5 ms·

Sounds like many of the acute problems are microfrustraions created by poor software design and engineering. Slow login/relogin, unrealistic scheduling, illegi

Sounds like many of the acute problems are microfrustraions created by poor software design and engineering. Slow login/relogin, unrealistic scheduling, illegibility of pre- and post-surgical tasks to the timekeeper, etc. We can't solve the structural problem, but better software could help create more humane working environment under the constraints. Of course, the real problem is running medicine like a business, but technology can only serve the megamachine...

ghnws 2y ago
The article reads like all the little annoyances is what is wrong when the doc is expected to work almost 24/7 for days on end. No amount of software improvement will make any realistic improvements. It's insane that a truck driver _must_ have 8 hours of sleep before work (they should, not arguing against it), but a surgeon can work with a couple of naps for days.
karmakurtisaani 2y ago
I keep asking myself why they hire the worst developers to do time recording software. Ones who can't design an intuitive UI, can't make it help you automate recording, can't make it respond without 1-2 second delay every time.. Of course HR needs us to log in our hours in these systems, and then the managers tell us what hours to put where. It's absurd all the way. Having been exposed to this only a little, I can imagine what kind of garbage the medical staff has to endure to make their reports and time keeping.
jimbokun 2y ago
There is a strong argument to be made that paper charts were more efficient and provided better quality documentation with better user experience than modern EMR software systems. Also, this is one place where AI can potentially provide both a more efficient system and greatly improve job satisfaction for physicians. Automatically generating and updating medical records based off ambient recordings of patient interactions fits right into LLMs wheelhouse.
- tivert 2y ago
  > There is a strong argument to be made that paper charts were more efficient and provided better quality documentation with better user experience than modern EMR software systems. > Also, this is one place where AI can potentially provide both a more efficient system and greatly improve job satisfaction for physicians. Automatically generating and updating medical records based off ambient recordings of patient interactions fits right into LLMs wheelhouse. No, LLM's are not reliable enough for that. If the technology sucks and is in fact a regression, the solution is not to hope yet more half-backed technology will fix the problem. The solution is to dump the technology until someone can actually do it right. If paper charts are better, go back to paper charts...and maybe hire a digitization/data entry team to realize whatever benefits to electronic records there are.
  - jimbokun 2y ago
    > No, LLM's are not reliable enough for that. It requires physicians to read and verify the LLM output before signing it. And not just rubber stamping. There is a precedent for this with speech recognition, which a lot of doctors use to dictate their documentation. Speech recognition isn't completely reliable either, so the doctor needs to be diligent to review before signing. And not just assume it's all correct.
    - tivert 2y ago
      > It requires physicians to read and verify the LLM output before signing it. And not just rubber stamping. Then what's the point? That's not going to provide a "more efficient system and greatly improve job satisfaction for physicians." AI would only improve the situation if it can actually be trusted. You're actually making things far worse if you replace a "production" task with a "continuous monitoring for errors. Humans are terrible at the latter. > There is a precedent for this with speech recognition, which a lot of doctors use to dictate their documentation. Speech recognition isn't completely reliable either, so the doctor needs to be diligent to review before signing. And not just assume it's all correct. The one transcript like that I've seen had obvious speech recognition errors, when the notes got to my primary care doctor.

ghnws 2y ago

The article reads like all the little annoyances is what is wrong when the doc is expected to work almost 24/7 for days on end. No amount of software improvement will make any realistic improvements. It's insane that a truck driver _must_ have 8 hours of sleep before work (they should, not arguing against it), but a surgeon can work with a couple of naps for days.

karmakurtisaani 2y ago

I keep asking myself why they hire the worst developers to do time recording software. Ones who can't design an intuitive UI, can't make it help you automate recording, can't make it respond without 1-2 second delay every time.. Of course HR needs us to log in our hours in these systems, and then the managers tell us what hours to put where. It's absurd all the way. Having been exposed to this only a little, I can imagine what kind of garbage the medical staff has to endure to make their reports and time keeping.

jimbokun 2y ago

There is a strong argument to be made that paper charts were more efficient and provided better quality documentation with better user experience than modern EMR software systems. Also, this is one place where AI can potentially provide both a more efficient system and greatly improve job satisfaction for physicians. Automatically generating and updating medical records based off ambient recordings of patient interactions fits right into LLMs wheelhouse.

tivert 2y ago
> There is a strong argument to be made that paper charts were more efficient and provided better quality documentation with better user experience than modern EMR software systems. > Also, this is one place where AI can potentially provide both a more efficient system and greatly improve job satisfaction for physicians. Automatically generating and updating medical records based off ambient recordings of patient interactions fits right into LLMs wheelhouse. No, LLM's are not reliable enough for that. If the technology sucks and is in fact a regression, the solution is not to hope yet more half-backed technology will fix the problem. The solution is to dump the technology until someone can actually do it right. If paper charts are better, go back to paper charts...and maybe hire a digitization/data entry team to realize whatever benefits to electronic records there are.
- jimbokun 2y ago
  > No, LLM's are not reliable enough for that. It requires physicians to read and verify the LLM output before signing it. And not just rubber stamping. There is a precedent for this with speech recognition, which a lot of doctors use to dictate their documentation. Speech recognition isn't completely reliable either, so the doctor needs to be diligent to review before signing. And not just assume it's all correct.
  - tivert 2y ago
    > It requires physicians to read and verify the LLM output before signing it. And not just rubber stamping. Then what's the point? That's not going to provide a "more efficient system and greatly improve job satisfaction for physicians." AI would only improve the situation if it can actually be trusted. You're actually making things far worse if you replace a "production" task with a "continuous monitoring for errors. Humans are terrible at the latter. > There is a precedent for this with speech recognition, which a lot of doctors use to dictate their documentation. Speech recognition isn't completely reliable either, so the doctor needs to be diligent to review before signing. And not just assume it's all correct. The one transcript like that I've seen had obvious speech recognition errors, when the notes got to my primary care doctor.