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- cross-posted to:
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Twenty years after President Bush laid out his vision for electronic health records, the U.S. has spent $100 billion for systems that keep doctors and nurses glued to their screens
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Electronic health records when used appropriately are miles better than paper. More than half the article talks about the benefits before noting the two problems that paper does not solve. Which is crossing records from one system to another and the bloat that has been added as different specialties need to input different things. There will always be room for improvement but saying EHRs are a problem fully neglects that they are still a massive improvement.
Yeah, but like… Are they really? No two systems communicate, every hospital configures even the same systems to be essentially incompatible, and the system is built as if it’s all seamless
It’s so bad. Paper records in a secure central database would be an improvement - 20 years of this and bending over harder for insurance companies is the only change
They’re a lot better in terms of tracking. No white out, backdating, loss in natural disaster. Better privacy as who looks is logged and requires note of reason for a non-provider to look. Tracking helps bill you yes but it can also help fight if records don’t match.
Even if records can’t be directly imported across systems it can be sent a lot faster and easier which is important to efficient, effective care. If you stay within a given hospital/provider system integration works pretty dang well.
Paper records are worse in many ways getting rid of them was a big push of the ACA for a reason. Obama admin did choose implementation before integration at the time but that is a reform to what exists you don’t have to reinvent the wheel so to speak.
The insurance dildo is a mostly separate issue from ehr.
Okay… But how much of that is realized?
Before, you told a doctor where to call to get your past records… Now, you tell your doctor where to request your past records. If your doctor works in the same healthcare system campus, they might get them automatically, past that it might happen behind the scenes if you get a referral
Backups are true… Except everyone has their own proprietary formats that require specific software to access the data, and if one of those companies go under, then what?
Access controls and tracking are true, but what’s digital can be hacked or leaked. Paper is far more secure - maybe they can phish one person’s records more easily without it, but the wrong IT person (who is multiple steps removed) can leak the whole database
I’m not saying paper is better - I’m saying electronic medical records are such a garbage fire in implementation that they bog down the healthcare part of healthcare. They eliminate jobs by automating processeses, but they end up getting rid of support staff in exchange for making the healthcare workers do more work
And I’m not saying it couldn’t be better - I’m saying that it’s just such a mess of proprietary software and regulation that it became one more layer of wealth extraction that bogs down actual healthcare
My primary care doctor resigned in Jan 2025 because it was too depressing being on screens all the time…
Everytime we find a doc we like, they leave to do concierge medicine.
the U.S. has spent $100 billion for systems that keep doctors and nurses glued to their screens
Man do I hate that “wording”. It’s not the US. It’s healthcare organizations located in the US.
AI is a mixed bag, and a whole lot of hype.
But voice-to-text auto-generation of patient notes during dr visits will be a huge win for the medical profession. Data entry by doctors and nurses will be cut down 10x (just review what the software transcribed, make edits, and sign off).
You really gotta hope those 5-10% LLM interpretive miss rares don’t hit your particular case.
Also if it fucks up, the doctor is still liable for malpractice right? Or do they get to kick that ball down into the abyss of trying to get LLM companies to take responsibility for their products.
My fiancé works at a vet clinic that uses it and she says the doctors love it. The customers, however, don’t like that there’s an AI that listens to their visit so they just say it’s “software”
Transcription software has existed for decades and has no need for AI. It doesn’t need to interpret anything you’re saying, shoving AI into it is literally just making things worse.
In this particular use case, no. The LLM not only transcribes, but it summarizes, drafts, and categorizes as well (ICD-10 codes, cross-referencing medical history, etc.).
Very useful for overworked and under-resourced healthcare workers.
Look, AI bolt-ons to existing software and processes often do suck. But this specific instance is a real positive use-case.
Every technology has a place where it’s useful - with LLMs, it’s just mostly been “let’s throw it at everything.” In most cases, it’ll fall away as useless, and a few cases, it’ll stick where it really adds value.
teledoc is eliminating doctors being able to pratice elsehwere, or privately, its pretty severe that you wont get quality healthcare at all.
