Becker's Hospital Review

54 CIO / HEALTH IT Why this medical school is teaching residents to use chatbots for diagnosis By Mariah Taylor P hysicians at Boston-based Beth Israel Deaconess Medical Center are teaching students to use artificial intelligence chatbots to help diagnose cases, e New York Times reported July 22. Instructors hope medical students will use chatbots like GPT-4 to do curbside consults — where physicians pull a colleague aside to ask an opinion about a difficult case. e idea is a chatbot could perform the same task by providing suggestions and insights. But some worry that future physicians may come to rely too heavily on AI. Christopher Smith, MD, director of internal medicine residency program at the medical center, told the Times that medical students and residents are using AI, but "whether they are learning anything is an open question. Part of learning is the struggle. If you outsource learning to GPT, that struggle is gone." Relying too heavily on AI to make diagnoses could be dangerous, Dr. Smith said. As a curbside consultant, AI chatbots can provide new suggestions to students, but they have to use it correctly. Many students use chatbots like a search engine, which brings little insight, according to the report. Part of their training includes learning how to ask GPT-4 for a consult using phrasing like, "You are a doctor seeing a 39-year-old woman with knee pain," and listing symptoms. ey also suggest asking the bot for its reasoning, as they would with a medical colleague. "It's not wrong to use these tools," Byron Crowe, MD, an internal medicine physician at the hospital, told the Times. "You just have to use them in the right way." n HCA faces lawsuit over massive data breach By Naomi Diaz N ashville, Tenn.-based HCA Healthcare is facing a lawsuit for a recent data theft incident that affected 171 hospitals and health systems across the U.S. and may have breached information of about 11 million patients. The lawsuit, filed by Gary Silvers and Richard Marous on July 12 in the Tennessee Middle District Court, alleges that the health system was negligent in safeguarding patients' protected health information. HCA confirmed to Becker's on July 10 that an unauthorized party stole patient data from its systems and posted it to an online forum. The health system did not confirm the exact number of individuals whose data was affected, but said 27 million rows of data were compromised. The plaintiffs are seeking monetary damages, legal fees, a jury trial and injunctive relief, as well as demanding that HCA Healthcare implement additional safeguards to better protect patient data. A spokesperson for HCA told Becker's "our focus now is on our patients and ensuring they have information about the data security incident and the actions already underway to take care of them. Our commitment to our patients is unwavering and is not affected by any class action lawsuits or other legal proceedings. We will respond to any lawsuits or proceedings, in the appropriate forums and ordinary course." The news was first reported by HIPAA Journal. n Why Johns Hopkins Medicine is charging for MyChart messages By Giles Bruce Baltimore-based Johns Hopkins Medicine will begin charging for some MyChart messages July 18. Johns Hopkins patients who send messages through the Epic EHR patient portal can expect to be billed if the matter takes more than five minutes of a provider's time and is for a new medical issue or symptom requiring an assessment or referral, a medication adjustment, chronic condition check-in and management, or a flare-up or change in a chronic illness. The health system joins numerous others that have begun charging for the service. "Virtual options have become a standard part of healthcare. Insurance companies now recognize some MyChart medical advice messages as billable services," Johns Hopkins Medicine said in a statement on its website. "We want to make sure our clinicians have the time they need to review and respond appropriately to your concerns, just as they would with an in-person or video visit." The health system estimates that out-of-pocket costs will be, depending on how long it takes the clinician to respond, $15 to $50 for uninsured patients, $3 to 10 for Medicare beneficiaries, and a $10 or $20 copay for people with private insurance (or the full amount if it's a high deductible plan). Patients with Medicaid will pay nothing out of pocket. The charges don't apply to patients at St. Petersburg, Fla.- based Johns Hopkins All Children's Hospital, Baltimore Medical System locations (East Baltimore Medical Center and BMS at Yard 56) or Baltimore-based Esperanza Health Services. n

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