Amazon Lets Doctors Record Your Conversations and Put Them in Your Medical Files (cnbc.com) 66
Amazon's next big step in health care is with voice transcription technology that's designed to allow doctors to spend more time with patients and less time at the computer. At Amazon Web Services' re:Invent conference on Tuesday, the company is launching a service called Amazon Transcribe Medical, which transcribes doctor-patient interactions and plugs the text straight into the medical record. From a report: "Our overarching goal is to free up the doctor, so they have more attention going to where it should be directed," said Matt Wood, vice president of artificial intelligence at AWS. "And that's to the patient." At last year's re:Invent, AWS introduced a related service called Amazon Comprehend Medical, which "allows developers to process unstructured medical text and identify information such as patient diagnosis, treatments, dosages, symptoms and signs, and more," according to a blog post. Wood said the two services are linked and can be used together. Voice-to-text transcription is one of the many areas where Amazon is battling with cloud rivals Microsoft and Google. All three companies operate speech assistants that can in real time translate spoken words and sentences and offer text translation. Businesses can use the technology in a variety of ways to weave into their applications.
[...] A big challenge for Amazon, a huge consumer company with tons of customer data, is ensuring that its health-care tools are compliant with privacy rules and regulations under the Health Insurance Portability and Accountability Act and when it comes to transcription, maintaining an extremely high level of accuracy to avoid problematic outcomes or potential liability. Imagine, for instance, if the machine learning system inputs the term "hyper" instead of "hypo," or if doctors noticed so many inaccuracies that they ended up doing the work manually anyway. Wood said the service is HIPAA compliant. He said it took a lot of work for the technology to correctly annotate the "domain specific language and abbreviations" that are common in the medical field, and added that the accuracy is very high. Amazon hasn't published research showing how its accuracy compares with other offerings, but Wood said the company hasn't ruled it out.
[...] A big challenge for Amazon, a huge consumer company with tons of customer data, is ensuring that its health-care tools are compliant with privacy rules and regulations under the Health Insurance Portability and Accountability Act and when it comes to transcription, maintaining an extremely high level of accuracy to avoid problematic outcomes or potential liability. Imagine, for instance, if the machine learning system inputs the term "hyper" instead of "hypo," or if doctors noticed so many inaccuracies that they ended up doing the work manually anyway. Wood said the service is HIPAA compliant. He said it took a lot of work for the technology to correctly annotate the "domain specific language and abbreviations" that are common in the medical field, and added that the accuracy is very high. Amazon hasn't published research showing how its accuracy compares with other offerings, but Wood said the company hasn't ruled it out.
Do not want in medical file (Score:1)
Re: Do not want in medical file (Score:2)
You know it's already at your insurance company, right? Amazon isn't necessary for this to happen.
single player (Score:2)
single player
Re:single payor (Score:4, Interesting)
I am not sure how that makes it any better or worse then what we have now.
Insurance companies are collecting more and more information about the visit than before. They entice people to join wellness programs whre they will collect more information.... Single Payor means we have one organization to complain too if they go to far. Currently, we have a slew of private companies who do their own thing.
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Re:Do not want in medical file (Score:4, Insightful)
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Bullshit. That is exactly what the HIPPA agreement you sign when you comes in allows Doctors to do. It is an agreement that allows your Doctor to use third party providers to handle your data without having to get you involved for each one. I never sign HIPPA agreements.
Re:Do not want in medical file (Score:4, Interesting)
It's spelled HIPAA and it's Federal law (along with the HITECH Act). There is no agreement to be signed. Your information may be shared with any business associates related to your care and there is no requirement to get your consent first.
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Re: Do not want in medical file (Score:2)
related to your care
Since when is Amazon/Google related to my care? Imho this is a "Trust Me" situation, TM =>FU.
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HIPPA
Not applicable in my country.
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They are ALL confidential information. I'm a doctor and I would never dream of letting a 3rd party into any sort of doctor-patient conversation. The law is very specific that the only time I can violate confidentiality is in the case of a credible threat of harm to themselves or others. It certainly is none of the business of a company who has ALREADY PROVEN they cannot keep personal information private.
So your home grown IT is going to be better at protecting this information than a service provider who specializes in it? That seems ... unlikely, at least on average.
Re:Do not want in medical file (Score:5, Informative)
1. Yahoo
Date: 2013-14
Impact: 3 billion user accounts
2. Marriott International
Date: 2014-18
Impact: 500 million customers
3. Adult Friend Finder
Date: October 2016
Impact: More than 412.2 million accounts
4. eBay
Date: May 2014
Impact: 145 million users compromised
5. Equifax
Date: July 29 2017
Impact: Personal information (including Social Security Numbers, birth dates, addresses, and in some cases drivers' license numbers) of 143 million consumers; 209,000 consumers also had their credit card data exposed.
6. Heartland Payment Systems
Date: March 2008
Impact: 134 million credit cards exposed through SQL injection to install spyware on Heartland's data systems.
7. Target Stores
Date: December 2013
Impact: Credit/debit card information and/or contact information of up to 110 million people compromised.
8. TJX Companies, Inc.
Date: December 2006
Impact: 94 million credit cards exposed.
9. Uber
Date: Late 2016
Impact: Personal information of 57 million Uber users and 600,000 drivers exposed.
10. JP Morgan Chase .https://www.csoonline.com/article/2130877/the-biggest-data-breaches-of-the-21st-century.html/ [slashdot.org]
Date: July 2014
Impact: 76 million households and 7 million small businesses
You were saying?
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That 'list' is obvious bullshit.
Each and every single one of those companies has publicly stated that they take user/consumer privacy very seriously. That said, even if there were a shred of truth to it, they've since stated it won't happen again; they promised.
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And in case you scream "those weren't medical records!"
Top October breaches by number of patients affected
10/4/19: The Methodist Hospitals, Inc., a Healthcare Provider. 68,039 people were affected by a/an Hacking/IT Incident. Emails were targeted.
10/24/19: Tots & Teens Pediatrics, a Healthcare Provider. 31,787 people were affected by a/an Hacking/IT Incident. Network servers were targeted.
10/3/19: University of Alabam
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Transcription services have been around for a long time. Most modern transcription services even to Voice to Text, with tools that codify the conversation. The question is Will Amazon do this any better than the competition? But in terms of what is being collected already, it is already happening. HIPAA is meant to prevent such data from being spread publicly or to companies that will want to upsell you or charge you extra for your condition.
I work with Healthcare data all the time. For me to do my job
Re:Do not want in medical file (Score:4, Interesting)
Not often, but there are times when you speak to your physician off the record....or just asking questions, etc...that you want to know, but may not be directly with regard to you at that time, but you still don't want it on your record, especially if the question is not directly about you, but perhaps about a loved one, etc.
I don't think that the exam room is the proper place to have legally "bugged".
Hell, it's hard enough to get patients to open up and talk and get a good diagnosis as it is currently even without the proposed threat of transcribing everything they say or do in the exam room.
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It's up to your doctor to choose to record/transcribe your conversations.
It's an ability, not a requirement.
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I just put my phone with some audio recorder on the table when i want to record the conversation, that works without sending your recording to anyone else. Great if you don't remember what exactly was said.
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Wow, great - how do you get a transcription? Also, this is for the Dr., not the patient.
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As bad as it sounds, I only tell my doctors what I want them to know. I tell them enough for them to be able to make accurate diagnoses. However with insurance companies having access to my medical records as well as anyone else that adds the terms to various disclaimers I'm forced to sign, I'm not telling them everything.
Too many people either have or can obtain access to my personal medical records. That's unfortunate but it's the reality of stored computer records.
Is this new? (Score:2)
The summary makes this sound new, but this has been around since at least the late 1990's. At that time, most doctors paid a transcriptionist to do it, but the technology to do this has bee around for a long time. I figured it was pretty common now. Is that not the case?
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Automated voice-to-text transcription is FAR from perfected. A human is still needed to type it out.
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FFS - do people not even read the summaries?
"Shop talk" = domain-specific language
He said it took a lot of work for the technology to correctly annotate the "domain specific language and abbreviations" that are common in the medical field, and added that the accuracy is very high.
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Actually, that is where dictation software does the best so long as the software knows the field. It's quite amazing to watch someone dictate something to a computer where you have no idea what the person said, but the computer got it perfectly. I read the transcript and go what is a "non-ST segment elevation myocardial infarction?"
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Dragon Systems and others have been allowing good to excellent transcriptions for years, yes. However, if you wanted to comb the data for nice tidbits, you might even pay the professionals to use your service so that you could resell those tidbits to the highest bidder.
The US protects this information, but if you're in say, Guatemala or Turkey, the data has little to no protection.
And there will be temptation in the US to attempt to somehow mine the data, or use it for law enforcement purposes-- even local
Lawsuit (Score:2)
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Somewhere in your agreement is probably something allowing them to share info for processing and storage electronically on computers with companies that do that.
As long as they adhere to HIPAA, Amazon is no different from any other such company, which have existed for decades.
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Yea Hospitals have no experience dealing with random individuals who want to sue for whatever.
You probably have already signed paperwork that would make what they are doing legal. Normally that HIPAA agreement that you sign for service means you data will be shared to groups that will work on it.
Typo (Score:2)
Ftfy
Note to self: (Score:2)
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Your signature actually doesn't matter. The HIPAA notice is just a notice and HIPAA applies either way.
https://www.hhs.gov/hipaa/for-... [hhs.gov]
"Acknowledgement of Notice Receipt. A covered health care provider with a direct treatment relationship with individuals must make a good faith effort to obtain written acknowledgement from patients of receipt of the privacy practices notice. The Privacy Rule does not prescribe any particular content for the acknowledgement. The provider must document the reason for any fai
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Soon notes, the doctor just has to remember what you talk about? That sounds good, I'm sure that won't be a problem.
No. No. No no no no. (Score:3)
Now something like Almond [stanford.edu] would be great for Doctors. Self hosted & local.
But Amazon? No.
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You're assuming that doctors are running their own IT operations today, which is not really the case. Some of the largest hospitals do have internal IT departments, but to comply with regulations you really need a specialist company to help out, at the very least with writing and maintaining the specialized software used. If you're looking at a smaller outfit like a clinic, there's pretty much no chance that they'll have their own IT, instead outsourcing it to a company that knows what they're doing.
This is
Two-party consent laws? (Score:1)
How do they handle states with two-party consent laws, where both parties to a conversation must consent to being recorded?
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What makes you think you haven't already agreed to it as a condition of having your medical insurance?
The only thing new about this is an Amazon is trying to take over yet another market. Firms that provide similar services have been around for many years, and most doctors use them because either the insurance companies or their own medical group requires it.
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It's PHI (protected health information) and is covered by the HIPAA and HITECH Act. Covered providers are allowed to share PHI with business associates related to your care. You have provided consent by seeking care; there is no additional consent needed to share information.
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HIPAA and HITECH are federal laws. State law regulates recording conversations.
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State laws vary, some are single participant, some are two-party, If you live in a two-party state the doctor will say "mind if I take notes?" And you can say yes or no.
The recording is likely only retained for quality purposes - why retain every recording? You've got the transcript.
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The purpose/intent of the recording is irrelevant.
How does Amazon's proposal fit in with two-party consent laws?
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The recording is an interim step to a transcription that resides in the doctors notes, doctors have been taking notes for years, this is nothing new, except the doctor doesn't need to take notes while talking. The transcript is part of your medical records, it's got much of the same information as your medical record already has.
Your recording and transcript are just as vulnerable as your medical records - nothing changed.
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Nothing you typed is relevant to my original question. State laws dictate who is allowed to be recorded in a conversation and every state is different. I'm familiar with doctor and medical transcription and I've never heard of an actual oral conversation between a doctor and patient being recorded in that process.
So once again, how does Amazon's proposal fit in with two-party consent laws?
My Dr uses a human medical transcriber (Score:2)
And I'm OK with that. Occasionally I'll say something to his transcriber in India (like "Hello.") What's important to me is this is clearly disclosed by the physician!
Don't Sign HIPPA (Score:2)
And this is why you should never sign the HIPPA notices your Doctors want you to sign. A HIPPA notice is an agreement that you authorize your Doctors office to use any third party they normally do business with. A right to treat document is not the same thing. HIPPA notices are nothing but you agreeing to give up your rights to authorize each and every entity that handles your data separately. Now note... the Doctos are not going to change the way they operate. They are still going to put your data into wha
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Those documents are just notices and you don't have to sign them for HIPPA to be in effect. The reason they don't bug you about it is that they aren't required to get your signature, so they can continue with business as usual even if you don't sign them.
They can already share your records with 3rd parties as outlined in HIPPA, which is pretty restrictive and also puts the 3rd parties under HIPPA restrictions as well. HIPPA also gives you plenty of recourse if something goes wrong, and the penalties for pro
Re:Don't Sign HIPAA (Score:2)
Reference:
https://www.hhs.gov/hipaa/for-... [hhs.gov]
"Acknowledgement of Notice Receipt. A covered health care provider with a direct treatment relationship with individuals must make a good faith effort to obtain written acknowledgement from patients of receipt of the privacy practices notice. The Privacy Rule does not prescribe any particular content for the acknowledgement. The provider must document the reason for any failure to obtain the patient’s written acknowledgement. The provider is relieved of the n
Not a bad idea as an idea (Score:5, Interesting)
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Cut the drama, ask for a copy of the transcript. My dr gives me a copy of his notes when I see him, no big deal.
Another thing that's illegal with the GDPR. (Score:3)
Probably the best new law we enacted in the last 50 years or so.
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Screw Amazon (Score:2)
Nothing good in this, a doctor's perspective (Score:2)
I cannot see anything good in this. The comments so far emphasize a lot of relevant concerns, many focused on not trusting Amazon (or any big tech service agency) to handle your personal data. Here are my concerns.
There is a tendency the past few decades to assume that new tech must be good, that it will improve how we do everything. (Wrong, it turns out.) So, let's use tech to automate whatever we traditionally do, like transcribing medical conversations.
In real medicine, the information we get from pa
In other news (Score:2)
Less time at the computers?? (Score:1)
They spend barely any time at the computers, excepting very detailed medical reports (as in surgery and other major medical operations) in the first place. To boot, they barely spend any time at all with patients (3 hours visit, 2.9 hours spent waiting, 0.1 hours spent seeing a doctor and dealing with billing.)
Whomever thought this up needs to actually go to a fucking doctor and see how this really works.
Is this something that doctors want? (Score:2)
Patients talk gibberish. Through a series of doctor's questions, patient's answers and expert interpretation, the doctor can write some salient notes and arrive at a differential diagnosis. I can't imagine any scenario (except for the ubiquitous "this call is being recorded for quality assurance purposes") where a doctor wants the patient's conversation in the medical record. It's simply not worth recording. Nor would it be useful for other medical professionals to replay in future medical interventions.
It'
Accuracy (Score:2)
The idea sounds rather beguiling. Then I thought about the state of machines understanding human conversations. If this record is voice to text then leave me out. If it is voice stored as voice, in the echos of a hard walled office, is the recording going to include critical sections of indecipherable and talk-over right on top of a critical point in the conversation.
I'd rather the doctor make her record and let me look it over to provide corrections where she might not have understood me.
{^_^}