EMAIL LIST: https://www.clinicians-exchange.org & LEMMY: https://lem.clinicians-exchange.org
.
I'm a bit behind on this news cycle, so you may have read about these
issues. _My point is to tie them to data privacy and OUR clinical
practices._

**THIS BELOW** is one of the main reasons /I keep throwing a fit about
data leaks from HIPAA BAA subcontractors/ - whether or not they end up
being legally PHI, and despite the fact that not too many therapists are
interested in the topic.

*If an Attorney General is willing to go after unredacted medical
records* in-state or out-of-state, /then they are certainly *_capable of
getting data from data brokers and marketing firms_* (or Google,
Facebook, LinkedIn, Twitter, etc.)./

Closer-to-home -- It's not too much of a stretch to speculate if
psychotherapists in blue states will get subpoenas for chart records
pertaining to clients who moved to a red state shortly after counseling,
then got in trouble for whatever the legal medical issue of the moment
is (abortion, birth control, transgender concerns, fertility clinic
involvement, etc.).

*Here’s why Tennessee’s AG wants access to reproductive medical records
— including for out-of-state abortions**
*https://wpln.org/post/heres-why-tennessees-ag-wants-access-to-reproductive-medical-records-including-for-out-of-state-abortions/
/"State attorneys general in 18 states — including Tennessee’s — are
fighting with the Biden Administration over medical records related to
reproductive care."//
/
*Tennessee A.G. weaponizes private medical records in GOP campaign
against trans people**
*https://the-rachel-maddow-show.simplecast.com/episodes/tennessee-ag-weaponizes-private-medical-records-in-gop-campaign-against-trans-people
/Maddow podcast recording.  Talks about attorneys general from 16 states
writing a letter to President Biden asserting their right to go after
medical records located outside their states.//
/
*Biden’s HIPAA expansion for abortion draws criticism, lawsuit threats **
*https://www.politico.com/news/2023/07/18/biden-hipaa-expansion-abortion-00106694
/Biden administration trying to shield abortion medical record data
located in blue states from red state Attorney General probes.//
/

In case you are interested, here are some of my past articles on medical
data privacy and various vendors:
*
hipaalink.net security initial testing*
https://lem.clinicians-exchange.org/post/49122
*
Nearly All Hospital Websites Send Tracking Data to 3rd Parties,
Endangering Pt Privacy—Common Recipients: Alphabet, Meta, Adobe, AT&T*
https://lem.clinicians-exchange.org/post/24598
*
To become an Amazon Clinic patient, first you sign away some privacy,You
agreed to what? The ‘HIPAA authorization’ for Amazon’s new low-cost
clinic offers the tech giant more control over your health*
https://lem.clinicians-exchange.org/post/24603
*
FTC, HHS warn health providers not to use tracking tech in websites, apps*
https://lem.clinicians-exchange.org/post/44657
*
Would you want #AI used to help write a medical or psychotherapy chart
note?**(Ongoing Poll)*
https://mastodon.clinicians-exchange.org/@admin/110799586045837116
*
AWS rolls out generative AI service for healthcare documentation software*
https://lem.clinicians-exchange.org/post/57450

I'm not posting this to be political (although it certainly is) --*I'm
posting it as a legit medical records concern for all of us regardless
of each individual reader's political positions.  We need -- as
therapists -- to care about data leaks and privacy.*

+++++++++++
#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes #legal #lgbtq #abortion
#transgender
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal
#HIPAA #dataprotection #infosec @infosec #doctors #hospitals
#amazon #BAA #businessassociateagreement

EMAIL LIST: https://www.clinicians-exchange.org & LEMMY: https://lem.clinicians-exchange.org
.

TITLE: AWS rolls out generative AI service for healthcare documentation
software

Yeah... If it's going to be worth using it would have to listen to the
whole visit... But this needs more thought.  In my past quick
experiments, it took 90% of the effort typing directions to get an AI to
generate a halfway okay note.  So the AI (I think) would have to listen
in and then do the note to be worth it.

Would we want this?  Can we trust this?

--Michael

+++++++++
------------------------------------------------------------------------
"Amazon Web Services announced Wednesday a new AI-powered service for
healthcare software providers that will help clinicians with paperwork."

"AWS HealthScribe uses generative AI and speech recognition to help
doctors transcribe and analyze their conversations with patients and
drafts clinical notes, the company announced Wednesday at its AWS Summit
New York."

https://www.fiercehealthcare.com/ai-and-machine-learning/aws-rolls-out-generative-ai-service-healthcare-documentation-software

------------------------------------------------------------------------
Posted by:
Michael Reeder LCPC
Baltimore, MD

#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #medicalnotes #progressnotes #Amazon
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal

Would you want #AI used to help write a medical or psychotherapy chart note?

Health professionals are under lots of time pressure -- often unpaid for charting time, and increasingly typing notes during appointments.

But, there may be privacy and accuracy concerns with using AI in charting.

++++
#CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #EPIC #medicalnotes #progressnotes #Microsoft
@psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #technology #psychiatry #healthcare #patientportal

It occurred to me this morning that by the time I fill out the form and write two or three sentences, I've already done all the work that is needed for an official note (after adding start and end times, diagnosis, name, client age, and a few other elements to the form). There is no need to convert it all to narrative -- it can stay in form factor mostly.

So -- while I want an AI I can trust to help with notes (and this one may grow into such) -- right now the effort of getting it to create a note is about exactly equal to the effort of just writing it myself anyway.

@psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry
#mentalhealth #technology #psychiatry #healthcare #patientportal #autonotesai #AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #EPIC #medicalnotes #progressnotes #Microsoft

*If* AutoNotes.ai just plugged in a free AI available from elsewhere with a front-end they created, I wonder what legalese governs use of the AI on the backend? I am not a lawyer and none of us know the licensing agreement or ownership of the AI which AutoNotes.ai is using.

And, well hey -- while I'm just busy making up wild speculations -- let's play with this a bit:

So I know AutoNotes.ai is sending SOME kind of information to Google tracking services because my browser plug-ins are preventing this data from being sent to Google and telling me so.

Let's just suppose for a moment that they are using Google's Bard AI on the back-end. Because -- why not -- there is no PHI being collected anyway...

Meanwhile, both the therapist and the client are using the Google Chrome web browser for televideo. Or maybe they are using Gmail and the Gmail text is being mined. Or the data input for the note is sent along to Google datamining regardless of whether or not the Bard AI is used...

Let's go further out on our hypothetical limb and say that the therapist sees only three clients that day. The therapist creates three notes in AutoNotes.ai that day...

It's now a more than fair chance that one of those three unnamed clients has Acute Stress Disorder (like in my example above). If Google has gone to the bother to devote the computer tracking power to it, they might know from Gmail, or Bard, or data aggregation the names of the clients the therapist saw that day.

Of course, I really am making this all up -- we are just not given enough data to know what's real and false anymore.

Here is a paragraph from the welcome message they emailed me:

"Here are a couple of simple suggestions, first, complete as thorough a Mental Status Exam (MSE) as possible, submit a few sentences related to the session and theme, and include treatment plan goals, objectives, and strategies; this will ensure the best possible clinical note. Please revise and submit your revised version inside the app! This will assist all of us in building the greatest tool on earth for the field!"

Well, okay -- I do want the AI to get better at its job...

But this DOES mean they are keeping a version of what you provide, doesn't it?

@psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry
#mentalhealth #technology #psychiatry #healthcare #patientportal #autonotesai #AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #EPIC #medicalnotes #progressnotes #Microsoft

This is for a new product called AutoNotes.ai that will create progress notes for you for about $14+ per month.

I am tentatively interested in this and signed up for a free trial.

I have concerns (below) but am hopeful this continues to improve.

~~~
The system has no BAA agreement for HIPAA because they claim not to collect any PHI. This may be true.

Their terms of service and privacy policy may be amended at any time and the only notification provided will be on their website. I am weary of this now that I have been burned by such stealth changes by one of my own BAA subcontractors.

Information for each client will have to be entered from scratch each time as they do not store data about clients. For the free demo, it takes about 60 seconds to generate each note. You then cut and paste it into your EHR.

While they claim to collect no PHI, they do send SOME data of SOME sort to several tracking systems and data aggregators. At best, they are tracking YOU -- the clinician. At worst -- they may be sending some of the data you enter to data aggregators which -- hopefully -- do not have data from other sources to be able to pin down the individual clients you are describing.

DATA IS SEND TO THE FOLLOWING OUTSIDE TRACKING COMPANIES ON BOTH THEIR DATA INPUT PAGE & THE GENERATED NOTE PAGE:

PRIVACY BADGER BLOCKED:
connect.facebook.net
www.googletagmanager.com
s.gravatar.com
snap.licdn.com
i0.wp.com

GHOSTERY BLOCKED:
Google Tag Manager
LinkedIn Analytics
Facebook Connect
Gravatar

The following is an example of the note generated for a fake client with Acute Stress Disorder:

%GREEN = IN WHAT I REPORTED%
&RED = INVENTED BY AI, NOT REPORTED BY CLINICIAN&
BLACK = I HAVE NO STRONG OPINION

Subjective:
Client &reported increased levels of stress, particularly in the& %workplace. Described experiencing anxious mood and labile mood, but was able to demonstrate appropriate behavior and normal speech throughout the session. Client was self-reflective% and &engaged& %during the 45-minute video session%, %which allowed for a comprehensive exploration of the current challenges they face&. The client recognized the need to address these issues in order to improve their overall well-being.

Objective:
During the session, several areas were discussed. &Client was open and honest& about %feeling overwhelmed and stressed at work, further precipitating their anxiety. They were able to identify specific work situations that were particularly difficult for them to navigate. It was noted that the client was able to maintain self-reflective behavior during discussions,% which will be beneficial for making progress in therapy.

Assessment:
%The client is showing signs of progress in therapy, taking active steps to address and work through their challenges with stress and anxiety.% Their willingness to participate and self-reflect in session indicates a strong commitment to achieving their therapeutic goals. %Current therapeutic interventions, which are directed at helping the client build skills and coping strategies, are having a positive impact on the client's progress.%

Plan:
%In order to lower workplace stress and continue advancing in therapy, the client agreed to set specific objectives for themselves. They plan on talking to their manager about ways to manage their workload or address any outstanding concerns. Additionally, they will begin practicing meditation four times a week during their lunch breaks, as a means of managing stress and promoting relaxation.% &Continued exploration of these& and other stress reduction &strategies will be a focus in future sessions.&

Hmmm... My take-away is that this needs more work (that's fine); I want to know why they have to report to LinkedIn, Facebook, Gravatar, and Word Press while I'm logged in and what they report; and the system IS inventing minor elements that I did not tell it to add. For example, while I reported the client was overwhelmed and stressed, I did not say the client was open and honest about it. I told the system the client was "progressing", but never said that increased levels of stress were reported in this session.

#AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt #artificialintelligence #psychology #counseling #socialwork #psychotherapy #EHR #EPIC #medicalnotes #progressnotes #Microsoft
@psychotherapist @psychotherapists @psychology @socialpsych @socialwork @psychiatry #mentalhealth #technology #psychiatry #healthcare #patientportal #autonotesai

TITLE: Healthcare From Best Buy??

Here's an article no one needs to read, but I'll link to it below in case anyone wishes to relish and dwell in the absurdity.

So, YES, *Best Buy* -- the company that just finished all but going out of business and closing hundreds of stores nationwide -- now is using
their "expertise" to provide you with healthcare. That's right, why not buy healthcare from the sales people who use to sell you TVs and cordless phones at your local mall?

As my wife quipped -- "instead of Geek Squad, its now Doc Squad".

The entirety of the article is just full of meaningless phrases so I'll save you the trouble of clicking through by listing a few choice quotes:

"During a keynote address Wednesday morning at HIMSS23, executives at
these so-called 'disrupters' shared their vision for the future of care
delivery." (That's what we need -- tech company disruption... This was their KEYNOTE address!...)

"All three agreed that the current healthcare system is broken. 'We’re not thinking enough like a system,' Barry said." (?...)

"U.S. healthcare is 'a collection of solutions,' Walsh echoed. In its current siloed, fragmented state, it will continue to fail patients. What’s needed instead is a holistic, collaborative approach to care."
(?? -- Yeah, when I think of the term holistic, big tech is immediately what comes to my mind...)

"Best Buy Health works with providers like Atrium Health to power home care. 'We’re bringing what we’ve done in computer electronics for years
into health,' DiSanzo said." (??? -- LOL!)

"Tech companies must listen to providers when serving them, DiSanzo said. To build trust and buy-in, they must offer visibility into their methods. For instance, providers want to know where given data come
from, what algorithm is being employed to train a device and who is training the model in order to feel good about letting it work for them." (???? -- So the people who could not sell me a computer or refrigerator are developing AI systems to improve my healthcare...)

*Best Buy Health, VillageMD execs see collaboration as critical to future of healthcare*
https://www.fiercehealthcare.com/health-tech/himss23-disruptors-best-buy-villagemd-healthpartners-keynote-future-care-delivery

--

#healthcare #EHR #disruptors #BestBuy #caredelivery #mentalhealth
#medical #*/HIMSS23 #AI /#medicalnotes #progressnotes #patientportal
#CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence
#caredelivery

TITLE: Healthcare From Best Buy??

Here's an article no one needs to read, but I'll link to it below in
case anyone wishes to relish and dwell in the absurdity.

So, YES, *Best Buy* -- the company that just finished all but going out
of business and closing hundreds of stores nationwide -- now is using
their "expertise" to provide you with healthcare. That's right, why not
buy healthcare from the sales people who use to sell you TVs and
cordless phones at your local mall?

The entirety of the article is just full of meaningless phrases so I'll
save you the trouble of clicking through by listing a few choice quotes:

/"During a keynote address Wednesday morning at HIMSS23, executives at
these so-called 'disrupters' shared their vision for the future of care
delivery."/ (That's what we need -- tech company disruption... This was
their KEYNOTE address!...)

/"All three agreed that the current healthcare system is broken. 'We’re
not thinking enough like a system,' Barry said."/ (?...)

/"U.S. healthcare is 'a collection of solutions,' Walsh echoed. In its
current siloed, fragmented state, it will continue to fail patients.
What’s needed instead is a holistic, collaborative approach to care."/ 
(?? -- Yeah, when I think of the term holistic, big tech is immediately
what comes to my mind...)

/"Best Buy Health works with providers like Atrium Health to power home
care. 'We’re bringing what we’ve done in computer electronics for years
into health,' DiSanzo said."/ (??? -- LOL!)

/"Tech companies must listen to providers when serving them, DiSanzo
said. To build trust and buy-in, they must offer visibility into their
methods. For instance, providers want to know where given data come
from, what algorithm is being employed to train a device and who is
training the model in order to feel good about letting it work for
them." /(???? -- So the people who could not sell me a computer or
refrigerator are developing AI systems to improve my healthcare...)

*Best Buy Health, VillageMD execs see collaboration as critical to
future of healthcare**
*https://www.fiercehealthcare.com/health-tech/himss23-disruptors-best-buy-villagemd-healthpartners-keynote-future-care-delivery

--
*Michael Reeder, LCPC
Baltimore, MD

#healthcare #EHR #disruptors #BestBuy #caredelivery #mentalhealth
#medical #*/HIMSS23 #AI /#medicalnotes #progressnotes #patientportal
#CollaborativeHumanAISystems #HumanAwareAI #artificialintelligence
#caredelivery

TITLE: Epic taps Microsoft to integrate generative AI into EHRs with
Stanford, UC San Diego as early adopters

https://www.fiercehealthcare.com/health-tech/himss23-epic-taps-microsoft-integrate-generative-ai-ehrs-stanford-uc-san-diego-early

Hmmm... So the stated goal is to enhance provider productivity so they
can focus on patients... Followed immediately by a sentence that the
first use -- already deployed in a few hospitals -- is to automatically
generate message responses...

While this could go good places, the cynic in me speculates what those
responses might look like if sent in response to client EPIC portal
inquiries?  Implemented especially badly this could close the last
direct route to speak with doctors.

I wonder if this will slow the trend of clients having to pay for
message portal responses from medical staff?

-- Michael

#AI  #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #chatgpt
#artificialintelligence #psychology #counseling #socialwork
#psychotherapy #EHR #EPIC #medicalnotes #progressnotes #Microsoft
@psychotherapist @psychotherapists
@psychology @socialpsych @socialwork
@psychiatry #mentalhealth #technology #psychiatry #healthcare
#patientportal

Definitely OT: Hosed by YouTube Algorithms Again

(Slightly sensitive content below mentioned by name but not described in any detail.)

As some may be aware, I've been playing with AI lately to see if there is a useful and ethical way to use it in the creation of psychotherapy
progress notes.  (See series of toots at https://mastodon.clinicians-exchange.org/@admin/110171203899758952 )

I have once again been caught in an insidious YouTube algorithm. The kind where a YouTube channel has one or two videos that you want to see, then a bunch of videos you have NO interest in seeing.  This gets especially fun when you share your wife's YouTube Premium account, and so she gets to see your suggested playlist.

[ Previous Example: YouTube Pseudo-Psychology, Algorithm Traps, and How I Got Set-Up
to Look Like I Cheat --
https://mastodon.clinicians-exchange.org/@admin/109705551829241507 ]

Here's how it goes this time:

STEP #1: Watch a video on how to download the #Vicuna AI to your desktop instead of running it in the cloud. (Why? Privacy of medical data if I
choose to ever use this for real. )

STEP #2: Watch a video from the same channel on how to download an AI with all guards and filters unlocked.  (Why? Because psychotherapy notes
occasionally deal in tough topics like suicide and
cutting/self-mutilation behaviors that might be deemed too sensitive in censored AI versions.  Maybe.  Have not tried it yet.)

STEP #3: Have the bad luck to have stumbled upon a channel where the video creator has an obsession with dirty sexy text chat with AI personas.  Video after video on how to create sexy AI personas who will
fulfill your wildest keyboard-typed fantasies.  I don't think I'm oversharing when I state that any fetishes or fantasies I might have do not include this.  To each his own and its all cool -- but now I have explaining to do...

STEP #4: Explain all the above to my (happily amused) wife as she sees the fetish AI suggestion videos appearing in our YouTube feed for days.

--
Michael Reeder, LCPC

@psychiatry @socialwork @psychology @socialpsych #Ethics #EthicalAI #AI #CollaborativeHumanAISystem#HumanAwareAI #chatbotgpt #security #dataanalytics #artificialintelligence #HIPAA #privacy #psychology #counseling #socialwork #psychotherapy #research
#SOAP #EHR #technology #psychiatry #healthcare #medical #doctor​ #vicuna #progressnotes
#youtube #mentalhealth @psychotherapists #Algorithms

Definitely OT: Hosed by YouTube Algorithms Again

(Slightly sensitive content below mentioned by name but not described in
any detail.)

As some may be aware, I've been playing with AI lately to see if there
is a useful and ethical way to use it in the creation of psychotherapy
progress notes.  (See series of toots at
https://mastodon.clinicians-exchange.org/@admin/110171203899758952 )

I have once again been caught in an insidious YouTube algorithm. The
kind where a YouTube channel has one or two videos that you want to see,
then a bunch of videos you have NO interest in seeing.  This gets
especially fun when you share your wife's YouTube Premium account, and
so she gets to see your suggested playlist.

[ Previous Example: YouTube Pseudo-Psychology, Algorithm Traps, and How
I Got Set-Up
to Look Like I Cheat --
https://mastodon.clinicians-exchange.org/@admin/109705551829241507 ]

Here's how it goes this time:

STEP #1: Watch a video on how to download the #Vicuna AI to your desktop
instead of running it in the cloud. (Why? Privacy of medical data if I
choose to ever use this for real. )

STEP #2: Watch a video from the same channel on how to download an AI
with all guards and filters unlocked.  (Why? Because psychotherapy notes
occasionally deal in tough topics like suicide and
cutting/self-mutilation behaviors that might be deemed too sensitive in
censored AI versions.  Maybe.  Have not tried it yet.)

STEP #3: Have the bad luck to have stumbled upon a channel where the
video creator has an obsession with dirty sexy text chat with AI
personas.  Video after video on how to create sexy AI personas who will
fulfill your wildest keyboard-typed fantasies.  I don't think I'm
oversharing when I state that any fetishes or fantasies I might have do
not include this.  To each his own and its all cool -- but now I have
explaining to do...

STEP #4: Explain all the above to my (happily amused) wife as she sees
the fetish AI suggestion videos appearing in our YouTube feed for days.

--
*Michael Reeder, LCPC
*
*michael(at)hygeiacounseling.com*

@psychiatry
<https://mastodon.clinicians-exchange.org/@psychiatry@a.gup.pe>
@socialwork
<https://mastodon.clinicians-exchange.org/@socialwork@a.gup.pe>
@psychology
<https://mastodon.clinicians-exchange.org/@psychology@a.gup.pe>
@socialpsych
<https://mastodon.clinicians-exchange.org/@socialpsych@a.gup.pe>
#Ethics <https://mastodon.clinicians-exchange.org/tags/Ethics>
#EthicalAI <https://mastodon.clinicians-exchange.org/tags/EthicalAI> #AI
<https://mastodon.clinicians-exchange.org/tags/AI>
#CollaborativeHumanAISystems
<https://mastodon.clinicians-exchange.org/tags/CollaborativeHumanAISystems>
#HumanAwareAI
<https://mastodon.clinicians-exchange.org/tags/HumanAwareAI> #chatbotgpt
<https://mastodon.clinicians-exchange.org/tags/chatbotgpt> #security
<https://mastodon.clinicians-exchange.org/tags/security> #dataanalytics
<https://mastodon.clinicians-exchange.org/tags/dataanalytics>
#artificialintelligence
<https://mastodon.clinicians-exchange.org/tags/artificialintelligence>
#HIPAA <https://mastodon.clinicians-exchange.org/tags/HIPAA> #privacy
<https://mastodon.clinicians-exchange.org/tags/privacy> #psychology
<https://mastodon.clinicians-exchange.org/tags/psychology> #counseling
<https://mastodon.clinicians-exchange.org/tags/counseling> #socialwork
<https://mastodon.clinicians-exchange.org/tags/socialwork>
#psychotherapy
<https://mastodon.clinicians-exchange.org/tags/psychotherapy> #research
<https://mastodon.clinicians-exchange.org/tags/research>
@psychiatry
<https://mastodon.clinicians-exchange.org/@psychiatry@a.gup.pe> #SOAP
<https://mastodon.clinicians-exchange.org/tags/SOAP> #EHR
<https://mastodon.clinicians-exchange.org/tags/EHR> #technology
<https://mastodon.clinicians-exchange.org/tags/technology> #psychiatry
<https://mastodon.clinicians-exchange.org/tags/psychiatry> #healthcare
<https://mastodon.clinicians-exchange.org/tags/healthcare> #medical
<https://mastodon.clinicians-exchange.org/tags/medical> #doctor
<https://mastodon.clinicians-exchange.org/tags/doctor>​ #vicuna
<https://mastodon.clinicians-exchange.org/tags/vicuna> #progressnotes
<https://mastodon.clinicians-exchange.org/tags/progressnotes>
#youtube <https://mastodon.clinicians-exchange.org/tags/youtube>
#mentalhealth
<https://mastodon.clinicians-exchange.org/tags/mentalhealth> @psychology
<https://mastodon.clinicians-exchange.org/@psychology@a.gup.pe>@psychotherapists
<https://mastodon.clinicians-exchange.org/@psychotherapists@a.gup.pe>
#Algorithms
<https://mastodon.clinicians-exchange.org/tags/Algorithms><https://mastodon.clinicians-exchange.org/tags/personalitytests>

Definitely OT: Hosed by YouTube Algorithms Again

(Very slightly sensitive content below mentioned by name but not
described in any detail.)

As some may be aware, I've been playing with AI lately to see if there
is a useful and ethical way to use it in the creation of psychotherapy
progress notes.  (See series of toots at
https://mastodon.clinicians-exchange.org/@admin/110171203899758952 )

I have once again been caught in an insidious YouTube algorithm. The
kind where a YouTube channel has one or two videos that you want to see,
then a bunch of videos you have NO interest in seeing.  This gets
especially fun when you share your wife's YouTube Premium account, and
so she gets to see your suggested playlist.

[ Previous Example: YouTube Pseudo-Psychology, Algorithm Traps, and How
I Got Set-Up
to Look Like I Cheat --
https://mastodon.clinicians-exchange.org/@admin/109705551829241507 ]

Here's how it goes this time:

STEP #1: Watch a video on how to download the #Vicuna AI to your desktop
instead of running it in the cloud. (Why? Privacy of medical data if I
choose to ever use this for real. )

STEP #2: Watch a video from the same channel on how to download an AI
with all guards and filters unlocked.  (Why? Because psychotherapy notes
occasionally deal in tough topics like suicide and
cutting/self-mutilation behaviors that might be deemed too sensitive in
censored AI versions.  Maybe.  Have not tried it yet.)

STEP #3: Have the bad luck to have stumbled upon a channel where the
video creator has an obsession with dirty sexy text chat with AI
personas.  Video after video on how to create sexy AI personas who will
fulfill your wildest keyboard-typed fantasies.  I don't think I'm
oversharing when I state that any fetishes or fantasies I might have do
not include this.  To each his own and its all cool -- but now I have
explaining to do...

STEP #4: Explain all the above to my (happily amused) wife as she sees
the fetish AI suggestion videos appearing in our YouTube feed for days.

--
*Michael Reeder, LCPC
*
*michael(at)hygeiacounseling.com*

@psychiatry
<https://mastodon.clinicians-exchange.org/@psychiatry@a.gup.pe>
@socialwork
<https://mastodon.clinicians-exchange.org/@socialwork@a.gup.pe>
@psychology
<https://mastodon.clinicians-exchange.org/@psychology@a.gup.pe>
@socialpsych
<https://mastodon.clinicians-exchange.org/@socialpsych@a.gup.pe>
#Ethics <https://mastodon.clinicians-exchange.org/tags/Ethics>
#EthicalAI <https://mastodon.clinicians-exchange.org/tags/EthicalAI> #AI
<https://mastodon.clinicians-exchange.org/tags/AI>
#CollaborativeHumanAISystems
<https://mastodon.clinicians-exchange.org/tags/CollaborativeHumanAISystems>
#HumanAwareAI
<https://mastodon.clinicians-exchange.org/tags/HumanAwareAI> #chatbotgpt
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<https://mastodon.clinicians-exchange.org/tags/dataanalytics>
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<https://mastodon.clinicians-exchange.org/tags/artificialintelligence>
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#psychotherapy
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<https://mastodon.clinicians-exchange.org/tags/research>
@psychiatry
<https://mastodon.clinicians-exchange.org/@psychiatry@a.gup.pe> #SOAP
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<https://mastodon.clinicians-exchange.org/tags/doctor>​ #vicuna
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<https://mastodon.clinicians-exchange.org/tags/progressnotes>
#youtube <https://mastodon.clinicians-exchange.org/tags/youtube>
#mentalhealth
<https://mastodon.clinicians-exchange.org/tags/mentalhealth> @psychology
<https://mastodon.clinicians-exchange.org/@psychology@a.gup.pe>@psychotherapists
<https://mastodon.clinicians-exchange.org/@psychotherapists@a.gup.pe>
#Algorithms
<https://mastodon.clinicians-exchange.org/tags/Algorithms><https://mastodon.clinicians-exchange.org/tags/personalitytests>

While the main point of psychotherapy is for client to get BETTER, sometimes they don't for awhile. Some clients with severe conditions need ongoing supportive therapy to simply maintain their highest level of functioning without backsliding.

When this happens, the clinician has to find new ways to write the same thing again, and again, and again...

Why? Because insurance auditors frown on cutting and pasting the same exact old text into multiple notes.

In this unfortunate situation, Vicuna actually does fairly well in this sample:

PROMPT: lease reword the following paragraph changing some words and sentence order, but using the exact same information facts and adding nothing: Pete is a 45 year old electrician reporting continuing depression. Symptoms remain unchanged from last session. Today we discussed his workplace frustrations at length. He continues to blame workplace stressors for his mood and problems with his family.

VICUNA: Pete, who is 45 years old and a electrician, reported continued symptoms of depression during his previous session. The symptoms have remained unchanged since the last time he visited. During this session, Pete and his therapist discussed in detail his workplace frustrations. Despite this, Pete continues to attribute his mood and problems with his family to workplace stressors.

@jonobie @kwh561 @psychiatry @socialwork @psychology @socialpsych
#Ethics #EthicalAI #AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #security #dataanalytics #artificialintelligence #HIPAA #privacy #psychology #counseling #socialwork #psychotherapy #research
@psychiatry #SOAP #EHR #technology #psychiatry #healthcare #medical #doctor​ #vicuna #progressnotes

So far this is NOT promising although I have not given up yet.

Before bothering to download and install Vicuna on my computer I tried it out online first.

I have so far not been able to get it to stop inventing information despite direct requests not to do so:

PROMPT 1: Please write a paragraph with the following facts. Do not add additional facts or get creative. Marie is 32 years old. Has depression. Has anxiety. We practiced breathing exercises, CBT, and guided visualization.

VICUNA 1:Marie is a 32-year-old woman who has been struggling with depression and anxiety. As part of her treatment, we have been practicing various techniques, including breathing exercises, cognitive-behavioral therapy (CBT), and guided visualization. These techniques have helped Marie to better manage her symptoms and improve her overall well-being. By learning how to breathe more effectively and calm herself down when she feels anxious, Marie has been able to reduce her reliance on medication and feel more in control of her emotions. Through CBT, Marie has been able to identify negative thought patterns and challenge them, leading to a more balanced outlook on life. And through guided visualization, Marie has been able to visualize positive outcomes and increase her motivation and hope for the future. These techniques have played an important role in Marie's recovery and will continue to be useful tools for her as she continues her journey towards wellness.

PROMPT 2: Stick to only information provided in the prompt and try again please.

VICUNA 2: Marie is a 32-year-old woman who has depression and anxiety. We have been practicing breathing exercises, CBT, and guided visualization with her. These techniques have helped her manage her symptoms and improve her well-being. By practicing breathing exercises, Marie has been able to reduce her reliance on medication and feel more in control of her emotions. Through CBT, Marie has been able to identify negative thought patterns and challenge them, leading to a more balanced outlook on life. And through guided visualization, Marie has been able to visualize positive outcomes and increase her motivation and hope for the future. These techniques have played an important role in Marie's recovery.

PROMPT 3: Marie is not on medication and her symptoms remain stable. Please try again thanks.

VICUNA 3: Marie is a 32-year-old woman who has depression and anxiety. We have been practicing breathing exercises, CBT, and guided visualization with her to help manage her symptoms and improve her well-being. These techniques have helped Marie to better control her anxiety and depression symptoms without the need for medication. By practicing breathing exercises, Marie has been able to calm herself down when she feels anxious and reduce her stress levels. Through CBT, Marie has been able to identify negative thought patterns and challenge them, leading to a more balanced outlook on life. And through guided visualization, Marie has been able to visualize positive outcomes and increase her motivation and hope for the future. These techniques have played a significant role in Marie's recovery and will continue to be useful tools for her as she maintains her well-being.

PROMPT 4: Marie has not yet experienced improvement. Please try again thanks.

VICUNA 4: Marie is a 32-year-old woman who has been struggling with depression and anxiety. We have been practicing breathing exercises, CBT, and guided visualization with her in an effort to help manage her symptoms and improve her well-being. While these techniques have potential benefits for many people, unfortunately, Marie has not yet experienced any improvement. Despite our best efforts, we have not been able to help her reduce her symptoms or improve her overall well-being. We will continue to work with Marie and explore other treatment options to help her manage her symptoms and move towards recovery.

@jonobie @kwh561 @psychiatry @socialwork @psychology @socialpsych
#Ethics #EthicalAI #AI #CollaborativeHumanAISystems #HumanAwareAI #chatbotgpt #security #dataanalytics #artificialintelligence #HIPAA #privacy #psychology #counseling #socialwork #psychotherapy #research
@psychiatry #SOAP #EHR #technology #psychiatry #healthcare #medical #doctor​ #vicuna #progressnotes

I'm almost, probably, about halfway done with the linework for this page. yikes. then I'll be done with lines and ready to move on to coloring! I've been working on the first chapter for 6 months, fuck me
#supernovas #webcomic #progressnotes