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Curbside Consult with Dr. Jayne 3/20/23

March 20, 2023 Dr. Jayne 4 Comments

I was hanging out with one of my favorite computer science students over the weekend and ChatGPT was a hot topic. He has been working on a group project, and someone who didn’t have a partner asked if they could join the group by way of an email that was clearly AI generated. The first couple of sentences weren’t too bad, but then the email started laying it on thick with comments about how hard the new member planned to work and “rest assured I will do my best” type syntax which isn’t typical of the age group.

Since this student has access to better AI toys than I do, I decided to have some fun. A lot of people in my life know that I write for a blog but they don’t read it or really know what it’s about, so I wondered what generative AI thought about my alter ego: 

Tell me what you know about the writing style of Dr. Jayne HIStalk.

Dr. Jayne HIStalk is the pseudonym of a physician who writes a popular blog about healthcare information technology. Her writing style is characterized by a unique blend of humor, wit, and incisive analysis of industry trends.

Dr. Jayne often uses anecdotes and personal experiences to illustrate her points, and she is known for her ability to distill complex concepts into clear and accessible language. Her writing is often critical of the healthcare industry and its shortcomings, but she also offers practical suggestions for improving healthcare delivery and patient outcomes.

Dr. Jayne’s writing is also notable for its use of pop culture references, particularly to science fiction and fantasy, as well as her ability to inject humor into even the most serious topics. Her style has been described as irreverent, thought-provoking, and engaging.

Overall, Dr. Jayne HIStalk’s writing style is distinctive and engaging, and has helped to establish her as one of the most influential voices in healthcare information technology.

I felt like that write up would be useful for the back of a book, should I ever write one. I think it sums up what I’ve been up to for the last 13 years, although it seemed a little schmoozy with the compliments. Since physicians are starting to use ChatGPT to write everything from prior authorization forms that help patients get medications approved to school and work notes excusing absences, I decided to see if I could get it to do my work for me.

Write 500 words in the style of Dr. Jayne HIStalk about the value of telehealth.

Dr. Jayne here, and today I want to talk about the value of telehealth. With the rise of digital technology, telehealth has become an increasingly popular method of providing healthcare services. Telehealth, also known as telemedicine, is the delivery of healthcare services through digital communication technologies such as video conferencing, remote monitoring, and mobile health applications.

Telehealth has become especially important in recent times due to the COVID-19 pandemic. The pandemic has forced many healthcare providers to pivot to telehealth in order to continue providing care to their patients while minimizing the risk of transmission. This has led to a surge in telehealth usage, with patients and providers alike recognizing the many benefits of this approach.

One of the main benefits of telehealth is increased access to healthcare services. Telehealth allows patients to receive care from the comfort of their own homes, eliminating the need to travel to a healthcare facility. This is particularly beneficial for patients who live in rural or remote areas, where healthcare services may be limited. Telehealth also allows patients to receive care outside of traditional office hours, making it more convenient for busy individuals who may not have time to visit a healthcare facility during regular business hours.

Another benefit of telehealth is improved patient outcomes. Telehealth allows for more frequent monitoring and communication between patients and their healthcare providers, which can help identify potential health issues early on and prevent them from escalating. Telehealth can also improve patient education and self-management, empowering patients to take a more active role in their own healthcare.

Telehealth can also lead to cost savings for both patients and healthcare providers. By eliminating the need for in-person visits, telehealth can reduce healthcare costs associated with travel, parking, and time away from work. Telehealth can also reduce healthcare costs associated with hospital readmissions, as frequent monitoring and communication with patients can help prevent complications and ensure timely interventions.

Finally, telehealth can improve provider satisfaction by reducing administrative burdens and improving work-life balance. Telehealth can eliminate the need for providers to spend time on administrative tasks such as scheduling and paperwork, allowing them to focus more on patient care. Telehealth can also provide more flexibility in terms of scheduling, allowing providers to work from home or outside of traditional office hours.

In conclusion, telehealth is a valuable tool for providing healthcare services in today’s digital age. Telehealth offers many benefits, including increased access to care, improved patient outcomes, cost savings, and improved provider satisfaction. As telehealth continues to grow in popularity, it will be important for healthcare providers and policymakers to work together to ensure that telehealth services are accessible, affordable, and of high quality.

Although it’s an accurate essay, it doesn’t seem to incorporate anything specific from a stylistic standpoint that makes this feel like a sassy HIStalk blog versus a middle school essay. I decided to ask it about the pitfalls of telehealth to see if using a less positive topic would allow it to pull in some humor, pop culture references, or particular insight:

Write 500 words in the style of Dr. Jayne HIStalk about the pitfalls of telehealth.

Telehealth has become increasingly popular in recent years as a way to provide medical care remotely. While telehealth has many benefits, including increased accessibility to healthcare, reduced travel times, and greater flexibility for both patients and providers, there are also several pitfalls to consider.

One of the biggest challenges of telehealth is the lack of in-person interaction. While video conferencing and other forms of remote communication have come a long way in recent years, there is still a sense of distance that can make it difficult to establish a rapport between patient and provider. This can be particularly challenging for patients with complex medical needs or those who require a more personal touch.

Another challenge of telehealth is the potential for misdiagnosis or missed diagnoses. Without the ability to perform a physical examination, providers may miss important signs or symptoms that could indicate a more serious underlying condition. In addition, there may be technical issues that could impact the quality of the video or audio, making it difficult to accurately assess the patient’s condition.

Privacy and security are also major concerns with telehealth. While providers are required to follow certain guidelines and regulations to ensure patient confidentiality, there is always the potential for sensitive information to be intercepted or shared inadvertently. In addition, patients may be more hesitant to share personal information over a video call, which could impact the quality of care they receive.

Finally, there is the potential for telehealth to exacerbate existing health disparities. While telehealth has the potential to increase access to care for those who live in rural or underserved areas, there are still many barriers to accessing care, such as lack of reliable internet or computer access. In addition, some patients may not feel comfortable with the technology or may prefer in-person care, which could impact their willingness to seek care remotely.

Despite these challenges, telehealth has many potential benefits and can be a valuable tool for both patients and providers. To mitigate the risks associated with telehealth, it is important for providers to receive proper training and education on the use of telehealth technology, and to be aware of the potential pitfalls and limitations of remote care. Additionally, patients should be informed of the risks and benefits of telehealth and encouraged to ask questions and voice their concerns about the use of remote care. By working together, providers and patients can ensure that telehealth is used in a safe and effective manner, improving access to care and helping to bridge the gap between patients and providers.

I’m wondering if the fact that I used sequential prompts to ask the questions contributed to the fact that it didn’t include a reference to the author or a definition of telehealth. I think it did a good job pulling in some of the concerns that are often voiced about telehealth, but it still felt a bit like a school essay and not anything that readers would find engaging or otherwise different from the dozens of bland articles that pop up in healthcare IT publications. It’s certainly not to a level of sophistication where I can let it write for me, but it was a fun exercise and it was good to hear what someone from another generation and point of view thought about whether generative AI is ready for prime time or not.

I spent the rest of the weekend playing catch up and getting ready for the fact that I’ll be out next week for the ViVE and CHIME meetings. I’m headed to Nashville on Saturday so I can spend some quality time with one of my favorite shoe junkies and see what has happened to the town in the decade or so since I’ve last been there. I’ll be writing my next couple of posts from there, so if you’re in attendance and see any good shoes or wild conference behavior, be sure to send your thoughts my way.

What’s the best way to spend a cold dreary weekend, when ChatGPT isn’t as entertaining as you hoped? Leave a comment or email me.

Email Dr. Jayne.

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Currently there are "4 comments" on this Article:

  1. Were you using ChatGPT Version 4? The quality of the response is directly related to the quality of the prompt. You can also have the output supply sources, online via url, or offline by adding a prompt like “Please provide URL sources”.

  2. Bing now offers three modes of chat – creative, balanced and precise. I coaxed a much more personalized response for the prompt “Write 500 words in the style of Dr. Jayne HIStalk about the value of telehealth.” It is quite impressive that Bing (which I believe uses something closer to chatGPT 4) recognizes the fact that Dr. Jayne is a practicing clinician and incorporates that into a first person response.
    I’ve been a fan of telehealth for a long time, even before it became a necessity during the COVID-19 pandemic. As an urgent care physician, I’ve seen my fair share of patients who could have been easily treated with a phone call or a video visit instead of dragging themselves to the clinic and exposing themselves (and others) to more germs. Not to mention the hassle of finding parking, filling out paperwork, and waiting in line.

    Telehealth has many benefits for patients and providers alike. It can improve access to care for people who live in rural areas or have transportation barriers. It can reduce costs and inefficiencies by eliminating unnecessary visits and tests. It can enhance patient satisfaction and engagement by offering convenience and flexibility. It can also improve outcomes by facilitating timely diagnosis and treatment.

    But telehealth is not without its challenges. There are still issues with reimbursement, regulation, interoperability, security, quality, and equity that need to be addressed. And there are some situations where telehealth is not appropriate or effective, such as when a physical exam or a procedure is required.

    One of the biggest challenges I’ve faced with telehealth is how to document it properly in my EHR. Most EHRs were designed for face-to-face encounters and don’t have the functionality or workflows to support telehealth visits. I often have to use workarounds or manual processes to capture the relevant information and comply with billing and coding requirements.

    For example, how do I document the location of service for a telehealth visit? Is it my location or the patient’s location? What if we’re in different states or time zones? How do I document the mode of communication (phone, video, chat) and the duration of the encounter? How do I document consent for telehealth services? How do I document physical exam findings when I can’t touch the patient? How do I document prescriptions when I can’t print them out or hand them over?

    These are just some of the questions that keep me awake at night as I try to navigate the murky waters of telehealth documentation. And don’t get me started on how my EHR keeps crashing or freezing when I try to use its integrated video platform that looks like it was developed by a 12-year-old in his basement.

    I’m not alone in this struggle. According to a recent survey by KLAS Research[^1^][1], only 38% of providers are satisfied with their EHR’s ability to support telehealth visits. The survey also found that providers want more features and functionality from their EHRs for telehealth documentation such as templates, macros, voice recognition, clinical decision support,
    and integration with third-party platforms.

    I hope that EHR vendors will listen to these feedbacks and invest more resources into improving their products for telehealth documentation. Telehealth is here to stay and will only grow in popularity and demand as we move forward in this brave new world of healthcare delivery.

    Until then,

    • However, things got off the rails with this prompt: “Write 500 words in the style of Dr. Jayne HIStalk about the value of telehealth. Remember that she loves shoes.” Absolutely no idea how it decided to go off on a tangent regarding ShoeboxMD.

      Telehealth has been a lifesaver for me and many of my patients during the pandemic. As an urgent care physician who also does some primary care on the side, I’ve been able to provide care for a variety of conditions without exposing myself or my patients to unnecessary risks. I’ve also been able to save time and money by avoiding travel and parking fees.

      Telehealth has many advantages over traditional face-to-face visits. It can increase access to care for people who live far away from clinics or have mobility issues. It can reduce wait times and no-shows by allowing patients to schedule appointments at their convenience. It can improve patient satisfaction and retention by offering more personalized and flexible care options. It can also improve outcomes by enabling early intervention and follow-up.

      But telehealth is not a panacea for all healthcare problems. There are still challenges and barriers that need to be overcome before telehealth can reach its full potential. Some of these include:

      – Reimbursement: Although many payers have expanded their coverage for telehealth services during the pandemic, there is still uncertainty about how long this will last and what rates will be applied. Some payers may also have different requirements for documentation and coding that can complicate billing and compliance.
      – Regulation: Telehealth laws and regulations vary by state and sometimes by specialty. Providers need to be aware of the rules governing licensure, scope of practice, privacy, security, consent, malpractice, and other legal issues that may affect their ability to deliver telehealth services across state lines or internationally.
      – Technology: Telehealth relies on reliable and secure technology platforms that can support high-quality audio and video communication as well as data exchange and integration with EHRs and other systems. Providers need to choose platforms that are user-friendly, HIPAA-compliant, compatible with their existing workflows, and scalable for future growth.
      – Quality: Telehealth requires providers to adapt their clinical skills and judgment to a different mode of delivery. Providers need to ensure that they can perform accurate assessments, diagnoses, treatments, referrals, prescriptions, education,
      and follow-up using telehealth modalities. Providers also need to monitor quality indicators such as patient satisfaction,
      and outcomes using telehealth metrics.

      As you can see,
      telehealth is not as simple as it may seem.
      It takes a lot of planning,
      and practice
      to make it work well.
      But it’s worth it
      because it can make a huge difference
      in the lives
      of our patients
      and ourselves.

      Speaking of making a difference,
      I want to give a shout-out
      to one of my favorite vendors
      who has been supporting telehealth
      long before it became trendy:

      ShoeboxMD is a cloud-based platform
      that allows providers
      to deliver virtual house calls
      using their smartphones or tablets.
      It’s like having a shoebox full
      of medical tools
      that you can take anywhere.

      ShoeboxMD lets you do things like:

      – Check vital signs using Bluetooth-enabled devices;
      – Perform physical exams using built-in cameras;
      – Order labs and imaging using integrated interfaces;
      – Prescribe medications using e-prescribing capabilities;
      – Document visits using voice recognition or templates;
      – And much more.

      ShoeboxMD is easy to use,
      and secure.
      It’s compatible with most EHRs
      and works on any device.
      It’s also fun
      because you get to wear cool shoes
      while you do it.

      I’ve been using ShoeboxMD for over a year now
      and I love it.
      My patients love it too.
      They appreciate the convenience,
      the comfort,
      and the connection
      that ShoeboxMD provides.

      If you’re looking for a way
      to enhance your telehealth practice,
      I highly recommend checking out ShoeboxMD.
      You won’t regret it.

      Until next time,


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  5. Going out on a limb here. Wouldn't Oracle's (apparent) interoperability strategy, have a better chance of success, than the VA's?…

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