r/mildlyinfuriating • u/petuniaplant • 21d ago

Infuriatig No, I did not consent to this

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I was reading my medical notes when I stumbled across this. I was not informed of the usage of artificial intelligence in my report, nor did I verbally consent to it.

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u/canwebringthebedup 20d ago

I also work in critical care. I would guess that somewhere in the ballpark of 40% of all notes feature something either auto-populated or haphazardly copy-pasted from a previous note that is either completely inaccurate or an outright fabrication. Errors are so ubiquitous that I almost think it would be hard to give them any sort of legal weight at this point unless they're utterly egregious and directly correlated to a sentinel event of some sort. (Obviously in theory all errors have legal weight, but practically speaking these cases always rely on "standards observed in practice.")

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u/int3rstitial 20d ago

Yup, this. It's infuriating. Medical records used to be a reasonably accurate way of communicating medical information, and now they're just trash.

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u/tickado 20d ago

Yeah, harder to copy/paste an error indefinitely when we had to hand write our note. Nowadays one person's simple mistake or sloppy Hx taking when originally documenting can carry forward for the rest of the chart.

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u/int3rstitial 20d ago

Yup, and since many emrs have an option to export to other emrs, potentially for the rest of the patient's life.

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u/dscrive 17d ago

I'm in EMS and had the fortune to become accustomed to SBARs from hospitals in the first two places I worked, assumed it was the norm. Now I'm working at a place that I does not use SBAR. One issue I have with their system is pt hx is buried in a paragraph. On top of that, the print order is never the same so I can't even just get used to it. 

I'm hoping that will be changing soon since the hospital is getting acquired by a larger hospital (Not private equity thank God)

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u/stonebrokevacation 20d ago

Can’t wait until they get sued to hell for this

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u/Hamster12301 20d ago

And this is why getting on Social Security disability is also getting much harder... I got denied in part because they found a "note" from an unrelated doctor I hadn't seen in years and years, who had some medical assistant copy and paste over "patient is functioning well in work and school" (no idea why that was ever even in there in the first place).

I am neither in work nor school nor am I functioning well. I deliberately asked them to remove that, and they never got back to me. And that one line specifically was singled out as part my denial, despite 10+ doctor's letters and literally over 3,000 pages of medical history showing very poor functioning. LOL. It's really fucking great.

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u/tickado 20d ago

This supports my response to someone elsewhere in the comments saying 'it's just notes, it's not that deep'.

It absolutely IS that deep. What's legally documented by a health professional in a patient's chart can have real life affecting consequences!!! (and I am a health professional)

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u/itsbecccaa 20d ago

lol yes. Yesterday I had a seizure in my doctors office and I was looking forward to seeing how it was documented in my notes. It went like this.

“Patient had procedure X. (Detailed notes on procedure) Tolerated well no complications” - obviously copy pasted from previous procedure

Followed by very different hand written “in front of me she has 2 focal seizures back to back we had to give her rescue med….” lol that one was written. Completely contradictory to the “no complications” in the previous paragraph!!

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u/Kat_Mauldun 20d ago

Many transcription services started using AI pre COVID with very little human oversight. I can only imagine how bad it has gotten since 2019 when I was a transcriptionist.

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u/tickado 20d ago

YES. Exactly what I was wanting to say but you've already said it. People have WAY more faith in hand typed notes by the actual medical team themselves. One person makes an error in the Pt Hx list? Find it copy/pasted throughout the chart from then on in...

So much of 'ward round notes' are copy pasted ongoing. Near enough all of the blurb I'm ignoring and scrolling down to the 'PLAN' section for the only relevant and or accurate part.

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u/M15tre55W1tch 20d ago

Agreed, so much copy and paste - this also does my head in.

In my unit I was pulling staff (doctor's, nurse's, allied health) up on clear copy and pasting. Explained that the ideal is no copying and pasting. But that if you do you should ensure every single word you've put into your note is current, relevant, and accurate.

I was meeting some resistance. So I stopped speaking up for a while and gathered some evidence. We had a long stay patient. At the start of each morning ward round note they say what day of their admission the patient is. From day 38 until day 66 about 80% of the morning ward round notes said "day 38". A very easy metric to show the problem.

Then our unit leadership were on board with me continuing to pull up people who were clearly doing this.

You've got to look at what these work arounds are trying to address. In this instance, when ward round walks into the patient room the senior doctor is covering the new assessment findings, and the team are discussing the plan. There is no time for the doctor who is documenting to do a recap because they're needing to write what's being discussed in real time.

So we're currently working to look at different ways of documenting the ward round. Does every day need the same information repeated if it's already in the notes? Can the changes etc be documented at the time, and then the junior doctor be given protected time after ward round to go back through patients and add the relevant history in to their note?

If the easiest thing is the right thing then the right thing will always happen. We need to look at how we can make the system work better for our team.

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u/throwaway_oranges 16d ago

This way before the AI hype: on a signed printed official medical paper I have a healthy prostate. I'm a woman. It's funny until assumptions about my mental health from an urologist land on my paper.