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I can't help but think there could be two solutions to this problem. 1) A speech-to-text transcripting intelligent system that could automatically make some gu

I can't help but think there could be two solutions to this problem. 1) A speech-to-text transcripting intelligent system that could automatically make some guesses at the notes the doctor would want to write. Could save them quite a bit of time if it can be tuned for utility 2) (the cheaper short-term solution) An assistant who can focus on taking notes while the doctor focuses on the patient. Unfortunately, (1) is a technologically challenging AI problem and I bet the current medical rules and patient's expectations of being able to 1:1 with their doctor without a third-party listening in probably scuttle (2).

ploxiln 11y ago
Speech recognition could help. In fact some doctors already make (very quick) voice-recording notes and have an assistant transcribe them. But... we already have much more advanced technology than we had 30, 20, or even 15 years ago. And the problem has only gotten worse. > “Our notes could be shorter back then,” was his reply. (Insurance, regulations and electronic health records weren’t issues back then.) This quote in passing just assumes everyone is familiar with the fact that "electronic health records" are something that makes things harder. That doesn't make sense, does it? Shouldn't electronic records make things easier? They should. But they don't, due to adverse incentives in the medical system, and in the political organizations which constitute it. My point is, the pressing need is not for more advanced technology. We have the technology, we have had it for years. We just need to somehow reduce the crazyness. Medical software is like enterprise software but worse - it's the crappiest, most expensive software you've ever seen in your life. There are all sorts of reasons for this. It's not chosen by the people who use it, checkbox feature lists are more important than what works, regulations, political deals, "high touch" sales, etc. The result is often "I have to sign in three times, then wait 5 minutes for it to load the patient, and hope it doesn't crash in the middle". It has to be seen to be believed.
adrianN 11y ago
There is also option 3: Reduce the amount of paperwork doctors need to do.
RHSeeger 11y ago
3) Push back and let supervisors/managers know that treating a patient takes X + Y time, where X is the time with the patient, and Y is the time for admin/non-billable duties for that patient. Admittedly, doing so isn't as easy as it sounds, but this isn't all that much different than developers being told to push back on schedules that don't leave time for (testing, documentation, technical debt payoff, etc)
djb_hackernews 11y ago
My SO is a family medicine MD and works at an inner city clinic. When we first started dating she'd mention the need to spend time during the evenings to write notes. As someone that a) wanted more of her time b) wrote software for a living, it surprised me that such a system doesn't already exist. It seems like it could aid in catching errors and also being a helpful assistant of sorts to ensure good notes are being captured and all possibilities are being addressed. From what I've seen, even with newer EHR systems (Epic, Athena), medical technology is about 15 years behind current technology.
- Spooky23 11y ago
  It's worse than 15 years behind -- it is a step backwards. In ye olden days, they recorded notes on a $50 voice recorder, and had a transcriptionist transcribe notes into a written form that went into records. Now, to make data more standardized, it's a wall of clicks and checkboxes, which require domain expertise. So doctors canned the transcriptionists, replaced them with enterprise IT and hire PAs and NPs to try to bridge the gap. I shake my head every time I go to my doctor. He's a brilliant guy and really good physician, but easily 50% of his time is dedicated to click-monkey bullshit.

ploxiln 11y ago

Speech recognition could help. In fact some doctors already make (very quick) voice-recording notes and have an assistant transcribe them. But... we already have much more advanced technology than we had 30, 20, or even 15 years ago. And the problem has only gotten worse. > “Our notes could be shorter back then,” was his reply. (Insurance, regulations and electronic health records weren’t issues back then.) This quote in passing just assumes everyone is familiar with the fact that "electronic health records" are something that makes things harder. That doesn't make sense, does it? Shouldn't electronic records make things easier? They should. But they don't, due to adverse incentives in the medical system, and in the political organizations which constitute it. My point is, the pressing need is not for more advanced technology. We have the technology, we have had it for years. We just need to somehow reduce the crazyness. Medical software is like enterprise software but worse - it's the crappiest, most expensive software you've ever seen in your life. There are all sorts of reasons for this. It's not chosen by the people who use it, checkbox feature lists are more important than what works, regulations, political deals, "high touch" sales, etc. The result is often "I have to sign in three times, then wait 5 minutes for it to load the patient, and hope it doesn't crash in the middle". It has to be seen to be believed.

adrianN 11y ago

There is also option 3: Reduce the amount of paperwork doctors need to do.

RHSeeger 11y ago

3) Push back and let supervisors/managers know that treating a patient takes X + Y time, where X is the time with the patient, and Y is the time for admin/non-billable duties for that patient. Admittedly, doing so isn't as easy as it sounds, but this isn't all that much different than developers being told to push back on schedules that don't leave time for (testing, documentation, technical debt payoff, etc)

djb_hackernews 11y ago

My SO is a family medicine MD and works at an inner city clinic. When we first started dating she'd mention the need to spend time during the evenings to write notes. As someone that a) wanted more of her time b) wrote software for a living, it surprised me that such a system doesn't already exist. It seems like it could aid in catching errors and also being a helpful assistant of sorts to ensure good notes are being captured and all possibilities are being addressed. From what I've seen, even with newer EHR systems (Epic, Athena), medical technology is about 15 years behind current technology.

Spooky23 11y ago
It's worse than 15 years behind -- it is a step backwards. In ye olden days, they recorded notes on a $50 voice recorder, and had a transcriptionist transcribe notes into a written form that went into records. Now, to make data more standardized, it's a wall of clicks and checkboxes, which require domain expertise. So doctors canned the transcriptionists, replaced them with enterprise IT and hire PAs and NPs to try to bridge the gap. I shake my head every time I go to my doctor. He's a brilliant guy and really good physician, but easily 50% of his time is dedicated to click-monkey bullshit.