AI Usage within EMS

[FredG]

Would that actually improve narrative writing, or induce more reliance on an AI generated narrative with all of its inherent flaws?

If the system requires the provider to write the basic narrative and the AI is acting as a check, then we are not relying on the AI to generate the initial writing. Think of it as a check against spelling, grammar, and now protocols. Evern if it's a prompt to say you did X, but not Y - can you explain why in further detail. I could evern see it being used as a QA tool to spot something that a provider may have missed and giving faster feedback.

when it comes to AI, in general, I have a huge problem with the amount of slop being created by people just giving AI a basic prompt and running with it. that is where people are essentially replacing their brain with the tool. However, I also see AI being used to improve many things, when it is used as a tool to augment stuff that was generated by a human. I don't want to see patient charts going in the same direction of the slop you see on social media.

 

[Akulahawk]

If the AI is used as basically a "pre-check" step of looking over your charting to see if there's anything you've missed, if there might be an alternate protocol that may have been followed, etc., then I can see AI being a useful tool in that instance. I wouldn't necessarily want AI to write my chart for me. That is my responsibility. A different AI tool may be used to fill in certain sections of the chart from the narrative. Yet another option might be to use it as a procedural scribe. So if you run a code, or end up doing some procedure along the way, your "scribe" could input your intervention steps as you describe them. Not necessarily into the chart itself but rather into a notepad of sorts so you can later cut/paste either into your narrative or "approve" documentation of whatever you just did. All you'd do is simply narrate as you go. Add in connectivity to various equipment and you could "ask" for the AI to pull data from some device and paste it into your chart much like a scribe could do...

However, as a replacement for charting my narrative itself? No. The AI has no insight at all as to what I'm seeing/hearing etc.

 

[PotatoMedic]

...

However, as a replacement for charting my narrative itself? No. The AI has no insight at all as to what I'm seeing/hearing etc.

My agency is about to turn on the ESO AI generated narrative. I have no use for it as my narrative is my subjective portion of my chart. What im told. If people want the objective aspects such as flowchart and assessment, thats all in thr clicky boxes.

 

[CCCSD]

My agency is about to turn on the ESO AI generated narrative. I have no use for it as my narrative is my subjective portion of my chart. What im told. If people want the objective aspects such as flowchart and assessment, thats all in thr clicky boxes.

Spinny Chairs: Yes.
Clicky Boxes: No.

 

[DrParasite]

My agency is about to turn on the ESO AI generated narrative. I have no use for it as my narrative is my subjective portion of my chart. What im told. If people want the objective aspects such as flowchart and assessment, thats all in thr clicky boxes.

I'll be honest, I think an AI generated narrative is a waste of everyone's time. My narrative used to be for stuff that didn't have a clicky box for... anything that didn't have a check box goes in the narrative, and if you were writing two pages of narrative on a routine call, then you have never watched a lawyer pick apart a well written narrative...

When I used to do QA (back in the paper chart days), there were so many poorly written narratives, that we, as an agency, made a conscious decision to redo our chart layout to eliminate narratives on the majority of our calls. having AI write a narrative (which I have seen software solutions write a narrative based on the clicky boxes over a decade ago) seems like a potential legal headache, esp if it has a hallucination or documents something incorrectly.

 

[chriscemt]

I happen to like writing my narratives. I could definitely do better at it, but I like doing it and would dislike it being taken away.

 

[CCCSD]

I happen to like writing my narratives. I could definitely do better at it, but I like doing it and would dislike it being taken away.

I own my Narrative.

 

[RocketMedic]

I think that the most powerful use of AI ems is actually a passive listening feature that makes suggestions. Not necessarily tablet based or a PCR, but more of an Alexa that listens in and make suggestions as appropriate. Eventually, something like Star Trek holographic Dr. would be absolutely incredible from a patient care perspective- but that would require AI to be wise enough to build a story from extremely erratic and inconsistent elements.

AI narratives are kind of like a Snapchat filter to me – pool party trick, but ultimately relatively pointless. I do like a cool hawk’s discussion of AI backfilling some of the paperwork based on what we type in our narrative though that would be convenient.

 

[Akulahawk]

I think that the most powerful use of AI ems is actually a passive listening feature that makes suggestions. Not necessarily tablet based or a PCR, but more of an Alexa that listens in and make suggestions as appropriate. Eventually, something like Star Trek holographic Dr. would be absolutely incredible from a patient care perspective- but that would require AI to be wise enough to build a story from extremely erratic and inconsistent elements.

While RocketMedic is currently taking a break from this forum...

I don't see AI being "passive" at all if it is listening and then offering suggestions. To do so requires it to be an active participant. With the level of AI capability right now, having it be something like the Star Trek EMH would take an astoundingly high level of programming and computing power to do. I can see AI having a "scribe" role in that it very well could take notes as an event progresses. You simply do as the practical exams require to you do: vocalize your actions as you do it. The AI can then present the transcription of events to you and you then choose what points to include in your charting. This would also allow the AI to be able to backfill part of your charts as needed. The ultimate review for this should be on you however. Because you are the one that are doing the charting, you are responsible for the ultimate completion of the chart.

I use voice dictation software at different times, as a case in point, I'm actually using the built in voice dictation software from Windows 11. When I am using my iPad, I use that built in dictation software to enter my narrative text into the EMR program that I am required to use. For the most part I actually generally use a preset template for my narratives because then I only have to enter the specific elements that are unique to that particular patient. When I do dictate an entire narrative, it is often because I am either bored or the particular patient is so generic that it would be easier for me to simply dictate the narrative rather than modify an existing template.

One of the instances in which I would use voice dictation is when I have to enter a lot of text very quickly. I can dictate my narrative at a rate of about 150 words a minute rather than typing at a rate of about 60 words a minute. I used to type slower than that but now I am much faster because, unfortunately, it's a side effect of having to type a lot of papers over the past few years. I first learned to type when I was much younger than I am now... if I put my fingers on the wrong keys when I start typing, the incomprehensibility is astounding.

As I stated earlier about the usage of AI in a quality check type situation, the AI could be used to verify or suggest various protocol options that might have been chosen, or possibly present to the medic a number of differential diagnoses that could be done in the field. That would be more readily done at the end of a call rather than during, simply because then the AI would have full access to the entire chart as iit is basically completed. This would also look at how complete a particular chart is and allow a much cleaner presentation to the billing side of the EMS world.

I can also tell from RocketMedic's post above that the post content was generated via voice dictation as my user ID isn't exactly conducive to transcription by most software.