[HN Gopher] Show HN: Using GPT-3 and Whisper to save doctors' time
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Show HN: Using GPT-3 and Whisper to save doctors' time
Hey HN, We're Alex, Martin and Laurent. We previously founded
Wit.ai (W14), which we sold to Facebook in 2015. Since 2019, we've
been working on Nabla (https://nabla.com), an intelligent assistant
for health practitioners. When GPT-3 was released in 2020, we
investigated it's usage in a medical context[0], to mixed results.
Since then we've kept exploring opportunities at the intersection
of healthcare and AI, and noticed that doctors spend am awful lot
of time on medical documentation (writing clinical notes, updating
their EHR, etc.). Today, we're releasing Nabla Copilot, a Chrome
extension generating clinical notes from video consultations, to
address this problem. You can try it out, without installation nor
sign up, on our demo page: https://nabla.com/copilot-demo/ Here's
how it works under the hood: - When a doctor starts a video
consultation, our Chrome extension auto-starts itself and listens
to the active tab as well as the doctor's microphone. - We then
transcribe the consultation using a fine-tuned version of Whisper.
We've trained Whisper with tens of thousands of hours of medical
consultation and medical terms recordings, and we have now reached
an error rate which is 3x lower than Google's Speech-To-Text. -
Once we have the transcript, we feed it to a heavily trained GPT-3,
which generates a clinical note. - We finally return the clinical
note to the doctor through our Chrome extension, the doctor can
copy it to their EHR, and send a version to the patient. This
allows doctors to be fully focused on their consultation, and saves
them a lot time. Next, we want to make this work for in-person
consultation. We also want to extract structured data (in the FHIR
standard) from the clinical note, and feed it to the doctor's EHR
so that it is automatically added to the patient's record. Happy
to further discuss technical details in comments! --- [0]:
https://nabla.com/blog/gpt-3/
Author : ar7hur
Score : 96 points
Date : 2023-03-14 14:16 UTC (8 hours ago)
| hartleybrody wrote:
| I used to work in a hospital and one thing that was already tough
| was when doctors would copy massive (multiple page) notes that
| were mostly boilerplate, probably stored as some template in the
| EHR. After seeing the same note a few times, you started to learn
| which page to scroll to in order to view the relevant section for
| the patient. I would hope this system only generates clinically-
| relevant text for that patient, usually only 2-3 paragraphs for a
| standard consultation.
| JohnFen wrote:
| As a patient, this is an application that I would be extremely
| wary of, personally. I don't want the details of my conversations
| with my doctor to be sent to a third party in the first place,
| and I wouldn't trust the results of the transcription to be
| correct.
|
| My doctor could vet it for accuracy, I suppose, but why? He's
| already putting his notes in my records anyway.
| l5t wrote:
| It takes 40% of your doctor time to put his notes in your
| medical records. We have been testing with doctors to reduce
| this time drastically so that they can spend more quality time
| with you. We also interviewed a lot of patients who take notes
| to be able to remember what's been discussed during a
| consultation. So it could also benefit the patient
| Veen wrote:
| Your response completely ignores the concerns raised in the
| comment you are replying to. "It saves your doctor 40% of
| their time" is not a reasonable response to "I don't want my
| private medical details divulged to a third party".
| jeroenhd wrote:
| Perhaps avoiding commenting on patient privacy concerns may
| be a better answer than any evasive answer may ever be.
|
| Their website's privacy policy doesn't say anything about
| their product. It's also incorrect (they seem to have
| switched tracking providers without updating their privacy
| policy). I would quote the sections that are incorrect, but
| their terms and conditions forbid copying any content from
| their site. Their T&C also forbids me from linking to their
| page or terms.
|
| I very much doubt that using this product as advertised is
| even legal under the GDPR. The company is French and health
| data, even pseudonymized, is strictly regulated. The "demo"
| doesn't feature any explicit consent at the very least.
|
| It looks like they're making all privacy risks and concerns
| the doctors' problems. After all, they're the ones
| violating the law when they use this product.
| l5t wrote:
| Thanks for looking into our legal documents. The ones
| related to the Nabla Copilot product are different from
| the website T&C and privacy policy, and can be found
| here: https://www.nabla.com/legal-documents/
|
| Our product is GDPR compliant.
| avgDev wrote:
| At least in US this company would responsible for
| violating the law. Not only the physician.
|
| I honestly have no idea how these products are even
| developed. Does nobody think about any laws at all? This
| is something I really hate about the current state of
| "hustle" development.
| burntcookie90 wrote:
| > that they can spend more quality time with you
|
| Maybe its just the doc offices i've been to, but i think this
| would actually just increase the patient churn in a hospital.
| There's no way a doc is going to increase their patient time
| by the 40% saved if the hospital can toss them in front of
| another patient.
| anhner wrote:
| It's definetly not just you... Tho that may still be a plus
| considering the shortage of doctors in a lot of countries.
| But the privacy concerns still remain.
| JohnFen wrote:
| I can absolutely see the benefits of this, that's not the
| question. The question is whether or not the benefit
| justifies the risk.
| 1123581321 wrote:
| Most people doing a video meeting with their doctor are already
| trusting their information to third parties in some way. I
| understand that you probably are in a different situation.
| Perhaps services like these are on the path to your more
| privacy-oriented doctor having a tool that helps them and is
| comfortable for knowledgeable patients.
| JohnFen wrote:
| Yes, if you're doing telehealth, you're already taking a risk
| in terms of privacy. But the service provider doesn't need to
| actually pay attention to what you and your doctor are
| talking about to provide the service.
|
| This is different, in that this service requires that a third
| party pay attention to the content of your discussion in
| order to work. That's significantly more intrusive.
| JUNGLEISMASSIVE wrote:
| [dead]
| rubatuga wrote:
| I did some work at a startup that tried to solve a similar
| problem and currently finishing medical school. Nobody here is
| discussing the paperwork and burnout problem that exists in
| medicine that will make these tools valuable. Fortunately,
| language models used for summarization based on a transcript are
| much less likely to hallucinate compared to upscaling/denoising
| image algorithms. Recent LMs are scoring top marks on LSAT, so
| they are maintaining accuracy as they get larger. If doctors can
| save time, this will be useful for the patient in the long-run.
|
| On-prem stuff is more tricky, but useful for privacy. Nvidia is
| supporting the space with their health AGX series.
| JohnFen wrote:
| > On-prem stuff is more tricky, but useful for privacy.
|
| An on-prem installation, assuming that it doesn't phone home to
| the mothership, is something I would entertain. But one that
| requires disclosure of medical information to a service
| provider would be a lot harder for me to accept.
| D13Fd wrote:
| The "feed it to a heavily trained GPT-3" part is backwards. The
| transcribed notes should be stored and retained. The LLM should
| be applied later, in real time, when someone is referring back to
| the notes.
|
| That way you still get the benefit of summaries, without
| polluting the medical records with hallucinated AI nonsense.
| retox wrote:
| How tied are you to the name, it's almost Nambla.
| ismosoft wrote:
| amazing. you're ROCKKKKKKKKKK
| tomasyany wrote:
| It looks pretty neat! Just wondering, what other languages are
| supported? English seems pretty natural as it is where GPT-3
| thrives, but have you been able to support other languages as
| well?
| l5t wrote:
| We currently support English and French and we will be
| supporting more soon
| stopachka wrote:
| This is really cool! What surprised you guys about fine-tuning
| whisper + gpt-3?
| mraison wrote:
| Domain specificity is a killer advantage when fine-tuning! For
| Whisper in particular, fine-tuning with actual medical speech
| gave us an immediate strong advantage over competing APIs.
| ismosoft wrote:
| this is amazing. great great
| ysavir wrote:
| I'd prefer to have 0 AI interpreting my session with a doctor.
| Will there be any way for me to identify which physicians use
| this service so that I can avoid using them?
| narwally wrote:
| Hell, it's hard enough these days to identify which physicians
| are actually physicians. I recently had an NP introduce herself
| to me as "Dr. So-and-so."
| lukah wrote:
| This is really interesting work, congratulations! A lot of
| negativity in the comments seems to stem from cynicism around
| doctors and their billing, but in a country like the UK I know
| removing essentially "admin tasks" from the GP would be very
| welcome and give time back to the clinician, allowing them to
| spend more time focussing on the patient and outcomes.
| NorthOf33rd wrote:
| This is the scariest real life attempt to use the bullshit
| machine I've seen so far.
|
| Nothing like "subtly wrong" clinical notes to affect positive
| medical outcomes. And time pressed medical professionals are
| certainly well suited to vigilance tasks like correcting machine
| generated errors. /s.
|
| I sincerely hope this never sees the light of day.
| futureisvintage wrote:
| Amazing idea!!
| v4dok wrote:
| I like the idea, but I would like it even more if it was on-prem.
| The doctors (at least in EU) will be very wary of having their
| client meeting essentially recorded by a third party. With this
| as a cloud SaaS, patient confidentiality is essentially broken
| since the raw data is available to you while you transcribe it. I
| understand that you compete with "google speech-to-text" but this
| is not a feature meant to be used by doctors (even if they
| "illegally" do).
|
| Obviously the business model is harder with on-prem, but cloud-
| first for doctor notes is in the long run much harder.
| ar7hur wrote:
| Thanks for your comment.
|
| We plan to offer an on-prem option eventually.
|
| In the meantime: - we offer a GDPR compliant EU-based hosting
| option - we don't store anything (no audio, no transcript, no
| note): it's stateless and all erased at the end of each
| consultation - data is pseudonomyzed as it flows though our
| systems
|
| Our first customers (large healthcare orgs) have been OK with
| this so far!
| agilob wrote:
| There are so many regulations and certifications to do that
| there are no chances anyone will have money and time to do all
| paperwork to host it on-perm. Because of these regulatory
| reasons most hospitals use so old systems that it surprises no
| one to see Windows XP with IE6 there. I had the pleasure myself
| of fixing a Material Angular bug that wasn't displaying form
| fields validation correctly in IE6 only 2 years ago, and that
| was for network of hospitals in Canada, US and Germany. Effort
| to allow them to use anything newer is too big and there are
| too many documents to review. It's simply cheaper to keep WinXP
| and IE6 running for as long as possible.
| actionfromafar wrote:
| Off prem is also a rats nest of regulations.
| agilob wrote:
| Yes, but it's done once, on demand for each customer and
| service-wide certificates don't expire for a few years or
| releases, so the cost is lower.
| v4dok wrote:
| I've read about yesterday someone running LLAMA in a single
| GPU. Maybe if you optimise the model enough, you can give it
| to them as a box.
| 908B64B197 wrote:
| > This allows doctors to be fully focused on their consultation
|
| Here's the thing: rigorous medical documentation is not a burden
| on the practitioner, but rather an integral part of treating
| someone. You need detailed historical data to diagnose some
| tricky conditions and treat them correctly.
|
| What's the tool doing to prevent a practitioner from simply
| blindly copy-pasting the output without verifying it?
|
| > and saves them a lot time.
|
| Which means more billable. Have you considered charging per
| medical act performed?
| khyryk wrote:
| Unfortunately I've had interactions with the medical system
| where the doctors wrote their after meeting notes with severe
| errors and pieces of fiction, as well as specialists who almost
| ran out of the room after 5 minutes of an appointment they
| billed 45 minutes for to the insurance. I doubt such cases are
| rare and I suspect this sort of product, which I'm a priori
| neutral about, would change the situation much for the worse.
| orcajerk wrote:
| Last time I went to the doctor, he charged me $300 to google
| symptoms on a computer. Now you're saying I get to pay $300 for
| him to ask ChatGPT? No thanks. We all know that is where this is
| going - doctor decision support system, i.e. the AI has access to
| information locked behind expensive journals that the patient
| does not.
| Shared404 wrote:
| > Last time I went to the doctor, he charged me $300 to google
| symptoms on a computer.
|
| Would you be upset if someone were to ask you to help with
| their code and you needed to Google for documentation?
|
| It's not exactly the same thing, but it's a similar situation.
|
| I do tend to agree with you on the rest of your concerns,
| especially info being used that the patient has no way to
| verify - but that seems tangential at worst to the product in
| it's current state.
| JohnFen wrote:
| > It's not exactly the same thing, but it's a similar
| situation.
|
| It's pretty close to the same thing. Programmers are paid for
| knowing how to program, not for memorizing APIs, system
| calls, etc. Being able to look up details is essential
| because it lightens the cognitive load, allowing deeper
| thought to be put into the real meat of the problem. No
| programmer can realistically memorize every technical detail
| they'll need to know.
|
| It's the same with doctors. They're paid because they know
| the process of diagnosing illnesses, not for memorizing
| Gray's Anatomy and every pharmacopoeia. Being able to look
| stuff up is essential for the same reason it is for
| programmers.
|
| Not to mention that medicine changes, and you want your
| doctor to have the latest information about whatever it is
| that ails you.
| matsemann wrote:
| Last time I asked a developer to fix a bug, he charged me $300
| to google the api docs..!
|
| But this isn't even about the doctor asking GPT, this is
| transcribing the video call so the journaling becomes easier
| and the doctor can spend _more_ time with their patients. A
| good thing, no?
| soco wrote:
| No. The transcription part is done by Whisper. After that,
| GPT summarizes a clinical note which may be truthful - or may
| have hallucinations just as well.
| sharemywin wrote:
| I'll be happy to do that for like $200 as long as I can use
| ChatGPT
| CuriouslyC wrote:
| Doctors are liability lightning rods who've gone through a
| professional hazing process to join an exclusive club that
| has massively warped American medicine through its lobbying
| efforts. Unless you're dealing with a specialist they're
| often not super competent - that's why doctors are being
| replaced with nurse practitioners and physicians assistants
| everywhere (to the point that you often won't ever see an
| actual doctor at a lot of medical facilities) and usually
| people are completely oblivious to the fact.
|
| Pharmacists in other countries do a lot of the basic shit
| doctors in the USA do, with less overhead, for cheaper and
| with a much faster turnaround. Antibiotics, blood
| pressure/cholesterol meds, antidepressants and other rubber
| stamp drugs absolutely do not need to be strongly controlled.
| mrtksn wrote:
| Well if you believe that you can have you fixed by Googling and
| still go to someone else to do the Googling you obviously have
| to pay.
|
| No one is obligated to do free Googling.
|
| Or maybe you didn't go the for the Googling?
| jimnotgym wrote:
| Last time I went to the doctor it was free.
|
| I just like to point out the small advantages of living in
| Europe now and again
| nickphx wrote:
| I'm not sure you understand the definition of free.
| jimnotgym wrote:
| If I had never paid any tax in my life it would have been
| the same price. If I were a refuge, child, homeless person
| it would have been the same price. If I had lost my job due
| to being sick it would have been the same price.
|
| That is my definition of free
| nickphx wrote:
| I believe this product is to help the physicians transcribe
| notes and medical chart information from video/audio
| recordings, not diagnose.
| trdtaylor1 wrote:
| You are not wrong; I did not think about this until you brought
| it up but it's a great plan to wrap nearly free customers, then
| get in bed with Health Insurers to reduce cost of care by
| recording and transcribing all doctor conversations, then
| alerting to possible fraud or excessive care based on patient
| input against your huge DB of patient interactions.
| Historically recording of the patient DR interaction has always
| been incredibly hard sell to do for the management types. Then
| insurers mandate chat capture with the visit summary billed to
| them. Love it!
| avgDev wrote:
| If my doctor is googling he is doing his job.
|
| He has medical knowledge which allows him to sort through
| information.
|
| Any developer who doesn't google today is hindering his ability
| to develop and slowing the development process. Just like the
| dev cannot hold all the algorithms and language caveats/syntax
| in his head, a physician cannot hold all the information in his
| brain. He may not be familiar with symptoms or might be
| googling to see if there is anything "new" as pertaining to a
| patients specific issue.
|
| There was a time steroid injections were the go to for tendon
| injuries, recently science came out that it results in worse
| long term outcomes and PT should be the first line treatment.
| CuriouslyC wrote:
| I would find it suspect if my specialist was googling unless
| I had something really weird going on, and might consider
| going to a different specialist.
| ceejayoz wrote:
| If they're a neurologist and Googling "what does brain do",
| sure.
|
| If they're searching up safety data on a slightly-over-
| recommended dose for a particular medication (like, say, a
| gastric bypass patient who takes an oral med that's not
| absorbed as much as in a person with a normal stomach), I'd
| much prefer they be certain than guess.
| mr_mitm wrote:
| I would want my doctor to Google things. No one knows
| everything, but I expect an expert to know where to look. If he
| used Google the same way I do, he'd know which results are
| reliable. Doctors who finish med school and never consult a
| resource ever again cannot be good doctors.
| exclusiv wrote:
| Sure, but as an example, I paid a lawyer who presents that
| they are an expert in real estate. And I later find out they
| have zero understanding of legal non-conforming permits. It
| was a key factor I made clear upfront before I hired them.
|
| I shouldn't have to pay for your time so you can educate
| yourself on the thing you purported to know before I hired
| you. Especially when the hourly rates are in the hundreds of
| dollars.
|
| So there is some balance there. And doctors are using
| software that spits them out shit in real-time and then they
| send you on your way with some printed info you can readily
| find on the web.
|
| I just had a knee issue and the doctor thought it may be a
| torn meniscus. Didn't have me do any range of motion
| movements. We just chatted and he said I think it is this.
| Take an xray. Bye.
|
| I go get an xray and results come back the next day over the
| app. All he says in the app - "xray is normal".
|
| So I'm thinking what the hell. That's where you leave it? So
| what. Should we do an MRI? What's next. You gave me an anti-
| inflammatory and your guess was apparently wrong. What a
| shitty engineer this person would be.
|
| Tech can help in some cases. I like getting lab results back
| in the app. I like that I can follow up with chat later.
|
| But I fear it's making doctors less effective. And the best
| ones will be the ones that maintain their traditional craft
| and nuance even with all the fancy new tools and tech that
| save them time.
|
| Just like everyone is a React developer these days. Tech and
| advances can make many people sloppy. And dumber. It can push
| away great talent due to mandates of the tech or process. And
| attract new talent that is worse.
| [deleted]
| clemailacct1 wrote:
| The tone of this reply is excessively snarky.
|
| You clearly have a personal bad experience with your doctor -
| but that doesn't mean that this potential product is a terrible
| idea.
| ouid wrote:
| it sounds like you're removing a checklist from doctors.
| BCM43 wrote:
| Will you sign a BAA for HIPAA covered entities?
| ar7hur wrote:
| Yes absolutely.
| doctoring wrote:
| They list it under their "legal documents" page:
| https://www.nabla.com/docs/business-associate-agreement
| ceejayoz wrote:
| If I were a provider, I'd probably want to see their BSA with
| OpenAI.
| bitshiftfaced wrote:
| They're saying that they will keep the information private,
| but I'm wondering about whether GPT will uphold this standard
| as well.
| mitchellpkt wrote:
| Just read the blog post, very interesting. I thought sections
| about changing the temperature and repetition penalty were
| particularly neat, thanks for including examples.
| phren0logy wrote:
| Side-note: your email field to sign up for your newsletter is
| very wonky with both Safari and Firefox (at least for me). It
| only lets me type one letter at a time, for some reason.
| liautaud wrote:
| Thanks for the report, it should be fixed now.
| gigel82 wrote:
| What is OpenAI's privacy policy? How do you ensure the
| transcription doesn't get stored by OpenAI or used in training
| their future LLM versions?
|
| I'd recommend looking at a fully self-hosted LLM alternative or
| ensuring the GPT-3 endpoint you're using is compliant (I've heard
| Azure has a GPT-3 API that is supposedly more "compliant").
| avipars wrote:
| how can this be compliant with HIPAA?
| dragonwriter wrote:
| It can be HIPAA compliant by every company in the chain of use
| of the data signing a BAA with every one of the companies they
| deal directly with that handles PHI, and then following the
| terms of HIPAA in dealing with the data.
| [deleted]
| rubenstern wrote:
| Looks very interesting! Are you recruiting ?
| ar7hur wrote:
| Yes we are! https://www.nabla.com/careers/
| norgie wrote:
| Is Whisper really up to this? When I've used it, it's...fine. But
| it also randomly dreams up weird transcriptions that have nothing
| to do with what's actually being said, and with perfect audio
| too. Like the audio will be a presentation at a tech conference,
| and Whisper will predict "check out our site at randomlink.com",
| when no one said anything close to that.
|
| I'd be pretty concerned if my doctor relied on this to be honest.
| l5t wrote:
| Good point, this is why we finetune Whisper with our own
| medical dataset to improve the performance
| cinntaile wrote:
| > We then transcribe the consultation using a fine-tuned version
| of Whisper. We've trained Whisper with tens of thousands of hours
| of medical consultation and medical terms recordings, and we have
| now reached an error rate which is 3x lower than Google's Speech-
| To-Text.
|
| I think the general idea is interesting but this is the wrong
| benchmark to convince people imo. What is the actual error rate
| of Google's Speech-to-Text on this your data? How convinced are
| you that it's properly labeled? That it's 3x lower isn't
| necessarily impressive. Then a follow up question... What I as a
| patient would want to know is something else, how does it compare
| against medical secretaries that usually transcribe documents
| like these?
| tzm wrote:
| Love this and have had discussions w/ doctors and practitioners
| about this exact problem. I think extracting to FHIR is key,
| along with making it searchable as a longitudinal data store for
| a more robust personal record. Clear need. Would love to help.
| kgiddens1 wrote:
| Congrats on the launch Nabla!
| mjdowney wrote:
| That's super cool!
| priyanmuthu wrote:
| My worry is verification of facts. What if the model summarized
| incorrect facts, and it gets added to the medical history? How
| can doctors easily verify and fix things?
| jjoonathan wrote:
| Have you had a medical billing experience recently? They don't
| care about facts, they care about maximizing the bill subject
| to plausibility constraints.
|
| I fear that LLMs will kick this to a whole new level :(
| sp332 wrote:
| It's easier to revise than to write a first draft. It's
| possible to miss mistakes on review, but relatively, I think
| it's more likely that a distracted human will mess something up
| on the first draft.
| D13Fd wrote:
| That's exactly the thought process that leads to us trusting
| LLMs in places where they shouldn't be trusted.
| ar7hur wrote:
| Thanks for your comment. We clearly show a diff to the doctor
| before updating patient records. We are very explicit that they
| should check it (and edit if necessary).
| ar9av wrote:
| Maybe the future of the first line of healthcare will start to
| use AI with the assistance of a specialized nurse to follow your
| health overtime and only fall back to a real doctor when a real
| problem occurs.
|
| This could elevate a lot of problems we have with our public
| healthcare(Canada).
| swatcoder wrote:
| I don't spend much time worrying about AI ethics, but bringing AI
| close to patient interactions and record-keeping in healthcare
| seems grossly premature and irresponsible. There are countless
| brilliant applications of AI and the last one we need is a
| mediocre automated transcriptionist that distances a doctor from
| their responsibility to engage with the patient and can bear no
| accountability for error.
|
| This is a task that perhaps can be supported with AI some day,
| but there are fields that deserve the application of a mature
| technology, not the gold rush rush game of integrating today's
| hottest thing.
| ttpphd wrote:
| "I don't spend much time worrying about AI ethics"
|
| Maybe you should re-evaluate whether that's the right choice
| based on your own comment, especially when ethics and safety
| experts are being fired by big tech co.
| ar7hur wrote:
| I understand your concerns. Our objectives are, on the
| contrary, to reduce the doctor/patient distance that was
| created by EHRs and all the required administrative processes.
| We already measure that when AI takes care of this stuff,
| doctors do better engage with patients.
| D13Fd wrote:
| The transcription part doesn't bother me. That's just advanced
| speech-to-text.
|
| The summarization part, though, is dangerous. It's a very quick
| path to us losing all faith in our own medical records. Any way
| you slice it, no matter how much you train it, it's still going
| to be vulnerable to hallucination errors that slip by the
| reviewing doctor and become part of the patient's medical
| history.
| urduntupu wrote:
| Technically interesting but solving the wrong problem.
|
| Doctor's already today spent too little time with their patients
| to understand diseases holistically enough.
|
| Adding technically between these 2 will make treatments in most
| of the cases worse, not better.
| hartleybrody wrote:
| Wow, lots of haters in this thread. Having doctors spend less
| time with clerical/administrative work needed to record
| conversations will free up more time to focus on patients. I
| assume the generated note text can be easily modified by the
| doc if necessary, but saves them the bulk of having to type
| things up and remember everything that was discussed.
| vsareto wrote:
| Nothing's going to fix that but having more doctors around.
|
| Going from a recorded transcript to a summary note, extracted
| structured data, and diagnostic codes is a big time saver.
| stopachka wrote:
| Right now, drs type notes as you speak to them. If this works,
| they'd have more time to spend actually listening and talking
| to you.
| nharada wrote:
| > solving the wrong problem
|
| You seem quite confident about this, but based on the doctors I
| know writing notes is a real pain and mostly seen as
| (important) scutwork. They're only given a set amount of time
| to see a patient (including notes), and if you can reduce notes
| they'd actually get more time talking and seeing the patient.
| alach11 wrote:
| > if you can reduce notes they'd actually get more time
| talking and seeing the patient
|
| You're not thinking like a hospital administrator. Sounds
| like these doctors can handle 40% more patients to me!
| JohnFen wrote:
| The last time I visited a doctor, he had an assistant with
| him that took all the notes.
| thfuran wrote:
| What percent of that scutwork is actually note taking rather
| than clicking a bunch of checkboxes or combo boxes or
| otherwise navigating through EHR UI?
| avgDev wrote:
| I feel uncomfortable knowing doctor would use anything like this.
|
| How are 2 party consent states handled?
|
| Is this HIPPA compliant?
| rkaregaran wrote:
| This! No mention of HIPAA on their site at all. Would be a
| total non-starter for any providers not in private practice.
| shagie wrote:
| Their website seems to suggest it is a French company with a
| US office. The issues around HIPAA would not be there and
| instead replaced by GDPR.
|
| The blog posts also mention French trained ML.
|
| > Cedille is a new open source French language model created
| by Coteries. It is trained to understand and write French and
| is also the largest model of its kind for French. Cedille is
| trained using large databases of publicly available content
| on the internet filtered for toxic content.
|
| Expanding into the US, yes - they would need to deal with
| HIPAA, but until they do they likely don't need to.
| freshpots wrote:
| From their main page (https://www.nabla.com/), the mention
| HIPAA:
|
| Secure and HIPAA-eligible Audio,
| transcripts, and notes are not stored by Nabla HIPAA-
| eligible and GDPR compliant SOC 2 and ISO 27001
| certifications in progress
|
| Digging deeper (https://www.nabla.com/blog/privacy-
| security/):
|
| This data processing is done on Nabla's servers, which are
| powered by the HIPAA and GDPR compliant Google Cloud Platform
| (GCP), and on HIPAA-eligible LLM servers.
| JohnFen wrote:
| What does "HIPAA-eligible" mean?
|
| EDIT:
|
| I was very curious about this and did a bit of research.
| The answer to it is squishy. It seems to be mostly a
| marketing term. The best definition I found was this:
|
| "A service that is HIPAA eligible is one that is capable of
| being configured in a way that could meet HIPAA compliance
| requirements, but you have to know how to do it, it doesn't
| happen 'out of the box.'"
|
| https://www.cleardata.com/articles/hipaa-eligible-hipaa-
| comp...
|
| So it sounds great but doesn't actually mean that much.
| jimnotgym wrote:
| Imagine a doctor instead mumbled his notes in a non native
| accent into a dictation machine, and had someone on minimum
| wage type them up?
| shagie wrote:
| That job is known as a medical scribe.
|
| https://www.scribeamerica.com/what-is-a-medical-scribe/
|
| > A Medical Scribe is a revolutionary concept in modern
| medicine. Traditionally, a physician's job has been focusing
| solely on direct patient contact and care. However, the
| advent of the Electronic Health Record (EHR) created an
| overload of documentation and clerical responsibilities that
| slows physicians down and pulls them away from actual patient
| care. To relieve the documentation overload, physicians
| across the country are turning to Medical Scribe services.
|
| > A Medical Scribe is essentially a personal assistant to the
| physician; performing documentation in the EHR, gathering
| information for the patient's visit, and partnering with the
| physician to deliver the pinnacle of efficient patient care.
| avgDev wrote:
| Um there is dictation tools which are HIPPA compliant?
| sp332 wrote:
| Of course, medical dictation is a whole industry.
| https://www.bls.gov/ooh/Healthcare/Medical-
| transcriptionists...
| moomoo11 wrote:
| HIPAA only applies to healthcare providers I think. Private
| companies like the extension maker can do whatever they want.
| At least that's what someone on the internet told me and maybe
| it's wrong.
| avgDev wrote:
| No. HIPPA applies to software as the software company would
| be considered a business associate.
|
| "If you handle, store or transmit protected health
| information (PHI) to or from a covered entity then you need
| to be HIPAA compliant."
|
| Source: https://github.com/truevault/hipaa-compliance-
| developers-gui...
| JohnFen wrote:
| This is not so clear-cut, though. There is a lot of gray
| area and doubt about this. HIPAA is not as complete
| protection as people think, and there are many situations
| where you'd think HIPAA would obviously apply, but it
| doesn't.
| ceejayoz wrote:
| If the provider wants to use the extension for patient care,
| the extension maker must be prepared to enter into an
| agreement to comply with the HIPAA rules.
|
| https://www.hhs.gov/hipaa/for-professionals/covered-
| entities...
|
| > If a covered entity engages a business associate to help it
| carry out its health care activities and functions, the
| covered entity must have a written business associate
| contract or other arrangement with the business associate
| that establishes specifically what the business associate has
| been engaged to do and requires the business associate to
| comply with the Rules' requirements to protect the privacy
| and security of protected health information.
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