EPtalk by Dr. Jayne 7/20/23

There’s not a day that goes by that I don’t see an article or hear commentary about how AI is going to somehow cause the end of the world. Earlier this month, it caused plenty of chaos at Gizmodo, when an AI-created story about Star Wars hit the virtual presses.

The author, “Gizmodo Bot,” created a work about the chronological order of various installments in the Star Wars franchise. A deputy editor who performed an initial review found 18 issues with the story, including elements being out of order, missing, or incorrectly formatted. He also took issue with the fact that the story didn’t include a disclaimer that it was AI-generated except for the byline. I found it interesting that the story was written using both ChatGPT and Google Bard.

Gizmodo staff commented: “I have never had to deal with this basic level of incompetence with any of the colleagues that I have ever worked with… If these AI [chatbots] can’t even do something as basic as put a Star Wars movie in order one after the other, I don’t think you can trust it to [report] any kind of accurate information.”

As much as many of us share concerns about using AI in healthcare, using it in news might be even more worrisome. Although this certainly wasn’t a hard-hitting news article, it deals with subject matter about which there are a number of authoritative resources and its chronology is undebated. When you consider other subject matter where things might not be so clear (such as when there are consensus recommendations, expert opinion, and data from clinical research that might not always agree), the stakes are higher.

Still, I got a chuckle out of a description of employee feedback that was delivered in a Gizmodo Slack channel. A company comment about future use of AI received “16 thumbs down emoji, 11 wastebasket emoji, six clown emoji, two face palm emoji, and two poop emoji,” according to screenshots provided to media. Here’s to employees who feel comfortable speaking their mind.

Following a recent change to Utah law which allows pharmacists to prescribe birth control, Intermountain Health has launched a virtual care program to serve the state’s women. After a virtual visit, patients can receive prescriptions for contraceptive pills, patches, or rings. Medications can be mailed directly to patients. The $20 virtual visit fee makes it an economical care option for many. Utah joins 24 other states plus the District of Columbia in allowing pharmacists to have prescriptive authority for birth control.

The hot topic around the virtual water cooler this week was the Freed AI-driven virtual scribe service. They must have done a major marketing push because several people had heard of it and a couple were checking it out. They advertise 20 free visits with no credit card required for signup, and an ongoing price of $99 per month for unlimited visits with no lead time for cancellation. They also offer discounts if you are an “in-debt resident or facing financial challenges.” The solution says it will place all the documentation — including notes, pended orders, and after-visit summaries – into “your favorite EHR” for review and signature.

I’ve seen enough virtual scribe services to be at least a little skeptical, especially given the pricing. If you know more about Freed, or if you’ve given it a test drive, let me know. I’ll be happy to run your anonymous thoughts and impressions.

CMS has opened a call for public comments on MACRO cost measures. The 12 measures have been part of the Merit-based Incentive Payment System since the 2020 performance year and CMS is considering a comprehensive reevaluation. The survey  is open until July 21 at 11:59 p.m. Eastern and is divided into two sections covering cross-cutting questions and measure-specific questions. All questions are optional, which is nice for those of us who might not have the time to go through the entire thing or for those who just want to give specific feedback about a particular measure that applies to their specialty or subspecialty. CMS is using a survey partner to make recommendations on whether there should be changes, although the ultimate decision belongs to CMS.

I was intrigued to learn about the Alcohol Capture app that is designed for patients to capture 14 days of alcohol consumption data for research purposes. It’s been found to be valid and reliable, and includes the drinks and sizes commonly available in its development site of Australia. I enjoyed learning that there’s a drink size called a schooner (425 mL) and also one called a middy (285 mL). Users can report their alcohol intake in real time or by responding to twice-daily notifications. Although users can see a history of their data entry dates and times, they can’t look back at the alcohol data.

Pet peeve of the week: I attend webinars for professional organizations, vendors, and educational companies. There is nothing worse than hustling around to make it to a call on time and to find an idle “welcome” screen that says, “We’ll start in 5 minutes to allow everyone time to join.” That does a disservice to those people who worked hard to be there on time. We should honor the people who are doing the right thing. Those who arrive late can wait until the recording or transcript is distributed and can catch up on their own time.

Severe weather seems increasingly common these days, and on Wednesday a tornado struck a Pfizer pharmaceutical facility in Nash County, North Carolina with reports of “50,000 pallets of medicine that are strewn across the facility.” According to the Pfizer website, the facility is one of the largest in the world for manufacturing sterile injectables, with nearly 25% of all such medications used in US hospitals being manufactured at the site. I’m sure we’ll all be on the lookout for what are likely to be shortages of anesthesia, pain management, and anti-infective medications in the coming months.

Over the weekend, I had the chance to help teach the Radio Merit Badge at a local scout camp. It’s always good to see young people showing interest in activities where they are not traditionally represented. Watching them learn that radio is the force behind a lot of the technologies they use every day was rewarding. My co-instructors included a computer science expert, an electrical engineer, and an enterprise software architect.

They had lots of questions about what exactly a physician does in the technology space. It was great helping them understand what happens behind the scenes when they seek healthcare. Our students were engaged, and although they were initially nervous about using the radio, they quickly became confident in their skills. It’s always good to help people learn new things and maybe have the chance to inspire them in a career.

What do you do in your spare time that brings you joy or makes you hopeful for the future? Leave a comment or email me.

Email Dr. Jayne.