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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

#191

Post by ipython »

sxg wrote: post #169
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.

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…

Before I start, I'm not singling you out- I am happy that you're participating in this discussion and sharing your first hand knowledge.

The thing for me is that if HIPAA truly does provide me privacy of my personal information and health care information, why are all of these privacy and consent forms required?

Whenever I am handed a form that says "privacy policy" my sense is immediately raised - what is it that they're trying to hide from me through mountains of legalese? When I don't receive one (as was the case in my doctors visit) then I am REALLY on edge.

For example, with my health care visit, this thread prompted me to call the listed numbers on the website for the health care provider to discuss their privacy policy. The provider's number dumps you into an IVR that has zero way to reach a human - you must dial an extension, and there is no option for an operator. I ended up calling their headquarters to get a callback from a human.

If there are standard mechanisms and policies in place, then we should be able to understand the rules once and never have to sign another form again, because the rules would be clear, unambiguous, and applicable to every health care interaction. If the rules are clear about not waiving HIPAA privacy/security rights, then why have a privacy policy that's three pages of inscrutable legalese that gives a bunch of weasel room for them to "share" information?

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

#192

Post by beiller »

low_common wrote: post #66
puttycat wrote: post #60

Earlier quoted context omitted.

This is another version of "use public transport instead of throwing billions on futile self driving cars" -- it's the correct, rational thing to do, but it's not the American way!

It's a Canadian-developed tool used by Canadian doctors. It's popular on the internet to offer up overly-generalized platitudes like yours but do us a favor and at least read the article first.

I don't see how it being Canadian is relevant. First off Canada is part of North America and North America is big geographically. We have similar car culture compared to USA. There are very large subsidies given to battery manufacturing sector in Canada amounting to $43.6 billion over 10 years as part of the latest budget.

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

#193

Post by fencepost »

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…

This is a situation where running within the context of the EMR and having access to the existing chart data is likely to make a lot of difference. My bigger concern is that there are a lot of different things being lumped together under "AI", and this is going to hit a bunch of different areas of machine learning.

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

#194

Post by furyofantares »

Magi604 wrote: post #170
TacticalCoder wrote: post #163

Earlier quoted context omitted.

> 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.

Were they slow? There's actually plenty of people who can do that at a reasonable or even fast pace. Of course lots of people type reasonably quickly with two thumbs too (or in the case of this comment, a left thumb and right pointer finger).

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

#195

Post by forgetfreeman »

randomdata wrote: post #188
tiahura wrote: post #160

Earlier quoted context omitted.

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 ab…

> GOOGLE Maybe ChatGPT would have given you a more favourable answer?

Seems unlikely since at it's absolute best it's merely synthesizing a mashup of the same information that feeds Google search, and that's assuming it doesn't start seeing shit. Better to go directly to the source so you can at least make an attempt at vetting the credentials/expertise level that went into the information you're viewing instead of guessing how many mommy blogs, spam mills, and reddit comments got sucked into the intake in the process of producing whatever ChatGPT just coughed up.

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

#196

Post by tiahura »

randomdata wrote: post #188
tiahura wrote: post #160

Earlier quoted context omitted.

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 ab…

> GOOGLE Maybe ChatGPT would have given you a more favourable answer?

Perhaps, but this was pre-transformers.

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

#197

Post by forgetfreeman »

loceng wrote: post #146
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.

Well, the reality is likely once they get access to the data, are allowed to use it - they will likely be happy to be grandfathered into their accelerated position if legislation passes to create barriers of entry by preventing such mass data gather/access without express permission - to have an advantage on competition; but generally this won't be a winning tactic in the end because trust is the most important facto…

The mere implication that consumers can be driven by privacy concerns flies in the face of 20 years of observed reality so I'm not sure where you're getting the idea that that is credibly possible. Objectively consumers are driven primarily by convenience, with cost coming in a close second.

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

#198

Post by randomdata »

forgetfreeman wrote: post #195
randomdata wrote: post #188

Earlier quoted context omitted.

> GOOGLE Maybe ChatGPT would have given you a more favourable answer?

Seems unlikely since at it's absolute best it's merely synthesizing a mashup of the same information that feeds Google search, and that's assuming it doesn't start seeing shit. Better to go directly to the source so you can at least make an attempt at vetting the credentials/expertise level that went into the information you're viewing instead of guessing how many mommy blogs, spam mills, and reddit comments got suck…

Going directly to the source did not provide a favourable answer. Did you somehow miss reading the thread before you replied?

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

#199

Post by sxg »

ipython wrote: post #191
sxg wrote: post #169

Earlier quoted context omitted.

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…

Before I start, I'm not singling you out- I am happy that you're participating in this discussion and sharing your first hand knowledge. The thing for me is that if HIPAA truly does provide me privacy of my personal information and health care information, why are all of these privacy and consent forms required? Whenever I am handed a form that says "privacy policy" my sense is immediately raised - what is it that th…

No problem—glad to participate! There's a lot of cynicism that leads to misinformation about how healthcare works, so I'd like to clean that up. Let's attack and fix the broken parts of the system, but we should praise the working parts. I think patient privacy/security is one of the few things the US gets mostly right about healthcare.

Regarding the privacy policies: these are created by the legal department and physicians in the department are told to distribute them and get signatures when necessary in order to do things by the book. However, your rights are inalienable and protected regardless of whether you actually receive the policy and sign the appropriate box. If you don't receive the policy, the healthcare institution is on the hook and could face a fine if reported to the DHHS. Things could absolutely be done more efficiently and clearer for patients, but there's a fear in changing things ("if it ain't (horribly) broke, don't fix it"). Trying to improve how privacy policies are disseminated and patients informed could result in an inadvertent violation of HIPAA that results in large fines. So healthcare institutions are disincentivized from trying to improve things here.

I reviewed the patient privacy policy for a few large institutions in the US, and it all seems to support what I'm saying. For example, here's NYU's policy on business associates: https://nyulangone.org/files/business-associates.pdf

NYU has additional policies here: https://nyulangone.org/policies-disclaimers/hipaa-patient-pr.... UCLA Health has similar policies here: https://www.uclahealth.org/privacy-practices. Every institution has essentially the same policies as they're all just a reflection of HIPAA.

The only ways in which patient data can be shared with others are if (1) they're involved in your treatment (e.g., your doctor at another hospital), (2) payment purposes (e.g., insurance), (3) health care operations (e.g., third party vendor software like EMRs, PACS, etc.) All are required to be HIPAA compliant if they're covered entities (i.e., healthcare institutions) or sign a BAA with a covered entity that essentially puts the same HIPAA requirements on them. A violation again results in massive fines, C-suite level firings, and expensive legal fallout.

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

#200

Post by forgetfreeman »

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…

I'm a retired software developer that's worked in just about every healthcare-adjacent industry segment you can imagine with HIPAA compliance being an evergreen issue. I know how this sausage gets made on the back end and let me tell you regardless of what impression has been made to you about compliance and safeguards the reality behind the scenes is always messy. Hundreds of gigs of unanonymized user data lying around on developer machines, getting tossed out accidentally during equipment rollouts, leaky API implementations, half-assed compliance testing, lack of meaningful continuous oversight, vendor services with varying levels of compliance hot-glued together on the back end, outright theft of data, this list is incomplete. I'd recommend a weapons-grade dose of skepticism over any claims of meaningful data privacy as the last 30 years have consistently and comprehensively shown that anything that gets digitized eventually gets outed if there's a financial motivation to do so.
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