More thoughts on use of AI in healthcare – better coding in the EPR!

Our Prime Minister is apparently giving a talk today somewhere near me (Cheshire) on how AI could be the salvation of the NHS. She is pushing the early detection of cancer. I’m not going to get into the philosophical question of whether early detection of cancer truly extends life or just detects it early and subjects people to more worry and hassle, what I going to suggest is there are plenty of other uses of AI.

In a previous post, I mentioned the idea that AI could possibly help reviewing blood results speeding up the process and perhaps making it safer and more accurate.

Most people accept that GPs coding notes has been a good thing. It has allowed things like the QOF and DM audits to happen in a way that would be too time-consuming if you had to go through by hand.

However, as I’ve previously also posted quality of coding in notes isn’t always great and is very variable. Faced with an ill child – people will code it in a variety of ways. Some will use a template to record obs, some will free text, and some will choose one read code or the diagnosis – some another. Some will understand the difference between symptoms codes, working diagnosis codes and diagnostic or procedural codes others won’t. Even sore throats and viral illnesses can be coded in numerous ways.

Trying to make sense of it – trying to understand what work is done can be hard. Although I like to think I’m quite a good problem coder – when patients turn up with multiple problems I don’t tend to code them all. So a consultation for hypertension might include a prescription for Anusol for haemorrhoids; do I create two consultation entries? Often no as I’m lazy – so it ends up looking like I’m giving Anusol for hypertension!

Could an AI get around this? Could it prompt – you are prescribing Anusol – the pt has previously had this would you like me to create an entry for haemorrhoids and put this prescription against it?

One question that came up the other day was an asthmatic pt comes in with a chest infection – do you code it as exacerbation of asthma or chest infection or both? Well an AI could recognize that it’s both and add the missing code.

A lot of people free text a lot of data that could be coded. Could an AI read the free text and extract useful codes? So instead of us having to trawl through notes looking for handwritten bps it could find them automatically and convert them.

Could an AI change my codes – I put in chat to pt as a code and it works out from what I’ve done a better code. Or I put in one of the many synonyms and it changes it to the preferred one.

Getting big brother and following on from the Alexa Hack that a commentator mentioned – could Alexa listen in to my consultation and code questions and replies? A patient comes in with a headache – I ask how long have you had it? Describe it..? Alexa transcribes it into codes!