologies until they’ve achieved perfection - just when their mistakes are less frequent, less dangerous, or more predictable than human mistakes for the same task.

I'm saying getting close to perfection is truly dangerous territory, because everyone gets very complacent at that point. As a concrete example: https://www.cbsnews.com/news/pilots-fall-asleep-mid-flight-1...

We are already there with humans. Most people take a doctor at their word and don't bother to get a second opinion.

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

#165

Post by craigmcnamara »

tim333 wrote: post #113
forgetfreeman wrote: post #102

Earlier quoted context omitted.

Yeah but you can't get that genie back in the bottle. Once these data are made available to private industry it's only a matter of lobbyists chipping away at whatever protections were initially legislated. See Also: your TV, phone, car, fucking doorbell, and fridge are all spying on you.

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.

The law is called HIPAA and technology providers sign a BAA(Business Associate Agreement) that states they agree to handle and store your information in compliance with the relevant standards and laws. With tools like OpenAI Whisper and GPT the HIPAA mode means that the tools don't retain any memory of prior interactions. Health tech is built on 3rd party vendors AWS, Google, and Microsoft are huge in the space.

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

#166

Post by technofiend »

sxg wrote: post #157
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…

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…

Sure, next time I find one of the forms I'll snag it for you. It was rather eye catching because it explicitly stated "You're allowing us to share data with third parties and service providers that are not HIPPA compliant." How do I get it to you?

I wasn't claiming that MyCharts isn't HIPPA compliant: I was complaining as part of a MyCharts workflow I was presented with a form that wanted me to grant someone the right to send my data to non-compliant organizations, and as I said above explicitly stated so.

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

#167

Post by resource_waste »

Pigalowda wrote: post #111
resource_waste wrote: post #100

Earlier quoted context omitted.

>So we are lobbying for an increase in Medicare funding for residency positions (they are paid by Medicare). Hey taxpayers, can you pay for my grad degree too? Wait its worse, I actually profit during this period. Don't worry that I'm the highest paid profession upon graduation.

You think you’ll be able to recruit more people into medicine by reducing compensation, keeping education costs the same, and also keeping medicolegal liability on the physician? Residency as “profit” is a stretch. You tread water for 5 years. If you would like those apprenticeship years to go unpaid then I’m not sure how it increases the number of people who want to go into medicine.

>You think you’ll be able to recruit more people into medicine by reducing compensation

You don't need to recruit more, there is an abundant supply of people who want it.

>Residency as “profit” is a stretch.

Physicians are funny, a fantastic wage for the lower-middle class is considered 'treading water'. And its for education. Something every other degree pays for.

>I’m not sure how it increases the number of people who want to go into medicine.

This is not an issue, there are plenty of people who want degrees that don't involve math. The issue is number of licenses, not number of people who are capable of doing the job and want to.

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

#168

Post by whoomp12342 »

xyst wrote: post #92

As a person that used to be a “human scribe” but for emergency dept doctors. I would say the ER doctors shared the same experience as the one depicted in the news story. For a doctor that was nearing the age of retirement or had very poor keyboard proficiency. scribes were a godsend. Doctors worried less about documentation and focused more on patient care. Of course they still wrote things like admission orders, pre…

if AI is hosted in house I think it can have some very wonderful potential. Unfortunately lots of organizations are more worried about covering their asses legally than actually protecting the data

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

#169

Post by sxg »

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.

It's mind boggling because I highly doubt it's actually true. I'm not sure where the OP is getting that info. Patients can't waive away HIPAA privacy/security rights.

I think the OP is assuming that when healthcare institutions partner with third parties, those third parties are not required to uphold HIPAA. If that's his/her belief, it's 100% false. Third parties associating with healthcare institutions have to sign business associate agreements (BAAs) that require them to uphold the same standard of privacy/security regarding patient data as the first party healthcare institution. There are severe financial penalties for violating HIPAA, and every healthcare institution I've been a part of takes this extremely seriously.

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

#170

Post by Magi604 »

TacticalCoder wrote: post #163
xyst wrote: post #92

As a person that used to be a “human scribe” but for emergency dept doctors. I would say the ER doctors shared the same experience as the one depicted in the news story. For a doctor that was nearing the age of retirement or had very poor keyboard proficiency. scribes were a godsend. Doctors worried less about documentation and focused more on patient care. Of course they still wrote things like admission orders, pre…

> For a doctor that was nearing the age of retirement or had very poor keyboard proficiency... I went to a doctor recently who was typing very fast. I did kid with her that she could type nearly as fast as I did and yet she was also using one of this automated note taking thinggamagic (holding some kind of microphone in her hand). She'd type manually for stuff like email/subject, click click one sentence here, click,…

I once had to go to a walk-in clinic to deal with a minor emergency. The doctor who attended me was literally typing with his pointer fingers.
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