EPtalk by Dr. Jayne 8/15/24

Bain & Company recently released study findings looking at how patients perceive generative AI in healthcare. Long story short is that patients are more comfortable with AI tools taking notes during office visits or supporting analysis of radiology images. They’re less comfortable with AI running payer or provider call centers, and they’re least comfortable with AI providing medical advice, treatment plans, and prescriptions.

The authors of the piece also provided their opinions about the patient-physician relationship, which I found interesting since they differ from what I’ve seen in my own practice the last several years. In my community, we’ve seen a rise in transactional healthcare, where patients don’t seem to have a preference for seeing their own physicians and where they tend to place more value on being seen quickly or at a time that is convenient to them.

The authors feel that especially with telehealth, “the value of the relationship has prevailed,” with the majority of patients using telehealth only with their own existing providers. They also note that nearly equal numbers of physicians and patients (76% and 78%, respectively) see telehealth as complementary to in-person care, with only a small percentage eyeing it as a replacement. I suspect that varies dramatically depending on whether we’re talking about primary care or subspecialty care and the type of services that are being offered.

At my primary care physician’s office, the next available well visit for an established patient is in November 2025. The next available problem-oriented visit for an established patient is in November 2024. When you’re looking at wait times like that, I’d take telehealth as an alternative any day.

An article I read about single sign-on (SSO) technology resonated with me given the different environments in which I work. One organization has a robust SSO implementation and I literally enter zero passwords. We have card-based and biometric-based authentication, so regardless of what application I need to use, I’m good to go as long as I’m appropriately accessing the workstation.

Another facility has a hodgepodge of security solutions and I have to log in to the network then Citrix (fortunately with the same password) and then to the EHR separately. From there, I have to use different passwords to access clinical decision support tools, formulary information, and clinical quality measures dashboards. C’mon folks – if you want to make your end users’ lives easier, please implement SSO. Having all those different password entry points isn’t going to prevent you from being hacked and it doesn’t make you safer because it leads to people writing down passwords. Trust me.

From My Cousin Vinnie: “Re: the mouse. Did you see this article about the future of the mouse as a computing accessory?” I had just come home from the office supply store with a brand new mouse in hand when I saw this email. I’ve used a touch screen laptop for the last six years, but none of my company-issued devices are touch screen and I wanted a smaller mouse for travel. I have Raynaud’s Syndrome, and depending on the symptoms, a typical laptop touch pad doesn’t always work for me, despite the assurance of my health system’s ergonomics team that there is no technical explanation for what I observe, and that it should be working regardless.

The article quotes mouse giant Logitech’s CEO about a futuristic concept in which the mouse is a high-end accessory that you use forever “like a Rolex” with the benefit of periodic software updates. I’m not sure about the rest of you, but I’ve had my current desktop mouse for over a decade, which is just about an eternity in tech circles. I think I paid 40 bucks for it, so even if I had to buy two or three in a career, it’s going to be a hard sell to try to get me to purchase a premium product. Interestingly, the article notes that despite the CEO’s comments, a spokesperson for Logitech said that the so-called ‘forever mouse” is not actually on the product road map.

From Willie Nelson: “Waymo chaos. I couldn’t help but think of the lyrics to ‘On the Road Again’ after reading this piece about autonomous taxis going bonkers overnight in San Francisco.” The article describes a situation where Waymo’s driverless taxis converge on a parking lot, creating a situation for which their software isn’t optimized. The cars end up confused and begin honking while struggling to enter and exit parking spots. Residents of adjacent buildings note that it’s been happening repeatedly over the last few weeks, leading to sleep disruptions. A Waymo spokesperson is quoted as saying that they are “aware that in some scenarios our vehicles may briefly honk while navigating our parking lots. We have identified the cause and are in the process of implementing a fix.” Time will tell how proficient their coders are and how good their quality assurance process really is.

I was reminded the other day that if I am going to be doing contract IT work for the local health system in the coming months, I’ll need to show proof of influenza vaccination. They’ve had policies in place that address mandatory flu vaccines for more than 15 years, but I haven’t seen anything yet on what the policies will be for COVID vaccinations this season. It was particularly timely because I also saw this public health article today in JAMA Network Open that looked at how vaccine mandates impacted vaccine uptake among US healthcare workers. The authors looked at a sample of 31,000 healthcare workers across the US. Not surprisingly, they found that state vaccination mandates correlated with increased vaccine acceptance among healthcare workers.

We’re experiencing a COVID surge in our area, fueled partly by a contingent of individuals who attended a national youth rally on a college campus. The close quarters of tour buses, college dorms, packed arenas, and group breakout sessions created many exposure pathways, and according to those who attended, masking was nearly non-existent. I think we’ve been in a relative period of quiet with COVID and people have stopped thinking about it and their risks of exposure when they’re in large groups with crowded conditions, and it’s probably time to think about that again.

I’ve had several important work and family events lately that I don’t want to risk being sick for, so I’m typically one of the handful of people on planes who are masking. I just gave some N-95 respirators to a friend who was picking up two hospitalized elderly relatives at discharge, so it’s always good to have some supplies on hand and enough to share.

Has your institution announced COVID vaccination policies for the fall or are they sticking with only influenza requirements for now? Leave a comment or email me.

Email Dr. Jayne.