this post was submitted on 16 Feb 2024
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As a medical doctor I extensively use digital voice recorders to document my work. My secretary does the transcription. As a cost saving measure the process is soon intended to be replaced by AI-powered transcription, trained on each doctor's voice. As I understand it the model created is not being stored locally and I have no control over it what so ever.

I see many dangers as the data model is trained on biometric data and possibly could be used to recreate my voice. Of course I understand that there probably are other recordings on the Internet of me, enough to recreate my voice, but that's beside the point. Also the question is about educating them, not a legal one.

How do I present my case? I'm not willing to use a non local AI transcribing my voice. I don't want to be percieved as a paranoid nut case. Preferravly I want my bosses and collegues to understand the privacy concerns and dangers of using a "cloud sollution". Unfortunately thay are totally ignorant to the field of technology and the explanation/examples need to translate to the lay person.

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[–] Boozilla 14 points 9 months ago* (last edited 9 months ago) (1 children)

Will they allow you to use your own non-cloud solution? As long as you turn in text documents and they don't have to pay a person to transcribe, they should be happy. There are a number of speech to text apps you can run locally on a laptop, phone, or tablet.

But of course, it's sometimes about control and exercising their corporate authority over you. Bosses get off on that shit.

Not sure which type of doctor you are, but there's a general shortage of NPI people. I hope you can fight back with some leverage. Best of luck.

[–] [email protected] 11 points 9 months ago* (last edited 9 months ago) (2 children)

It will not be possible to use my own software. The computer environment is tightly controlled. If this is implemented my only input device to the medical records will be the AI transcriber (stupidity).

I'm a psychiatrist in the field of substance abuse and withdrawal. Sure there's a shortage of us too but I want the hospital to understand the problem, not just me getting to use a old school secretary by threatening going to another hospital.

[–] Boozilla 5 points 9 months ago (1 children)

I was afraid that might be the case. Was hoping they would let you upload the files as if you had typed them yourself.

Maybe find some studies / articles on transcription bots getting medical terminology and drug names wrong. I'm sure that happens. AI is getting scary-good, but it's far from perfect, and this is potentially a low-possibility-but-dangerous-consequences kind of scenario. Unfortunately the marketers of their software probably have canned responses to these types of concerns. Management is going to hear what they want to hear.

[–] [email protected] 4 points 9 months ago (1 children)

Thaks fot he advice but I'm not against using AI-models transcribing me, just not a cloud model specifically trained on my voice without any control by me. A local model or more preferrably a general local model woulf be fine. What makes me sad is that the persons behind this are totally ignorant to the problem.

[–] Boozilla 3 points 9 months ago (1 children)

I understand, and we're basically on the same page. I'm not fully anti-AI, either. Like any tool, it can be used for good or evil. And you are right to have concerns about data stored in the cloud. The tech bros will mock you for it and then.... oh look, another data breach has it been five minutes already. :)

[–] [email protected] 1 points 9 months ago (1 children)

Yes I agree. Broadening the scope a little, I frankly just wait for a big leak of medical records. The system we use is a birds nest of different softwares, countless API:s, all sorts of database backends. Many systems syem from MS-DOS, just embedded in a bit more modern integrated environment. There are just so many flaws and I'm amazed a leak hasn't happened (or at least surfaced) yet.

[–] Boozilla 2 points 9 months ago (1 children)

Do we work for the same place? 😆

[–] [email protected] 2 points 9 months ago (1 children)

I take this as humour - I understand my situation and IT suite isn't more insecure than many others :)

[–] Boozilla 2 points 9 months ago

Yes, I was trying to be funny. The place where I work has a goulash of mismatched old and new software, too.

[–] [email protected] 3 points 9 months ago (1 children)

my only input device to the medical records will be the AI transcriber

I understand that you keep steering away from legal arguments, but that can't be legal either. How could a doctor not have direct, manual access to patient records?

Anyway, practical issues:

You need some way to manually interact with patient records in the inevitable event the AI transcription gets it wrong. It only takes one time messing up transcription on something critical and you have a fucking body on your hands. Is your hospital prepared to give patients the wrong dosages because background noise or someone else speaking makes the AI mishear? Who would be held responsible in the case of mistreatment due to mistranscription? Is your hospital willing to be one of the first to try and tackle that legal rats nest?

A secretary is able to do a sanity check that what they heard make sense. AI transcription will have no such logic behind it. It will turn what it thinks it heard into text and chuck it wherever it logs to. It thinks you've called for leeches when you said something about lesions? Have fun.

Whenever there's an issue with the transcription service you'd be screwed too. That could mean network outage, power outage, microphone breaks, any part of this equipment breaks, and this whole system falls apart.

[–] [email protected] 2 points 9 months ago

The problem with incorrect transceiption exists with my secretary too. In the system I work in the secretary write my recordibg, sends it to me, I read it. I can edit the text at this point and then digitally sign it with a personal private key. This usually happens at least a day after being recorded. All perscriptions or orders to my nurses are given inannother system besides the raw text in the medical records. I can't easily explain the practical workings but I really don't see that the AI system will introduce more errors.

But I agree that in the event of a system failure, there will be a catastrophic situation.