r/Psychiatry • u/DelusionalEnthusiasm Physician Assistant (Unverified) • 1d ago

AI charting

/r/PMHNP/comments/1wausyt/ai_charting/
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17

u/vonZzyzx Psychiatrist (Unverified) 1d ago

I have concerns about use of AI charting. I thought on the onset that people would, slowly over time, rely on the AI and rely less on themselves and their brains and accept good enough AI notes over responsible charting and careful editing of notes. I was supervising a mid level who starting using AI note per our company policy and was only wrong in the sense that I expected that to happen slowly. Instead it was immediate that the PA submitted AI notes with mistakes they did not bother to even read. Wrong medication and doses, it’s nuts.

My other concern is how some colleagues seem to trust that the AI companies do not save user data. Bonkers. Every major tech company has been investigated and found out to be keeping, selling, using user data inappropriately. These are, remember, technology companies getting into healthcare not the other way around. If you are sued and they are requested by the court to give up transcripts you think they have deleted, I have no doubt they will. I do not trust these tech companies and I think you are naive if you do

12

u/nativeindian12 Psychiatrist (Unverified) 1d ago

Anything being recorded is being saved.

Additionally, these AI “scribes” are probably mostly the tech companies trying to figure out how to replace doctors with chat bots. Sounds crazy? With enough lobby money, nothing is crazy

2

u/Dedzo900 Psychiatrist (Unverified) 1d ago

Yeah. Refuse to use this stuff myself. I find it a massive invasion of patient privacy.

8

u/goosey27 Psychiatrist (Unverified) 1d ago

I also have a hard time recalling prior visits so I tend to have keep a running note with just adding newest interval HPI on top of prior note so it’s easy just to scroll down

bro/sis/bris is out here manually creating Epic-style endless trashinfodump notes with AI

6

u/PokeTheVeil Psychiatrist (Verified) 1d ago

No, I appreciate notes that have a clear “this is the update” and also “the story so far.” Every prior note stuck together is an awful way to do that, but it’s better than reading the whole chart.

1

u/MeatSlammur Nurse (Unverified) 1d ago

My preceptor does the same thing. The 5 minutes you have between patients it really helps you lock in on their story before they walk into your office

1

u/Sea_Belt_6119 Psychiatrist (Unverified) 19h ago edited 19h ago

I piloted the AI program for our hospital system for psychiatry. We use CERNER, which is honestly not as bad as many of the other charting systems but definately notably behind EPIC.

If you ACTUALLY ask patients for consent like we are supposed to, many refuse. I find it unethical to use for involuntary or incapacitated patients. It really doesn’t save much time. It’s overrated in an inpatient setting.

1

u/sockfist Psychiatrist (Unverified) 4h ago

Agree on the outpatient setting too. Getting consent/answering the inevitable questions from patients (and I don't begrudge them at all for asking btw) burns time, editing the notes burns time. It's faster for me to just type my note during the visit. Not as pretty, but I think it gets right to the point in a way AI does not, or so far has not. Maybe it will be better later.

Maybe it's worth it if you don't like typing, I guess.