dangers, advantages, and safer documentation methods [PODCAST]

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Household nurse practitioner Erica Dorn discusses her article “ChatGPT in well being care: Dangers, advantages, and safer choices.” On this episode, Erica explains how clinicians are experimenting with ChatGPT to assist with HPI prompts, process documentation, and discharge directions, whereas additionally cautioning towards its dangers similar to inaccuracy, lack of HIPAA compliance, and restricted integration with EHRs. She highlights the benefits of AI medical scribes, which give safe, real-time, and well being care-specific documentation options. Erica emphasizes sensible takeaways for suppliers: use ChatGPT fastidiously for brainstorming, however undertake specialised AI instruments for safer, extra environment friendly, and compliant documentation.

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Transcript

Kevin Pho: Hello, and welcome to the present. Subscribe at KevinMD.com/podcast. Immediately we welcome again Erica Dorn. She’s a nurse practitioner. Immediately’s KevinMD article is “Chat GPT and well being care: Dangers, advantages, and safer choices.” Erica, welcome again to the present.

Erica Dorn: Thanks for having me.

Kevin Pho: All proper, so inform us what your newest article is.

Erica Dorn: Yeah, so I specialise in serving to nurse practitioners implement charting and time administration ideas in order that they will get their chart notes written sooner, create a greater work-life steadiness, and cease charting at dwelling. One of many newer charting ideas, a subject that could be very fashionable, is utilizing AI to assist write chart notes. I do know I’ve heard a whole lot of suppliers discuss utilizing ChatGPT, if it’s a superb choice, and the way it may also help them. I simply wished to speak at this time about a few of the advantages, however then additionally some issues that suppliers ought to actually take note of, a few of these cons and issues they need to concentrate on.

Kevin Pho: AI scribes are actually exploding by way of that intersection between AI and well being care. There are a whole lot of competing AI scribe corporations on the market, and it’s virtually just like the wild west, proper? Ultimately, there’s going to be consolidation; there are going to be winners and losers. From the nurse practitioner standpoint, inform us the kind of questions that you just’re being requested about relating to that intersection between AI and what they do within the examination room.

Erica Dorn: So far as using ChatGPT, I get requested quite a bit if that’s a secure choice, if it’s HIPAA compliant, if it consists of medical observe tips, and if it’s going to exchange our essential considering abilities. These are a few of the questions that I get requested about utilizing ChatGPT. So far as utilizing AI medical scribes, I get requested some related questions: How does it work? Is it secure to make use of? What is going to it truly do for my chart be aware? How will it truly assist me, and if it’s a superb choice to assist save time?

Kevin Pho: Let’s discuss ChatGPT and let’s broaden that to different industrial massive language fashions like Google Gemini and Anthropic’s Claude. Basically, for these industrial massive language fashions, have they got a task in well being care?

Erica Dorn: I feel they do. We’ve seen AI in well being care simply explode over the previous few months. We’re using AI in a whole lot of alternative ways, from EKG interpretation, serving to us with radiology interpretation, serving to with drug manufacturing, and analyzing all the information. We’ve additionally seen it in hospital use too, to select up on a few of these early cues to determine how the affected person is monitoring and if any problems are coming about. That’s how we’ve already seen AI in well being care, and I do really feel like AI has an element so far as charting.

One factor that a whole lot of suppliers are questioning is, “How can I save time charting? Can I make the most of these instruments to assist me enhance my charting and make it circulation quite a bit simpler?” I’ve heard of a whole lot of suppliers desirous to make the most of ChatGPT to assist them write higher notes and get them signed sooner.

Kevin Pho: Particularly, relating to HIPAA compliance and affected person privateness considerations, inform us about a few of the points relating to these industrial fashions like ChatGPT.

Erica Dorn: ChatGPT is just not HIPAA compliant, so I strongly encourage suppliers to not put it to use for including patient-specific info. For instance, I’ve heard of some suppliers copying and pasting their transcript from their go to with the affected person into ChatGPT after which saying, “Summarize this and create a SOAP be aware for me.” I strongly discourage suppliers from doing that. ChatGPT is just not HIPAA compliant, and so we must be very, very cautious with our affected person’s private info.

Kevin Pho: Some folks would surprise what ChatGPT does with that info. You say that it’s not HIPAA compliant. What occurs if we do put delicate affected person info into that ChatGPT mannequin? What are a few of the worst-case situations that may occur?

Erica Dorn: The data we put into ChatGPT goes out into the worldwide net, and so it will be so unlucky if there was a breach of that affected person confidentiality and if their info was unfold all through. That’s the actually massive factor that clinicians want to concentrate on when utilizing ChatGPT.

Kevin Pho: Okay, so let’s discuss ambient AI scribes. Such as you stated, your specialty is to assist nurse practitioners be extra environment friendly and reduce that charting time. What have you ever seen by way of the efficacy relating to these ambient AI fashions? Do they actually work, and do they actually save time?

Erica Dorn: Yeah, I’ve seen them work and save clinicians a ton of time. One of many variations between ChatGPT and AI medical scribes is the precise manufacturing of the be aware. With ChatGPT, you’ll be able to all the time ask it, “What are the questions or assessment of techniques that I have to go over with the affected person after they are available for belly ache?” However with AI medical scribes, it’s doing that work so far as pulling the data out of your go to. The AI know-how listens to the affected person and the supplier, after which it might summary the necessary info that should go within the chart be aware and primarily write your chart be aware for you.

I feel the large distinction is the time you’re spending. Utilizing ChatGPT, you need to put in these prompts. It’s a must to ask it to create a complete neurological examination. It’s a must to ask ChatGPT find out how to create a template for a process. When you’re doing a laceration restore, you’ll be able to ask ChatGPT find out how to write that. That may be useful; it might enable you save a while. However primarily, the AI medical scribe is selecting up on that info that’s stated. Numerous them can help you create your individual templates, so you’ll be able to create fast phrases or sensible phrases, just like these dot phrases, and have that info already in there. Then the AI medical scribe goes in and adjustments something particular to the affected person. That’s the actually massive distinction and the way I feel AI medical scribes are higher than utilizing ChatGPT, simply because it’s doing that subsequent step for you. It’s HIPAA compliant. It’s writing your chart be aware for you, whereas with ChatGPT, you need to insert these prompts for it to supply the data.

Kevin Pho: Basically, how a lot time have you ever seen being saved documenting within the examination room? Simply give some ballpark contrasting numbers.

Erica Dorn: I’d say a mean of three to 5 minutes per affected person. When you’re seeing twenty or thirty sufferers a day, that’s a considerable quantity you can save through the use of an AI medical scribe. The opposite tip that I share is signing chart notes off proper after you see the affected person. That approach, the data is obvious in your thoughts. You don’t must, on the finish of the day, attempt to recall what indicators and signs the affected person had. That’s simply one other approach that even when it doesn’t essentially prevent a complete lot of time, it’s serving to together with your general psychological readability. You don’t have that psychological fatigue. You may transfer on to the subsequent process with out feeling bombarded by all of those open, unsigned charts that you just nonetheless have to deal with. Utilizing AI medical scribes writes the chart be aware proper after you see the affected person. You may copy and paste it into your template. Numerous the AI medical scribes are built-in into the EHR. I all the time suggest that suppliers assessment that chart be aware. Clearly, you’re signing it and you can be held liable. That’s only one approach that AI medical scribes may also help you keep caught up, keep constant, and signal these chart notes sooner.

Kevin Pho: How customizable is the output that the AI medical scribes provide you with? One of many questions I usually get requested is that the AI scribe doesn’t sound like me or might not write like me. How customizable is that output?

Erica Dorn: It relies on the AI medical scribe that you’re utilizing, however a whole lot of them are simply rising of their know-how. Many can help you create charting templates. When you’ve got a standard bodily examination that you just like to make use of, you’ll be able to insert that so it sounds extra such as you. Then, as I used to be saying, the AI picks up on the data that’s irregular and might change that. The templates are very customizable. Numerous them additionally study your preferences. The AI know-how can decide up on something that you just go and edit, after which you’ll be able to ask the AI to study that format. For the subsequent charting be aware, it picks up on that.

For instance, I used to be utilizing an AI medical scribe, and it was producing the chart notes in very long-form sentences. I like to make use of quick phrases in my charting. After I modified that and requested the AI to study that format, for the subsequent notes that it created, it made them briefly phrases. That’s only one approach that the know-how is getting there, that it’s going to sound extra like us. There are the templates, the issues we are able to do to insert our charting preferences and the way we sound, so it’s going to sound extra like a supplier and fewer like a pc.

Kevin Pho: I stated earlier that it’s slightly little bit of the Wild West relating to AI scribes. There are lots of completely different corporations making an attempt to achieve a foothold on this area, and ultimately, I feel some are going to achieve success and a few could also be purchased out. Are there any main variations, so far as , between the assorted manufacturers of AI scribes?

Erica Dorn: The most important distinction proper now’s the EHR integration versus an impartial web site or app the place you need to copy the be aware after which paste it into your EHR. I do agree. I feel we are going to transfer in the direction of EHR integration, and I feel all the main EHR corporations may have that AI medical scribe part. Pricing is pretty good throughout the board.

So far as the variations, there’s EHR integration versus impartial. There are some new options like customizable templates. There are ICD codes and assist together with your billing and coding part. There are another variations so far as writing an excuse, like a piece launch excuse, or a referral letter. I’ve seen a few of the AI medical scribes provide that whereas others don’t, but it surely looks as if they’re all catching up to one another in a short time. When you discover an AI medical scribe firm that you just like, it’s very possible they are going to make these updates throughout the subsequent a number of months simply to attempt to keep up with the opposite AI medical scribes.

Kevin Pho: We’ve spent a whole lot of time speaking about AI medical scribes, however there are a whole lot of different areas that AI is influencing what we do in well being care. What are another examples that AI is getting used within the examination room that your nurse practitioners are telling you about?

Erica Dorn: Yeah, I alluded to this slightly bit firstly, however with EKG interpretation and radiology interpretation, I feel these are useful methods that we’ll see AI. Affected person monitoring will likely be an enormous one so far as, within the hospital setting, can it decide up on these early cues {that a} affected person’s situation goes to deteriorate? Additionally, we’ll see much more outpatient-based functions, simply with a few of the limitations of entry to well being care. I feel AI will likely be a really sturdy part. We’ve already seen the analyzation of knowledge with these drug corporations doing their analysis, they usually save a lot time through the use of AI to assist them analyze that information.

Kevin Pho: What do you see arising within the foreseeable future? I do know that this area is so quickly evolving. What do you see within the foreseeable future that we might anticipate from AI in well being care?

Erica Dorn: I can not predict the long run, and I feel we are going to proceed to see new applied sciences coming. I don’t know any specifics that we’ll be seeing in our medical observe, however I simply need to encourage suppliers to just accept AI. I do know it nonetheless feels slightly scary with a whole lot of unknowns, and there are some limitations, however I do agree that AI will likely be utilized in well being care in many various facets. Changing into conversant in it, changing into comfy with it, and using the AI know-how that we do have, after which being conscious of what’s coming as properly, I feel that’s going to set clinicians other than different clinicians.

When you go for a job interview they usually ask you about your emotions on AI, or possibly they’re utilizing an AI know-how of their observe setting and also you’re not comfy with that, which may restrict your job alternatives. I feel it’s one thing that we must be cognizant of. We must be conscious, we have to embrace it, and simply study all of the ways in which AI may also help us in well being care.

Kevin Pho: Have you ever talked to a few of your nurse practitioner colleagues who tried an AI scribe and determined for no matter purpose it wasn’t for them and went again to the best way they initially documented, like dictating? Have you ever had any of these instances?

Erica Dorn: I’ve had a couple of. I feel some folks simply get caught of their methods. They don’t need to study a brand new know-how; possibly it feels overwhelming to make use of it at first. When you’re used to dictating your notes or typing them out, that’s tremendous to do. I’ve simply seen the influence of AI medical scribes and the way a lot time it might save me in my very own observe, however then additionally my different nurse practitioner followers. Once more, it’s one thing to find out about, uncover, and take a look at for your self. Numerous these AI medical scribes provide a free trial, so it’s one thing you can provide a strive in your individual observe. If it doesn’t work, that’s tremendous, however I strongly encourage suppliers to provide it a strive.

Kevin Pho: I do know that they’re getting used quite a bit within the outpatient setting, just like the one I’m conversant in. How about contained in the hospital in inpatient settings?

Erica Dorn: The large one is affected person monitoring. Numerous this includes selecting up on important indicators and bodily cues to assist maintain our sufferers secure. I don’t know the precise corporations or something which are within the hospital, however I do know we’ve already seen so many various applied sciences and methods we are able to use AI. Once more, it’s going to simply proceed to blow up and be capable to assist us as suppliers.

Kevin Pho: How about medical documentation? Are AI scribes getting used for documentation in an inpatient setting?

Erica Dorn: I don’t know for positive. I’ve heard of some inpatient nurse practitioners which have tried. I really feel like it might be slightly bit tougher until it’s one thing the place you’re seeing that affected person for the primary time. You may undoubtedly use AI medical scribes that can assist you get that info within the chart be aware. So far as your day by day rounding progress notes, you may make the most of that know-how. It’s slightly bit more durable as a result of while you’re within the hospital setting, you’re normally rounding on one affected person, you’ve already seemed over their labs, you may get some telephone calls or interruptions from nursing in between. It’s slightly bit more durable to open the AI medical scribe, begin your go to, and never get any of these distractions. I feel it’s one thing that may proceed to evolve and develop.

Kevin Pho: We’re speaking to Erica Dorn. She’s a nurse practitioner, and at this time’s KevinMD article is “Chat GPT and well being care: Dangers, advantages, and safer choices.” Erica, let’s finish with some take-home messages that you just need to go away with the KevinMD viewers.

Erica Dorn: Yeah. Once more, I simply strongly encourage suppliers to provide AI medical scribes or the AI know-how a strive. It’s going to be huge in well being care. It’s going to assist us in so some ways, so I simply encourage you to find out about it, embrace it, and provides it a strive.

Kevin Pho: Erica, thanks a lot once more for sharing your perspective and perception, and thanks once more for coming again on the present.

Erica Dorn: Thanks for having me.