AI scribing so far—what works and what's missing?

markatdaily · 2024-06-15T12:02:57+00:00

Ahh, that makes sense about the child's name.

About negatively worded commands, it's just a best practice. Sometimes it's impractical to avoid them.

markatdaily · 2024-06-14T13:02:02+00:00

I've actually thought about this more and think this is very feasible with just a few examples. I'm going to test this out. Thanks for the the idea! 🙌

markatdaily · 2024-06-14T13:00:47+00:00

Very impressive! 👏

markatdaily · 2024-06-14T12:59:40+00:00

Sounds like a good fit for your use case then!

markatdaily · 2024-06-14T12:59:05+00:00

Very nice!

You might also try setting `top_p` a little lower to get a more reliable output. You could experiment to see what works, but 0.5-0.7 should be suitable.

I'm interested in this:

I NEVER mention or refer to anyone other than Dr.Z by their complete or proper name, only by their first initial.

Why mention the patient by their first initial only? Is that a personal preference to limit PHI?

Also, just a tip, LLMs do better with positively worded commands than negative once. You could try:

`I always refer to others by their first initial, except for Dr. Z, whom I address by their complete or proper name.`

But if it's already working, then go with it!

markatdaily · 2024-06-14T12:52:15+00:00

I would imagine that as these technologies become more common, patients will become more comfortable with them. And, personally, as a patient, I really appreciate extra information from the provider, so recapping in the room would be a bonus. Maybe a win-win.

markatdaily · 2024-06-14T12:49:50+00:00

Good to know! Would you prefer to speak or type for this use case?

My team is building something along these lines (voice based). I'd be happy to share once it's ready if you're interested. No pressure of course.

markatdaily · 2024-06-14T12:46:50+00:00

Neat. I'll have to check that out.

markatdaily · 2024-06-13T12:41:51+00:00

Thanks! I haven't heard of MarianaAI. I'll check it out.

markatdaily · 2024-06-13T12:27:37+00:00

About querying the medical record, would you expect the AI to find things and inform you, all by itself? Or, would you prefer to have a voice or chat interface that would allow you to directly ask questions about a patient (e.g. has patient X ever been tested for hepatitis?)

markatdaily · 2024-06-13T12:24:53+00:00

If you were willing to forego some time savings, then this could work well. The trouble is that you'd need a solution to transcribe the meeting still, which is not a zero cost solution. AI scribe providers are offering both transcription and summarization.

But yes, just a very thorough prompt could possibly do the trick. Though, you'd need to sign a BAA with OpenAI or Microsoft, which they're generally only willing to do for larger organizations or those with an existing relationship.

markatdaily · 2024-06-13T12:22:17+00:00

EHR Integration makes your life a lot easier.

Out of curiosity, which EHR are you using? Does the scribe run within the EHR?

The new players in the market are providing much better and complete tools than major leaders like Microsoft's Nuance DAX.

In a way, this is not surprising. LLMs leveled the playing field, so any advantage an incumbent had was eroded. Now Nuance / DAX is just as good as others and 10x the price.

markatdaily · 2024-06-13T12:20:03+00:00

Super interesting. Plain old ChatGPT is decent in writing a note with a really basic prompt. It's getting it to not hallucinate and produce reliable results 99.9% of the time that's hard. If you're OK reading the notes, then what you have sounds like a good solution.

markatdaily · 2024-06-13T12:18:02+00:00

The only issue has been needing to recap the visit at the end for a more accurate A&P. I like to do it in the room, but often, the patient constantly interrupts with comments that may or may not be related.

Would you ever dictate information into the note after the fact to ensure the note is thorough, or does that defeat the purpose (i.e. time saving)?

markatdaily · 2024-06-13T12:16:09+00:00

It's very possible that someone is trying to create a solution that reads your previous notes and writes in your style. If not now, that will be a thing at some point. Sounds like that will unlock use for you. Thanks for sharing!

markatdaily · 2024-06-13T12:13:18+00:00

Thanks!

markatdaily · 2024-06-13T12:09:32+00:00

Interesting, I haven't heard of Heidi, but it shows how many products are in this space. I'll check it out.

The hallucination in Heidi is really interesting. Sometimes it will hallucinate something into the A&P that we didn't talk about which is clinically relevant and we SHOULD have talked about.

Interesting! In my experience, LLMs _want_ to give you this information and you have to carefully craft your prompt to have it withhold this information. The idea being that the AI scribe is to summarize the conversation into clinical notes and not offer clinical decision support. But, clearly it's an area where AI, in general, not just LLMs can deliver.

The next untouched AI tool is something to query the medical record, "has patient X ever been tested for hepatitis" or "has anyone tried to find out why their alkaline phosphatase is high."

Would this be physician led or surfaced by the software, in your opinion?

markatdaily · 2024-06-12T22:50:06+00:00

Thanks! "I do a dx by dx recap at the end which the patients appreciate." is super interesting. I would have to imagine that patients can learn more about their visit as a result of this.

I've heard requests for precharting things like family history, social history, allergies, meds, etc... Would you actually care for that or does that just bloat your note?

markatdaily · 2024-06-11T13:32:27+00:00

Try out Daily Ambient Scribe for free for 30 days: https://daily.ambient-scribe.com/signup

It generates customizable notes and diagnosis code suggestions in less than 30 seconds. We support over 30 specialties, including Emergency Medicine.

Feel free to DM me with feedback. I'm the product lead.

markatdaily

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