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Health NZ staff told to stop using ChatGPT to write clinical notes

rnz.co.nz

51–60 of 63 posts

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#51
post #43

This is a blatant violation of patient privacy. That the output is often hallucinated doesn't even matter here. If the hospital wants to use LLMs, better deploy them on-premise or a trusted network at least.

Noticing that people in the west would rather speak about privacy than more efficient or cheaper healthcare.

Enterprises are ok sharing their code base with OpenAI. I think it should be okay for patients.

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#52

Earlier quoted context omitted.

Very little protections. The entire medical records of a significant percentage of the NZ population were stolen recently and put up for sale online. Zero consequences for the medical practices who adopted the hacked software.

Interesting, a person was telling me recently that NZ privacy laws were quite strong. Perhaps a different category. https://news.ycombinator.com/item?id=44564349

The laws are, the policing is not. At least not in medical data

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#53
post #43

This is a blatant violation of patient privacy. That the output is often hallucinated doesn't even matter here. If the hospital wants to use LLMs, better deploy them on-premise or a trusted network at least.

Noticing that people in the west would rather speak about privacy than more efficient or cheaper healthcare. Enterprises are ok sharing their code base with OpenAI. I think it should be okay for patients.

Enterprises do that if they choose. Patients can choose as well. And it's their choice, not anyone else's

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#54
post #18

Earlier quoted context omitted.

Physicians need to have it pounded into them that every hallucination is downstream harm. AI has no place in medicine. If they insist on it, then all transcripts must be stored with the raw audio. Which should be accessible side by side, with lines of transcript time coded. It's the only way to actually use these safely, while guarding against hallucinations.

> Physicians need to have it pounded into them that every hallucination is downstream harm. I think any person using 'AI' knows it makes mistakes. In a medical note, there are often errors at present . A consumer of a medical note has to decide what makes sense and what to ignore, and AI isn't meaningfully changing that. If something matters, it's asked again in follow up.

> I think any person using 'AI' knows it makes mistakes.

You think wrong. I’m now encountering people on a regular basis arguing “those days are behind us” and it’s “old news.”

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#55
post #43

This is a blatant violation of patient privacy. That the output is often hallucinated doesn't even matter here. If the hospital wants to use LLMs, better deploy them on-premise or a trusted network at least.

Noticing that people in the west would rather speak about privacy than more efficient or cheaper healthcare. Enterprises are ok sharing their code base with OpenAI. I think it should be okay for patients.

Some AI bullshitting into my medical history isn’t making my healthcare cheaper or more efficient, it’s just making it worse.

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#56
I was applying recently to a role that was pretty interesting and so I wrote the email on the train on my way home, didn't have my laptop with me.

In the email I wrote out everything myself, absolutely no use of AI, but after I hit send I realised there was a pretty silly typo, nothing grave but it irked me.

I decided out of boredom to see would my email be considered AI as it was probably going to go through a million filters these days, I popped it into an online checker (I don't know the quality of these so who knows) and it told me with 75% certainty it was written by AI.

It was not at all. It was written overly hastily on a phone on public transport. So I wonder how someone who might be grammar orientated and particular with the semantics would prove otherwise.

I can see a company needing to find any excuse to let people go saying "well theAI says you used the AI to do your work, we're letting you go"

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#57
post #35

AI doesn't forget and soon all of new zealanders will have their health histories internalised by AI so it can individually calculate insurance premiums without knowing why....

This is a ridiculous sentence. Of course inference-only AI forgets. You can literally just program it that way. In fact, it's human transcribers who chose whether to forget the details of a case or whether to share the details of an especially funny patient with their buddies at the bar.

But in this case they’re actively being told by the hospital not to use AI due to privacy concerns so it seems unlikely that it’s been programmed to respect privacy doesn’t it

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#58

Earlier quoted context omitted.

This is a ridiculous sentence. Of course inference-only AI forgets. You can literally just program it that way. In fact, it's human transcribers who chose whether to forget the details of a case or whether to share the details of an especially funny patient with their buddies at the bar.

But in this case they’re actively being told by the hospital not to use AI due to privacy concerns so it seems unlikely that it’s been programmed to respect privacy doesn’t it

Sending data to OpenAI to train a new model on does not feel like it constitutes 'AI doesn't forget'. The AI has nothing to do with the thousands of other companies storing your data for various reasons.

You can program a harness to always send a MEMORY.md file like OpenClaw, or use Vector Stores like OpenAI does, or find some other implementation of 'memory', but these are not an inherent feature of 'AI'. Quite the opposite...the LLMs we currently see will never learn or adapt by themselves, they don't touch their own weights

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#59
post #2

Yeah, no privacy or security there. There are some tools explicitly designed at helping healthcare providers produce better notes faster, and a couple of them are AMAZING. I'm an AI-half-empty guy, I'm keenly aware of its shortcomings and deploy it thoughtfully, and even with my skepticism there are a couple of tools that are just plain great. I think using LLMs to create overviews and summaries is a great use of the…

The one my doctor was using got my obs numbers completely wrong. We had to correct them at the end of the consultation.

No different than if that doctor was using a human scribe and they typoed. We make all our doctors proof their notes, it's SOP even long before AI.

Re: Health NZ staff told to stop using ChatGPT to write clinical notes

#60
I'm a female doctor, for me the hardest thing so far was watching AI shut down a discussion on harassment in healthcare in real time. Women were contributing stories to a website documenting their experience until one claiming to be written by a male was published. All contributors were fluent but this hit different - lower information density (harder to get a read on the age, ethnicity, social class of the writer) but higher emotional impact. Women usually seemed to have interrogated themselves, identifying choices they had made (joining after work drinks, accepting a ride, being alone) but this showed no sign of any attempt to think through how alternative versions of the account would look (eg, a white woman contributing to a forum on racism to complain discrimination by non-white men protected by the patriarchy, also they were on cocaine?) The last-minute drug reference was weird (doesn't tha complicate the question of who the victim is, not reinforce it? why cocaine - except that "crack" would sit in a field adjacent to both "abuse" and" damage" and "drug" next to "doctor")? Other men had shared experiences, but not like this. Feed the stories into GPT and ask which is most likely AI and it "carefully and respectfully" identifies 239 for different reasons (symmetry, etc) and offered to rewrite in a more human way. Nobody has contributed since. https://www.survivinginscrubs.co.uk/your-stories/ yeah I'm in an industry that for no good reason still writes instructions using a language that hasn't been spoken since about 800AD. Ai scribes might not change how we practice but it is having real-world effects.
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