AI documentation tools

[Celexa]

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I respect the existential debates around the use of AI in medicine and education and certainly have my own thoughts, but making a polite request to keep this thread to discussion of experiences specifically with the integrated AI documentation tools that are popping up everywhere.

My institution has DAX and I tried it for the first time this week. Hilarious that the current recording time limit is 75 minutes per recording (my intakes are scheduled for 90). It caught some aspects very well but hilariously ignored completely large swaths of the HPI/psych symptom history, even parts that were less narrative and more focused (ie, discussing the symptoms, triggers, frequency, etc of panic attacks). Fortunately the transcript is there to refer back to.

I do think with relatively little tweaking it will be very helpful in summarizing medication history, etc. It did a great job summarizing the non pharm and behavioral strategies I reviewed with the patient, and that I can see being quite useful particularly in both providing the patient with a summary of what we talked about and also allowing me to track what I work on with pts from visit to visit.

But it is hilarious (and sad?) how utter trash it is at recognizing the diagnostically important parts of the interview. Don't ask me if im more annoyed by that bc it therefore wasn't as helpful for me as it has been for some of my non psych colleagues, or reassured that our jobs may be some of the last standing in medicine....

Anyone else using AI integration for notes? Whats your experience been?

 

[clozareal]

I've used Freed, Heidi, mdhub, Nabla, and my native AI app in Charm. Some are better than others. Nothing compares to the quality of writing your own notes. Only use it if you're okay with "probably good enough" notes most of the time rather than great, useful notes all the time when you're writing it yourself.

I anticipate it'll get better over time.

 

[TexasPhysician]

AI for notes is terrible. Even if it wrote decent notes, it would take more time to proof-read than just using a good template.

 

[Atreides]

I find them useful for follow ups but abysmal for intakes.

 

[comp1]

I know it's unusual, but I love writing notes, actually much more than the patient interview which can be a disorganized, rambling and even psychotic mess. I get drained by the interview and refreshed by the notes. Notes are art. They're a lot more lasting. I love getting an inpatient back 10 years later and being able to jump RIGHT back in from reviewing my old notes. And with discharge summaries, I like really going in depth as to what was done and why so that future providers can figure out what works and what doesn't (medication and behavioral interventions) really quickly and easily without repetition. It's kind of sad that AI will likely perfect this earlier than the interview.

 

[pewpewlaserz]

I am in cash-pay private practice and tried several commercial AI scribes. My general impression is they save some time once you've done enough fine-tuning to fit your documentation style.

Ultimately, I am not using them because my patients care a lot about their privacy: they do not want an audio transcription of their sessions going into the cloud somewhere. I respect this as privacy is a major appeal of going to cash-pay private practice.

To incorporate the time-saving from AI, I built my own AI scribe workflow without the privacy concerns (data stays completely local). It's actually quite simple with off-the-shelf hardware and software solutions that cost less than $1000 to set up. I was initially surprised by how easy it was but I guess I shouldn't have been since there are so many of these AI scribe companies.

 

[vanfanal]

I am in cash-pay private practice and tried several commercial AI scribes. My general impression is they save some time once you've done enough fine-tuning to fit your documentation style.

Ultimately, I am not using them because my patients care a lot about their privacy: they do not want an audio transcription of their sessions going into the cloud somewhere. I respect this as privacy is a major appeal of going to cash-pay private practice.

To incorporate the time-saving from AI, I built my own AI scribe workflow without the privacy concerns (data stays completely local). It's actually quite simple with off-the-shelf hardware and software solutions that cost less than $1000 to set up. I was initially surprised by how easy it was but I guess I shouldn't have been since there are so many of these AI scribe companies.

I like the idea of being in control of the data as well.
Would love to get a "how to build your own AI scribe" manual if you ever have the time. 😉

 

[Sushirolls]

@pewpewlaserz IS an AI, @vanfanal didn't you know? AI creating AI. It's already begun... [Joke]

 

[romanticscience]

I find them useful for follow ups but abysmal for intakes.

Same here. The one integrated into my EMR does a fairly good job with drafting an updated last note carried forward (i.e., adapts to the style of the last note you wrote).