OPINION
We are excited to introduce you to Heidi, said the email.
‘Heidi’, they enthusiastically explain, is a clinical note taker. The email informs that Heidi will provide:
1. Improved accuracy and detail
2. Enhanced focus on you (the patient)
3. Time efficiency
4. Consistency and continuity.
Heidi is described elsewhere as ‘your AI-powered medical resident’ or assistant. Using Heidi cuts out chit-chat, by automating notes and intelligently sifting and ‘separating pertinent medical details from tangential conversations’ and completes referrals in seconds. A patient’s needs however are more than physical conditions. Social, economic, mental, spiritual and empathetic factors may be overlooked. Subtle patient cues and body language could be missed.
An AI product such as Heidi sounds beneficial and has doubtless potential for addressing time pressures for the doctor and reducing burnout. More patient interfacing as the medical notes will be automated, and a higher number of patients seen, is a financial benefit for the practice and a partial answer to the question of desperate GP shortages.
Kiwis’ first point of contact for healthcare is normally their general practice. There are approximately 1,000 NZ general practices and, while they are private businesses, they are primarily government funded. Fifty per cent of our GPs have been trained overseas.
A chronic shortage of doctors is felt throughout the country, particularly in rural areas. Tele-services are being put in place instead of on-site doctors and are instructed to cover other regions due to there being no available doctors, especially at night.
Waiting times for face-to-face appointments are being stretched out further and further. Fees have risen. Some practices have closed their books to new patients. On 27 May 2024 RNZ reported that doctors fear some cancer patients will face life-threatening delays if a serious shortage of senior doctors is not fixed.
Doctors are currently very busy people.
Shirley Ross, director of clinical and care services at Oceania, an aged-care and retirement provider, recently confirms the disturbing shortage:
· NZ is 485 GPs short
· A survey of 220 general practice staff found four out of five had stopped or limited their enrollments over the previous three years (NZ Herald)
And:
· After-hours medical services in some regions are on the verge of collapse, as overworked GPs signal they can no longer provide cover, or the funding falls short. (NZ Herald)
Dr Emily Cavana, a specialist GP experimenting with AI technology to take patient notes, says it has the potential to be amazing. It also, however, raises privacy and ethical issues. Clinical notes are a medico-legal requirement, she says.
The AI note-taker I used informed me the audio is taken from my computer, through a web app transcribed by the infrastructure (housed in the US) and turned into a medical note and returned to Aotearoa [sic]. The audio is then immediately deleted, and the transcribed words are stored in the cloud for two further weeks before being deleted.
The cloud, despite its name, does not live in the sky. It is usually housed somewhere in the world, in a massive room full of electrical equipment. (Emphasis added)
Newsroom
AI still requires human surveillance and is susceptible to cyber-attacks. Some networks store large amounts of data in other countries and serious security questions are triggered. Could sensitive data be sold to market and be used to sell products and/or handed to pharmaceutical companies for a price?
Has NZ Privacy Act 2020 anything to say about storing personal medical information even temporarily overseas? Mistakes can be made and how are they corrected? In paper notes, an original mistake is not covered up but the correction added. Will a patient’s information be gathered for research or statistics? By whom? Will a patient’s AI vaccine status be accessed by the NZ Government?
Does Heidi capture NZ’s unique te Reo?
David Bell, public health physician and biotech consultant in global health wrote, We Reap the Harvest of Lies.
This really broke in the past four or five years. We were already in trouble, but now public discourse is broken. Perhaps it broke when governments elected to represent the people openly employed behavioral psychology to lie to their constituencies on a scale we had not previously seen. They combined to make their peoples do things they rationally would not; accept bans of family funerals, cover faces in public, or accept police brutality and the isolation and abandonment of the elderly. The media, health professionals, politicians, and celebrities all participated in this lie and its intent. Virtually all our major institutions. And these lies are continuing, and expanding, and have become the norm.
We are now reaping the harvest of untruth. The media can openly deny what they said or printed just months earlier about a new candidate for presidency or the efficacy of a mandated vaccine. A whole political party can change its narrative almost overnight about the fundamental characteristics of its leader. People paid as “fact-checkers” twist reality to invent new facts and hide the truth, unflustered by the transparency of their deceit. Giant software companies curate information, filtering out truths that run contrary to the pronouncements of conflicted international organizations. Power has displaced integrity. (Emphasis added).
Brownstone Institute
Informed consent was recently unlawfully abandoned by GPs. Instead, a harvest of lies was told, as an unsafe and ineffective Covid-19 jab was thrust into their trusting arms. People are now wary of what their GP tells them. Power has displaced integrity in the eyes of thousands of Kiwis. Healthcare providers must be required to explain AI to a patient in a way they can understand. Patients need to be informed about what happens to their personal or sensitive medical information?
Artificial intelligence is changing the GP-patient relationship. Soon it may be possible to have an online chat to a ‘listening’ global computer. The need of a human general practitioner could possibly become obsolete. And perhaps, in the end, that is the plan.
