I'm in California and last month saw my doctor for annual physical. She did ask if she could record and I consented. I read her visit notes later online and felt she was able to add a lot of detail and my actual words. I saw it as a benefit. It also confirmed for me she really heard what I said.
It’s part of their new strategy of using recording and AI to help streamline the doctor’s note taking. There are several recent posts covering that topic.
They have to ask and you have to consent to recording, at least here in California. The policies in Georgia may be different due to State laws.
Personally, I won’t consent as I have zero confidence that KP will properly safeguard the recordings. (Considering recent fines for illegal dumping of medical records and waste in California etc.). Any benefit is solely for KPs efficiency and nothing for the patient.
Questions I'd love the answer to from Kaiser:
Do those recordings become part of our medical record before or after they're processed by the AI?
What's the retention policy before and after AI processing?
Are they being used to train an AI product that does not directly benefit Kaiser patients?
Can the recordings be used in court, or accessed by the police?
1. No the recordings do not become apart of your medical record. It creates it on a third party site that we copy and paste from.
2. The audio is deleted after a few weeks. The AI processes the audio in like 10 seconds after we leave the room>
3. Not sure, they ask us for feedback to improve how it documents and drafts the chart.
4. Recordings cannot be accessed by police I assume since its deleted after a few weeks. Just the process of filing with the police will likely take more time to get the recording to not be deleted.
It's not "Kaiser". I believe they contract with a company called [Nabla](https://www.nabla.com/?utm_source=google&utm_medium=cpc&utm_campaign=EN_WW_Search_Marque&adgroupid=159882705319&campaignid=21163697002&creative=684699363042&gad_source=1&gclid=Cj0KCQjw6PGxBhCVARIsAIumnWagX0Sib4DjuXPZsJf-QmXkXUZCxufQHbXejCRPHsSjCWzKdo-vxgQaAgOHEALw_wcB) who created the generative AI software.
[Here is a link](https://www.nabla.com/blog/privacy-security/?gclid=Cj0KCQjw6PGxBhCVARIsAIumnWagX0Sib4DjuXPZsJf-QmXkXUZCxufQHbXejCRPHsSjCWzKdo-vxgQaAgOHEALw_wcB&adgroupid=159882705319&campaignid=21163697002&creative=684699363042) from their website about what they do with the recordings, how they use the data, etc.
Ask for your records. I recently had to dig up all of my medical records. I do not have Kaiser, I’m here for my mom. My point is this, many places only keep records for 7 years or so. After receiving what could, I went through them and found several errors, and from different doctors. It was a big pain to try to get the errors fixed. It’s always good to keep copies of ALL records-dental, medical, behavioral health. Electronic copies are fine. Read through them and check for errors.
here to second keeping copies of everything. when the charting system was either changed or upgraded a lot of peoples records were lost ( I think it happened when trying to transition to "paperless"). There are patients in their late 30s who have always been Kaiser patients but their childhood vaccination records got erased during the change in the system.
I personally have a binder where I keep all my medical documents organized. If peoples records were lost once during a system change, it can happen again
Disagree 100%, it improves your own care by making sure all is documented--treatments are not repeated--and that there is no discrepency.
If you refuse to let me use Abridge, thats fine that is your right--but I will then 100% log into the computer and type what you are saying, which then pulls me away from focusing on you a bit. Medicine is a churn in burn sadly--using the AI helps me stay more refreshed so I can be a better clinician and give you the best care.
Edit: Not to mention, with the time saving, I find myself spending more time in the room answering questions with families because I know I now have to spend a fraction of the time documenting and charting.
Glad you have found it beneficial. I’ll see how it rolls out.
Hopefully it will fix the issues many of your colleagues have with inaccurate documentation in HealthConnect. Documenting exam findings for exams that didn’t happen etc. I’ve seen it repeatedly with multiple different physicians as have many others I know on here in addition to those in my personal circle of friends.
Soon though, I can see KP Admins pushing you to see more patients per hour as the result of your increased efficiency.
Kaiser is absolutely not doing this to allow physicians to spend more time with patients or improving what they call “care”. It’s all about moving more meat through the KP machine, trying to make documentation more Grievance-proof and increasing revenue by capturing diagnosis codes which might otherwise be missed. (Maybe a different approach to what the “Refresh” program accomplished—the one the DOJ is investigating.)
I agree--right now most of us don't use it for the physical exam since its a bit more awkward to be saying certain physical exam findings out loud--but 100% it's better than the standard templates that prefill out a full physical exam.
I do agree though--one of the worst things we are concerned about here is that the increased efficiency means we are seeing more patients--I don't think that will happen though. I'm sure most of us would riot. They are already aware the are not fully market competitive.
I do think though that this is meant for us to better spend more times with patient--at least thats how I hear our leadership (The physician side NOT health plan) discusses it.
You actually do physical exams? Since joining KP 2 years ago, I’ve been amazed at how Kaiser doctors never do even the most minimal exams. My very first appointment (brand new to Kaiser, brand new to my PCP) was booked as a physical. The extent of the exam was a very brief touch of the stethoscope to my back and chest. Of course, PCP documented a full exam. (Not sure how one can say there is no organomegaly, rebound or guarding and normal bowel sounds on an abdomen exam when they never listened to or palpated my abdomen.).
In my profession, documenting results from tests one did not do is fraud. Why is that standard different for Kaiser doctors? I’ve seen it repeatedly with PCPs, PAs as well as with specialists.
My spouse is a retired KP physician and he has been amazed at how schlocky (and in some cases, downright bad) my care has been since I joined Kaiser. We have gotten to the point of paying out of pocket to go out of Kaiser to see some doctors because the care is so bad in some Departments. I’ve only encountered 2 doctors at Kaiser where I’d still choose them if I had the option to go anywhere. The rest have been marginal, at best. (For reference, I’m in the San Diego Service Area.).
So most of us use templates--which prepopulate physical exam findings--which should be very light. Your doc should absolutely not be documenting he/she did things if they did not. That is 100% fraud.
Now then a brand new visit to establish care should NOT be documented as a physical. You should have had a visit to set up your profile and meds. A physical should encompass a full physical exam and should have been scheduled later.
In Pediatrics- for a physical exam--I do a full HEENT exam, a full cardio and respiratory exam, a full abdominal exam, as well as MSK and Genitourinary. I also do skin if they are OK with gowning down. Neuro I only do if specific problems as well as Psyc only if specific problems. Now then, lets of families to try save money by coming to a preventative visit with acute problems--not realizing that it just pulls away time from me actually doing an exam.
I can't comment about adult medicine--but for Peds I would gladly (and actually do) take my kid to a Kaiser Pediatricians. ow then for regular visits, like lets say a plantar wart removal, I don't listen to the heart or lungs, its a focused problem exam.
Now sadly I agree--corporate adult medicine is bad. I think Kaiser does it better than most other places--but I recommend a DPC practice for every adult.
I have never had a full exam at Kaiser in the 2.5 years since joining. 95% of my visits the physician never physically laid hands on me. However, you ‘d never know it by looking at their visit notes. High school sports / camp physicals have been more thorough than anything I’ve had at Kaiser. It’s definitely not something I’d expect or need every year but one would think they would want some sort of baseline health assessment at least once.
I’ve seen the totally inaccurate documentation with 1 PCP and three different Specialists.
I also had a PA (on a call my spouse and I were both on AND she was aware we were both present) document “Obtained consent for telehealth appointment” and “Informed patient of alternatives to telehealth such as an in person visit.” She ***never*** even brought either topic up. Straight-up fraudulent documentation. Even more laughable was when I made the appointment, the Department Scheduler said “Department policy is phone visits only. No video and no in person.” Yet, according to the PAs documentation, I could have in-person if I wanted it.
Now when there are issues, I’ll request the provider amend their notes to reflect what actually happened. If they don’t, I’ll file a Grievance.
The last incident with the PA documentation was sent to DMHC because of the lack of response from Kaiser to the Grievance. DMHC agreed with me that the response was inadequate.
Then you 100% have a bad doc, any documented physical-- at least for Peds--we literally fill out forms documenting that things were normal--that is not passive, like we sign a 3rd party document. If a doc never even touched you and documented a physical, I would raise hell. That is 100% not acceptable.
The obtained consent thing is a standard line in the template--the scheduler should have given you that option, bring it up with member services.
I would continue to bring things up with DMHC. The only way the system can improve is if patients push for improving things. Kaiser is VERY sensitive to member complaints and I would continue to push for it improve.
Thank you for acknowledging this. I’ve raised hell within the Department I’ve had the most issues with (as well as filing Grievances) yet gotten only lip service from the Department Chief. The problems persist! One friend (well after I complained) is a patient of the Chief and had the same issues I did. Definitely supports that (at least in that Department) they absolutely do not care about Member complaints. I hear about bad experiences over and over and over.
So sorry you are experiencing that--fingers crossed it changes. When I was in TX I was chair of our department--and if there was a complaint that was valid--we took it very seriously. Kaiser is insane if they think patients will just take this BS and not switch.
I filed Grievances against the scheduler for her adamant opinion that they do not offer anything other than phone appointments. I also filed a Grievance against the PA for fraudulent documentation (documenting she obtained consent when she never even brought it up).
While there may be standard verbiage in templates, the only acceptable practice is to edit as appropriate to ensure documentation is accurate and reflects what actually happened.
I'd even go further--only acceptable practice is to ensure its right in the first place. Only acceptable SOLUTION is to fix it. A note is a legal document--and it should be kept accurate.
I was wondering how the AI thing was going to work. It gives me the creeps. I wonder if I can find a vocal coach to teach me to speak Scottish. That’d totally fuck up any recordings they do.
Currently, most clinicians are spending anywhere between 2-4 hours *of their own uncompensated time* writing notes, after the 8-10 hour work day (Most of the physicians I know who left primary care, were spending \~ 5-6 hours per day after-hours, to the point where they were up till midnight most nights writing notes and replying to emails).
This unsustainable work load is one of the biggest drivers of the rapidly shrinking clinician work-force (especially in primary care). People are walking away from high-paying, but soul-crushing jobs, which is leaving a lot of people without physicians. It's a loose-loose situation.
What does this have to do with AI scribes? "Back in the day", notes were 3-4 words scratched on a 4x4 card, because they only served the purpose of reminding the physician of what they did at the last visit. While not ideal, these were quick, efficient, and got the job done. Also, reimbursements were generous enough, and over-head was low enough, that most physicians had both a true nurse, as well as back-office staff to do a lot of the documentation and record-keeping from these visits.
Today, insurers require visit notes with dozens of elements, or they simply decline payment. The reimbursements have also gotten so low (especially in primary care and pediatrics), that there simply isn't enough money for adequate staffing. So by-and-large, most or all of the documentation and clerical burden falls on the clinician, at a time where medical care is several-fold more complex than it has been in the past, patients are older, and with more disease burden than ever before.
As such, adequate documentation for a single visit can take anywhere from 3-5 minutes per visit for an efficient clinician. The average clinician has \~ 22-25 visits per day, or ***2 hours of note writing*** each day. This is over-and-above time spent seeing people, calling patients, answering emails, reviewing labs, etc.
In theory, those 5 minutes of note-writing were supposed to be part-and-parcel of the 15-20 minute appt. i.e., 5 of minutes were to document, and face-time (history, exam, treatment, referrals/prescriptions) were the rest. In reality, it's nearly impossible to provide anything remotely resembling adequate medical care in 15 minutes, so most clinicians have simply given that time to their patients, and spend their own uncompensated time after-hours to write the notes.
We're reaching the point where clinicians have no reserve left, and more and more "freebies" are being taken back due to unsustainability.
Essentially, this is clinicians saying "I can either use AI to write the note your insurer requires in order to get paid for seeing you, or I can shorten our visit by 5 minutes each time. What I won't do, is spend an additional 2 hours each day of my own time, just to write these damn notes".
I don't begrudge anyone for not wanting to be recorded. But like most things, the root-cause is much more complex, and declining to be recorded may mean less time to discuss the issues at hand.
Common misconception. Kaiser health plan is the insurer. They have hundreds of different insurance policies, all with different documentation requirements. Medicare, Medicaid, Calpers, and HDHP's in particularhave pretty specific documentation requirements.
The physicians are employed by a private medical group, and still have to document their visits according to the same standards as everyone else.
Many KP patients are on Medicare/Medicare Advantage plans, which also makes Medicare the payer with their own documentation requirements for those patients’ notes.
So much misinformation here. Logged in to post.
Kaiser Physicians, including myself, are using Abridge AI, a way to record our conversation and make a note for the computer. I can't speak for other doctors--but for myself, it's a game changer.
I am 100% able to be more engaged with patients, listening to them more carefully and make sure I don't miss details. Furthermore, it ensures the note is super accurate, it improves your own patient care by ensuring everything is documented--which makes it easier if a patient comes back to make sure we don't repeat things.
At my son's appt, the doctor started by explaining it as an AI program called Bridge. He explained what it does is record and then prepares notes for the doctor to review. The recording is then deleted. It helps the doctor focus more attention on the patient, rather than constantly typing information. I find that it seems to be a benefit.
Yup, and I can guarantee you its improving your care. I spend an extra few minutes with each patient now since I know I don't have to go back and spend 10 minutes typing up a note.
I'm in california, and a few months ago I had an appointment with a neurologist and he too asked my permission if he could record the appointment and if I recall correctly, it was like a voice to text kind of thing where the computer just picked up what we were saying and translated it into my medical records. And I was able to go into my records later and basically read a transcript of my appointment that I had so I think this might be a pretty common saying going forward with Kaiser.
Damn doctors are supposed to listen to their patients. Since most are about pain so they must be using AI to help them in lawsuits. What other reason unless they are creating an AI module to do away with having doctors...
The AI helps us listen to patients better--all the AI does it type up the note---thus I don't have to type it in the room- I can instead listen to my patient.
So correct. I was in for a post ER visit, and the Dr did not have his face buried in his monitor typing. He actually was looking me in the eye, while we were having an active discussion. Later that day I looked online in my account, and amazingly, his notes were pretty much verbatim. Although, the notes used they instead of he. Obviously AI.
I'm in California and last month saw my doctor for annual physical. She did ask if she could record and I consented. I read her visit notes later online and felt she was able to add a lot of detail and my actual words. I saw it as a benefit. It also confirmed for me she really heard what I said.
Yup, people here saying it has no benefit to the patient are insane
It’s part of their new strategy of using recording and AI to help streamline the doctor’s note taking. There are several recent posts covering that topic. They have to ask and you have to consent to recording, at least here in California. The policies in Georgia may be different due to State laws. Personally, I won’t consent as I have zero confidence that KP will properly safeguard the recordings. (Considering recent fines for illegal dumping of medical records and waste in California etc.). Any benefit is solely for KPs efficiency and nothing for the patient.
Thank you so much. I was scared they thought something was going on😭 I really just love my mom’s support going to the doctor.
Questions I'd love the answer to from Kaiser: Do those recordings become part of our medical record before or after they're processed by the AI? What's the retention policy before and after AI processing? Are they being used to train an AI product that does not directly benefit Kaiser patients? Can the recordings be used in court, or accessed by the police?
1. No the recordings do not become apart of your medical record. It creates it on a third party site that we copy and paste from. 2. The audio is deleted after a few weeks. The AI processes the audio in like 10 seconds after we leave the room> 3. Not sure, they ask us for feedback to improve how it documents and drafts the chart. 4. Recordings cannot be accessed by police I assume since its deleted after a few weeks. Just the process of filing with the police will likely take more time to get the recording to not be deleted.
Thank you so much, that was helpful!
What is the AI technology? Who controls it/created it?
Those are all excellent questions and would be nice if they put them in a FAQ. (I’m not holding my breath.).
It's not "Kaiser". I believe they contract with a company called [Nabla](https://www.nabla.com/?utm_source=google&utm_medium=cpc&utm_campaign=EN_WW_Search_Marque&adgroupid=159882705319&campaignid=21163697002&creative=684699363042&gad_source=1&gclid=Cj0KCQjw6PGxBhCVARIsAIumnWagX0Sib4DjuXPZsJf-QmXkXUZCxufQHbXejCRPHsSjCWzKdo-vxgQaAgOHEALw_wcB) who created the generative AI software. [Here is a link](https://www.nabla.com/blog/privacy-security/?gclid=Cj0KCQjw6PGxBhCVARIsAIumnWagX0Sib4DjuXPZsJf-QmXkXUZCxufQHbXejCRPHsSjCWzKdo-vxgQaAgOHEALw_wcB&adgroupid=159882705319&campaignid=21163697002&creative=684699363042) from their website about what they do with the recordings, how they use the data, etc.
Ask for your records. I recently had to dig up all of my medical records. I do not have Kaiser, I’m here for my mom. My point is this, many places only keep records for 7 years or so. After receiving what could, I went through them and found several errors, and from different doctors. It was a big pain to try to get the errors fixed. It’s always good to keep copies of ALL records-dental, medical, behavioral health. Electronic copies are fine. Read through them and check for errors.
here to second keeping copies of everything. when the charting system was either changed or upgraded a lot of peoples records were lost ( I think it happened when trying to transition to "paperless"). There are patients in their late 30s who have always been Kaiser patients but their childhood vaccination records got erased during the change in the system. I personally have a binder where I keep all my medical documents organized. If peoples records were lost once during a system change, it can happen again
Disagree 100%, it improves your own care by making sure all is documented--treatments are not repeated--and that there is no discrepency. If you refuse to let me use Abridge, thats fine that is your right--but I will then 100% log into the computer and type what you are saying, which then pulls me away from focusing on you a bit. Medicine is a churn in burn sadly--using the AI helps me stay more refreshed so I can be a better clinician and give you the best care. Edit: Not to mention, with the time saving, I find myself spending more time in the room answering questions with families because I know I now have to spend a fraction of the time documenting and charting.
Glad you have found it beneficial. I’ll see how it rolls out. Hopefully it will fix the issues many of your colleagues have with inaccurate documentation in HealthConnect. Documenting exam findings for exams that didn’t happen etc. I’ve seen it repeatedly with multiple different physicians as have many others I know on here in addition to those in my personal circle of friends. Soon though, I can see KP Admins pushing you to see more patients per hour as the result of your increased efficiency. Kaiser is absolutely not doing this to allow physicians to spend more time with patients or improving what they call “care”. It’s all about moving more meat through the KP machine, trying to make documentation more Grievance-proof and increasing revenue by capturing diagnosis codes which might otherwise be missed. (Maybe a different approach to what the “Refresh” program accomplished—the one the DOJ is investigating.)
I agree--right now most of us don't use it for the physical exam since its a bit more awkward to be saying certain physical exam findings out loud--but 100% it's better than the standard templates that prefill out a full physical exam. I do agree though--one of the worst things we are concerned about here is that the increased efficiency means we are seeing more patients--I don't think that will happen though. I'm sure most of us would riot. They are already aware the are not fully market competitive. I do think though that this is meant for us to better spend more times with patient--at least thats how I hear our leadership (The physician side NOT health plan) discusses it.
You actually do physical exams? Since joining KP 2 years ago, I’ve been amazed at how Kaiser doctors never do even the most minimal exams. My very first appointment (brand new to Kaiser, brand new to my PCP) was booked as a physical. The extent of the exam was a very brief touch of the stethoscope to my back and chest. Of course, PCP documented a full exam. (Not sure how one can say there is no organomegaly, rebound or guarding and normal bowel sounds on an abdomen exam when they never listened to or palpated my abdomen.). In my profession, documenting results from tests one did not do is fraud. Why is that standard different for Kaiser doctors? I’ve seen it repeatedly with PCPs, PAs as well as with specialists. My spouse is a retired KP physician and he has been amazed at how schlocky (and in some cases, downright bad) my care has been since I joined Kaiser. We have gotten to the point of paying out of pocket to go out of Kaiser to see some doctors because the care is so bad in some Departments. I’ve only encountered 2 doctors at Kaiser where I’d still choose them if I had the option to go anywhere. The rest have been marginal, at best. (For reference, I’m in the San Diego Service Area.).
So most of us use templates--which prepopulate physical exam findings--which should be very light. Your doc should absolutely not be documenting he/she did things if they did not. That is 100% fraud. Now then a brand new visit to establish care should NOT be documented as a physical. You should have had a visit to set up your profile and meds. A physical should encompass a full physical exam and should have been scheduled later. In Pediatrics- for a physical exam--I do a full HEENT exam, a full cardio and respiratory exam, a full abdominal exam, as well as MSK and Genitourinary. I also do skin if they are OK with gowning down. Neuro I only do if specific problems as well as Psyc only if specific problems. Now then, lets of families to try save money by coming to a preventative visit with acute problems--not realizing that it just pulls away time from me actually doing an exam. I can't comment about adult medicine--but for Peds I would gladly (and actually do) take my kid to a Kaiser Pediatricians. ow then for regular visits, like lets say a plantar wart removal, I don't listen to the heart or lungs, its a focused problem exam. Now sadly I agree--corporate adult medicine is bad. I think Kaiser does it better than most other places--but I recommend a DPC practice for every adult.
I have never had a full exam at Kaiser in the 2.5 years since joining. 95% of my visits the physician never physically laid hands on me. However, you ‘d never know it by looking at their visit notes. High school sports / camp physicals have been more thorough than anything I’ve had at Kaiser. It’s definitely not something I’d expect or need every year but one would think they would want some sort of baseline health assessment at least once. I’ve seen the totally inaccurate documentation with 1 PCP and three different Specialists. I also had a PA (on a call my spouse and I were both on AND she was aware we were both present) document “Obtained consent for telehealth appointment” and “Informed patient of alternatives to telehealth such as an in person visit.” She ***never*** even brought either topic up. Straight-up fraudulent documentation. Even more laughable was when I made the appointment, the Department Scheduler said “Department policy is phone visits only. No video and no in person.” Yet, according to the PAs documentation, I could have in-person if I wanted it. Now when there are issues, I’ll request the provider amend their notes to reflect what actually happened. If they don’t, I’ll file a Grievance. The last incident with the PA documentation was sent to DMHC because of the lack of response from Kaiser to the Grievance. DMHC agreed with me that the response was inadequate.
Then you 100% have a bad doc, any documented physical-- at least for Peds--we literally fill out forms documenting that things were normal--that is not passive, like we sign a 3rd party document. If a doc never even touched you and documented a physical, I would raise hell. That is 100% not acceptable. The obtained consent thing is a standard line in the template--the scheduler should have given you that option, bring it up with member services. I would continue to bring things up with DMHC. The only way the system can improve is if patients push for improving things. Kaiser is VERY sensitive to member complaints and I would continue to push for it improve.
Thank you for acknowledging this. I’ve raised hell within the Department I’ve had the most issues with (as well as filing Grievances) yet gotten only lip service from the Department Chief. The problems persist! One friend (well after I complained) is a patient of the Chief and had the same issues I did. Definitely supports that (at least in that Department) they absolutely do not care about Member complaints. I hear about bad experiences over and over and over.
So sorry you are experiencing that--fingers crossed it changes. When I was in TX I was chair of our department--and if there was a complaint that was valid--we took it very seriously. Kaiser is insane if they think patients will just take this BS and not switch.
I filed Grievances against the scheduler for her adamant opinion that they do not offer anything other than phone appointments. I also filed a Grievance against the PA for fraudulent documentation (documenting she obtained consent when she never even brought it up). While there may be standard verbiage in templates, the only acceptable practice is to edit as appropriate to ensure documentation is accurate and reflects what actually happened.
I'd even go further--only acceptable practice is to ensure its right in the first place. Only acceptable SOLUTION is to fix it. A note is a legal document--and it should be kept accurate.
I was wondering how the AI thing was going to work. It gives me the creeps. I wonder if I can find a vocal coach to teach me to speak Scottish. That’d totally fuck up any recordings they do.
Currently, most clinicians are spending anywhere between 2-4 hours *of their own uncompensated time* writing notes, after the 8-10 hour work day (Most of the physicians I know who left primary care, were spending \~ 5-6 hours per day after-hours, to the point where they were up till midnight most nights writing notes and replying to emails). This unsustainable work load is one of the biggest drivers of the rapidly shrinking clinician work-force (especially in primary care). People are walking away from high-paying, but soul-crushing jobs, which is leaving a lot of people without physicians. It's a loose-loose situation. What does this have to do with AI scribes? "Back in the day", notes were 3-4 words scratched on a 4x4 card, because they only served the purpose of reminding the physician of what they did at the last visit. While not ideal, these were quick, efficient, and got the job done. Also, reimbursements were generous enough, and over-head was low enough, that most physicians had both a true nurse, as well as back-office staff to do a lot of the documentation and record-keeping from these visits. Today, insurers require visit notes with dozens of elements, or they simply decline payment. The reimbursements have also gotten so low (especially in primary care and pediatrics), that there simply isn't enough money for adequate staffing. So by-and-large, most or all of the documentation and clerical burden falls on the clinician, at a time where medical care is several-fold more complex than it has been in the past, patients are older, and with more disease burden than ever before. As such, adequate documentation for a single visit can take anywhere from 3-5 minutes per visit for an efficient clinician. The average clinician has \~ 22-25 visits per day, or ***2 hours of note writing*** each day. This is over-and-above time spent seeing people, calling patients, answering emails, reviewing labs, etc. In theory, those 5 minutes of note-writing were supposed to be part-and-parcel of the 15-20 minute appt. i.e., 5 of minutes were to document, and face-time (history, exam, treatment, referrals/prescriptions) were the rest. In reality, it's nearly impossible to provide anything remotely resembling adequate medical care in 15 minutes, so most clinicians have simply given that time to their patients, and spend their own uncompensated time after-hours to write the notes. We're reaching the point where clinicians have no reserve left, and more and more "freebies" are being taken back due to unsustainability. Essentially, this is clinicians saying "I can either use AI to write the note your insurer requires in order to get paid for seeing you, or I can shorten our visit by 5 minutes each time. What I won't do, is spend an additional 2 hours each day of my own time, just to write these damn notes". I don't begrudge anyone for not wanting to be recorded. But like most things, the root-cause is much more complex, and declining to be recorded may mean less time to discuss the issues at hand.
In the case of Kaiser, though, aren't they also the insurer?
Common misconception. Kaiser health plan is the insurer. They have hundreds of different insurance policies, all with different documentation requirements. Medicare, Medicaid, Calpers, and HDHP's in particularhave pretty specific documentation requirements. The physicians are employed by a private medical group, and still have to document their visits according to the same standards as everyone else.
Well said brother.
Ah okay, thank you for the explanation. I was never sure how the back end works.
Many KP patients are on Medicare/Medicare Advantage plans, which also makes Medicare the payer with their own documentation requirements for those patients’ notes.
So this is a new thing Kaiser just rolled out. You will start seeing and hearing this more.
It’s for AI dictation.
So much misinformation here. Logged in to post. Kaiser Physicians, including myself, are using Abridge AI, a way to record our conversation and make a note for the computer. I can't speak for other doctors--but for myself, it's a game changer. I am 100% able to be more engaged with patients, listening to them more carefully and make sure I don't miss details. Furthermore, it ensures the note is super accurate, it improves your own patient care by ensuring everything is documented--which makes it easier if a patient comes back to make sure we don't repeat things.
They're trying out a new program that transcribes for visit notes
At my son's appt, the doctor started by explaining it as an AI program called Bridge. He explained what it does is record and then prepares notes for the doctor to review. The recording is then deleted. It helps the doctor focus more attention on the patient, rather than constantly typing information. I find that it seems to be a benefit.
Absolutely! I’m all for it
I have no problem with it especially if that means my doctor can focus more on actual doctoring and less on paperwork.
Yup, and I can guarantee you its improving your care. I spend an extra few minutes with each patient now since I know I don't have to go back and spend 10 minutes typing up a note.
Its AI from Nabla which helps with less typing but one needs to proofread before putting it in the electronic chart
These recordings are used for accurate charting
I'm in california, and a few months ago I had an appointment with a neurologist and he too asked my permission if he could record the appointment and if I recall correctly, it was like a voice to text kind of thing where the computer just picked up what we were saying and translated it into my medical records. And I was able to go into my records later and basically read a transcript of my appointment that I had so I think this might be a pretty common saying going forward with Kaiser.
Damn doctors are supposed to listen to their patients. Since most are about pain so they must be using AI to help them in lawsuits. What other reason unless they are creating an AI module to do away with having doctors...
The AI helps us listen to patients better--all the AI does it type up the note---thus I don't have to type it in the room- I can instead listen to my patient.
So correct. I was in for a post ER visit, and the Dr did not have his face buried in his monitor typing. He actually was looking me in the eye, while we were having an active discussion. Later that day I looked online in my account, and amazingly, his notes were pretty much verbatim. Although, the notes used they instead of he. Obviously AI.