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- samglass09Meanwhile they are pushing AI transcription and note taking solutions hard.Patients are guilted into allowing the doctors to use it. I have gotten pushback when asked to have it turned off.The messaging is that it all stays local. In reality it’s not and when I last looked it was running on Azure OpenAI in Australia.I spoke to a practice nurse a few days ago to discuss this.She said she didn’t think patients would care if they knew the data would be shipped off site. She said people’s problems are not that confidential and their heath data is probably online anyway so who cares.
- gurachekThe union rep gets it - people improvise when you cut their tools and then threaten discipline for improvising.That memo is how you make staff hide things instead of asking for help.The scarier part though is that LLM-written clinical notes probably look fine. That's the whole problem. I built a system where one AI was scoring another AI's work, and it kept giving high marks because the output read well. I had to make the scorer blind to the original coaching text before it started catching real issues. Now imagine that "reads well, isn't right" failure mode in clinical documentation.Nobody's re-reading the phrasing until a patient outcome goes wrong.
- beatthatflightI know at least one GP that has stopped using Heidi Health for transcription. He (and as I've noticed with transcriptions from my medical professionals) has noticed many errors, far too many to be comfortable. Things might improve, but not yet.
- burnteYeah, 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 tech.
- jmward01I have seen the evolution of these tools and I think they are going to push a fundamental change to medical care. Notes have been getting more and more abused, at least in the US. Big health systems want them for a lot of reasons that have nothing to do with helping a practitioner improve the care of their patient. They want to capture every billable moment of that encounter and potentially prep things like labs, appointments, clinical trial screening, pre-auths, etc. Some of this is good for the patient but a lot isn't. Also, the reality is that many practitioners spend as much, or more time, on the note than on the patient. That clearly isn't to their benefit. There is a reason they sit there and type constantly while talking to you and that doesn't stop when you leave the room. The demands on them to document everything so that all the accounting can happen are actually harming healthcare.I think there is a chance that these systems will lead to a change where the note isn't the fundamental record of the encounter. Instead different artifacts are created specifically for each entity that needs it. Billing gets their view, and scheduling gets theirs, and, etc etc... It will, hopefully, give the practitioners a chance to get back to focusing on the patient and not ensuring their note quality captured one more billable code. Of course the negative is also likely to happen here too. As practitioners spend less time on the note they will likely not get that back in time with individual patients, but instead on seeing more patients. It will also likely lead to higher bills as the health systems do start squeezing more out of every encounter. There is no perfect here when profit is the driving motivator but with this much change happening I can only hope that it causes the industry as a whole to shake up enough to maybe find a new better optimum to land in.
- alliaoAI 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....
- keithnzFYI, AI adoption in health in NZ is moving forward, for example https://www.rnz.co.nz/news/national/589774/emergency-doctors...This is just about not using free/public AI tools.
- anonundefined
- yunnppThis 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.
- memolife23[dead]
- WWilliam[dead]