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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

#171

Post by pixl97 »

josephrmartinez wrote: post #124

Here is a similar open source project: https://github.com/josephrmartinez/soapscribe Just a starting point. But if you are interested in this space, fork away and build it into something useful! My personal take is that the current tools on the market are too expensive. The cost should go way, way down. This should stay open source. Patients should have easy access to full audio recordings and transcriptions of their…

Having worked in computing around medical facilities and providers, unfortunately, I believe this is just a pipe dream.

Companies that charge a lot for the software will buy up the smaller companies providing services until only a few are left. They'll bundle it up with an expensive price tag. Even more so, providers tend to have protection when they buy a piece of software used by a large number of other providers. They get to bandy about saying "industry standard". I promise you, you do not want to be in front of a medical malpractice jury saying "well we slapped these parts together that we downloaded online", it won't go well for you, even if that's what the big software service did just the same.

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

#172

Post by rqtwteye »

theptip wrote: post #114

This could be the thing that saves the US healthcare system; currently we pay 2x what a normal developed country would pay for the level of service provided, because there is a thick layer of paperwork, with insurance companies going back-and-forth with medical providers to debate and negotiate billing. Imagine if AIs on each side could run that negotiation process in seconds, at the cost of merely a few hundred thou…

This works only if everybody negotiates in good faith which isn't the case in the US system. Insurances deny legitimate claims, hospitals inflate prices as much as they can. You don't need AI to fix this. You just need more transparency and stable pricing. Hospitals need to stop making up cost but have stable pricing and insurances need to publish what they support and what they don't support.

Obviously this won't happen because there is way too much money to be made with the current state. If anything they will use AI to squeeze even more money from the patients. And employer based health insurance will keep patients captive.

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

#173

Post by sxg »

technofiend wrote: post #166
sxg wrote: post #157

Earlier quoted context omitted.

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 righ…

My email is in my profile page. And if you have truly found that the institution is sharing protected health information (e.g., even just names and date of birth) with third parties who have not signed BAAs, that is a lawsuit worth tens of millions plus government fines of $50,000 per piece of compromised data per patient. I highly suspect that there's some misunderstanding or miscommunication here.

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

#174

Post by pixl97 »

ceejayoz wrote: post #94
chollida1 wrote: post #91

Earlier quoted context omitted.

> But that's what will inevitably happen at some point, when they get to the point of only rarely making big dangerous mistakes. So the same as doctors making occasional big dangerous mistakes that cause lives. Seems like it would be a win then as it takes some mental load off of doctors so they can focus on where they should, on the patients and not on note taking.

> So the same as doctors making occasional big dangerous mistakes that cause lives. Will it be? There are already unanswered questions on who's liable if Tesla's FSD runs you into someone.

I would assume you, the person behind the wheel of the car. Much the same the doctor/staff hitting the submit button on the validity of the records statement.

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

#175

Post by darby_eight »

loceng wrote: post #149
karmakaze wrote: post #71

There's no mention of data privacy. Since AI Scribe[0] study is a run by OntarioMD, the digital technology arm of the Ontario Medical Association, it might be okay but it would be nice if it declared it. From the AI Scribe link: > This project is funded by the Ontario Ministry of Health and overseen by Ontario Health. The study is currently underway, with 150 primary care providers already selected from diverse demog…

I honestly don't love taxpayer funding being used - unless the underlying technology is open sourced and available for commercial use, so then the free market can make improvements on it, etc. Or funding situations like e.g. "we'll pay for you if the doctor/practitioner chooses your software" - but otherwise the free market is efficient, and unelected people administering taxpayer money have no real incentive to not…

> but otherwise the free market is efficient

Efficient in routing public goods to a locked box maybe

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

#176

Post by m3047 »

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.

Working at the edge of cybersecurity and privacy, you've just stepped in it: there is no "Health Insurance Portability and Privacy Act". It's the "Health Insurance Portability and Accountability Act" (HIPAA).

(And I see that noone corrects you below. [edit -- actually a few people do, or the comments are continuing])

Gravity is a fairly strict law too. Maybe you should review what it covers, what it doesn't. The Act greatly expands the "sloshability" of your data, whether the sanctions are appropriate or sufficient to prevent patient harm is debatable.

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

#177

Post by chollida1 »

b112 wrote: post #148
chollida1 wrote: post #138

Earlier quoted context omitted.

I think its basic certainty that computers will be better at transcribing notes than humans basically now and will continue to get better. I mean we're basically there now, I trust spell check and grammar check more than myself. That's what we're talking about here. IMHO computers are already better at that, what possibly makes you think this won't happen?

My reply was to the parent post, which started: This seems very similar to self driving cars. And continued discussing self driving cars. Regardless, what I said stands.

ah, then I mis-interpreted. My fault, appreciate you letting me know.

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

#178

Post by jewayne »

userabchn wrote: post #142
theptip wrote: post #114

This could be the thing that saves the US healthcare system; currently we pay 2x what a normal developed country would pay for the level of service provided, because there is a thick layer of paperwork, with insurance companies going back-and-forth with medical providers to debate and negotiate billing. Imagine if AIs on each side could run that negotiation process in seconds, at the cost of merely a few hundred thou…

I don't think it is for the same level of service provided. I have read that there are three substantial differences between medical care in the USA and in other countries: 1. More single-patient rooms 2. More surgical procedures performed in the final year of life 3. More obesity and that the difference in the percentage of GDP spent on healthcare can at least partially be explained by these.

No, the big difference is higher prices for the same services. All the things you listed are just distractions that the industry and its water-carriers use.

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

#179

Post by pixl97 »

danielmarkbruce wrote: post #164
ceejayoz wrote: post #106

Earlier quoted context omitted.

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.

Exactly. If you have any kind of illness this is displaying atypical symptoms or otherwise may be rare, your life is in your own hands. Even something that is somewhat common like EDS can get you killed by doctors missing the signs. Keep a printout of all our own symptoms as they evolve over time, and immediately bring up anything that conflicts with what the doctor says.

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

#180

Post by pixl97 »

Angostura wrote: post #41
monocultured wrote: post #30

Just the other day there were news about how many mistakes the AI-assisted journaling caused – wrong names, wrong diagnoses, typos (buksmärta -> kuksmärta which is hilarious but serious). Some of it is surely teething problems, but unless there is a robust check upon implementation it might just add another layer of inefficient new public management make-work to the system. https://sverigesradio.se/artikel/ai-journal…

It feels to me like an autopilot problem in the making. "This thing means that you don't have to keep your eyes on the road - but please ensure you keep your eyes on the road, in case of errors"

The issue is, if you have any kind of rare condition, it already is this way. Much like the entire white side of a semi being presented to you across the road is a rare condition for autopilot, a huge number of 'rare' diseases already present problems for humans leading doctors and their staff to make errors by assuming the most likely condition. There is some saying like "It's probably a horse and not a zebra", but when it comes to hospitals zebras and even unicorns do show up, especially in the cases with recurring problems.
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