EPtalk by Dr. Jayne 11/13/25

NCQA is accepting public comments on the AI standards that it is proposing for its 2027 Health Plan Accreditation and Health Plan Ratings program. Patients, health plan stakeholders, healthcare professionals, state agencies, and others are invited to weigh in as the program is being created. You have until December 5 to share your thoughts on topics such as AI program structure, governance, pre-deployment evaluation, and ongoing monitoring and intervention.

I’ve been through several NCQA recognition processes on the provider side. The staffers I’ve met are genuinely invested in improving healthcare quality and are responsive to organizational feedback.

My hospital is considering the addition of a new C-suite role, partly in response to escalating conflicts and violence against healthcare workers. There is debate around several potential job titles, but no consensus on whether the title should focus on safety or security.

A particularly vivid conversation ensued when the use of “public safety” in the title was brought up, since that mimics some state law enforcement agencies and might indicate the role has more authority than intended. Concern was also expressed that the use of “public” was more focused on patients and visitors rather than employees and caregivers. Future meetings will further discuss the role, so we’ll see where the wordsmiths land.

Earlier this week, Mr. H mentioned the Black Book Research survey on AI governance. I wanted to weigh in from the CMIO chair, although I’m not sure that I should call it a chair anymore because I’m spending more of my time lately in the clinical work areas sitting on a rolling stool that I swiped from an exam room.

One theme of the survey is that hospital budgets are underfunded for AI governance and safety, with a median 4.2% of IT quality and safety budgets devoted to AI oversight for 2026. Although that sounds like a small number, I’m curious as to what other line items are funded either higher or lower.

It’s hard to derive meaning from numbers out of context. Governance is likely a line item that scales better than others because it becomes a sustainable process after creation. It’s not like an implementation line item, which may vary dramatically across facilities or service lines as well as for applications or solutions that are being implemented.

As expected, large health systems with 10 or more facilities have a higher share of spend, but I would bet that’s because of the number and complexity of AI applications rather than the process itself. For those who have dug into the full report, I would be interested to hear your thoughts.

PerfectServe recently released a report on “The Rise of Emoji in Healthcare Communication.” From informal research via my texting app, folks from The Silent Generation and Baby Boomers are the most likely to send me messages using standard emoji. It’s hit and miss with my Millennial friends, although they tend to use a lot of GIFs. My Generation Z contacts are most likely to communicate through memes, although I do see a fair amount of photomoji use in that population, which is always entertaining.

The report recaps the use of pictographs and symbols in communication going back to 3000 BC, and highlights the pictographic elements that are already found in healthcare, such as the Wong-Baker FACES Pain Rating Scale.

It shares some interesting data points, such as an estimate of 10 billion emoji being sent every day. It also mentions Adobe data that shows that healthcare workers are losing their hesitancy around including emoji.

I’m glad it mentioned the early emoticons we once used that cobbled together colons and parentheses to look like faces. Younger generations probably find that quaint.

The authors set out to look within the PerfectServe ecosystem to see if they could identify trends in emoji use and if it could be tied to clinicians who are under stress or burned out. They concluded that rather than being potentially unprofessional, emoji were “used to convey politeness and positive intent.”

Other interesting tidbits included the “thumbs up” being the most frequently used symbol in medical communications. Internal medicine clinicians were more likely to use symbols than their peers. Other emoji making the top 10 included the “person facepalming” and the “person shrugging,” which makes me smile.

The authors also looked at explorations of emoji use in the medical literature, namely an article in The Journal of the American Medical Association (JAMA) from 2021 that cites emoji as containing “the power of standardization, universality, and familiarity, and in the hands of physicians and other health care providers could represent a new and highly effective way to communicate pictorially with patients.”

I learned that a lot of my correspondents might be confusing the “tears of joy” emoji with the “cry-laugh” one, which is fairly easy to do depending on the level of zoom in your messaging app.

The paper has a lot of other interesting information, including emoji frequency by subspecialty and day of the week. It will be interesting to see how this evolves over time. I would also like to see information on geographic variations or seasonal trends.

I’m always on the lookout for interesting uses of AI. A friend mentioned SessionKeeper, which uses ambient listening capabilities to create session summaries for tabletop role-playing games such as Dungeons & Dragons. In addition to capturing plot points and character details and building a knowledge base, it offers “story insights” that create a podcast-style analysis of play. I got a kick out of learning about the cultural background of trolls and how it can impact conversations, as well as seeing some of the AI-generated artwork.

I was pleased to see a clear data privacy statement in the FAQ, with the company clearly stating, “We’ve made sure companies like Anthropic, Google Cloud AI, and OpenAI can’t use your gaming sessions to train their systems.” 

What creative uses of AI have you seen? What do you find most useful in your non-work life? Leave a comment or email me.

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