As a medical doctor I extensively use digital voice recorders to document my work. My secretary does the transcription. As a cost saving measure the process is soon intended to be replaced by AI-powered transcription, trained on each doctor’s voice. As I understand it the model created is not being stored locally and I have no control over it what so ever.
I see many dangers as the data model is trained on biometric data and possibly could be used to recreate my voice. Of course I understand that there probably are other recordings on the Internet of me, enough to recreate my voice, but that’s beside the point. Also the question is about educating them, not a legal one.
How do I present my case? I’m not willing to use a non local AI transcribing my voice. I don’t want to be percieved as a paranoid nut case. Preferravly I want my bosses and collegues to understand the privacy concerns and dangers of using a “cloud sollution”. Unfortunately thay are totally ignorant to the field of technology and the explanation/examples need to translate to the lay person.
Do your patients know that their information is being transcribed in the cloud, which means it could potentially be hacked, leaked, tracked, and sold? How does this foster a sense of distrust, and harm the patients progress?
Could you leverage this information and the possibility of being sued if information is leaked with the bureaucrats?
It would be worth finding out more about how exactly the training process works, namely whether or not the AI company stores the training audio clips after training has been completed. If not, then I would say you don’t have anything to worry about, because the model itself can’t be used to clone your voice to any useful extent. Deep neural networks aren’t reversible like that. Even if they were, it’s not just trained on you, it’s trained on hundreds of thousands of people then fine-tuned to you.
If they do store the clips though, then maybe show them this article about GitHub to prove to them that there is precedence for private companies using people’s data to train AI without their explicit consent.
To expound on this, AI models are extremely narrow in scope. One which reproduces audio it is trained on is entirely different from one that understands what is being said. As Mr. Turkalino mentioned, the transcription AIs are built on a combination of speech recognition and incredibly specialized text data that is narrowly defined by your industry (medical in this case). In fact, they may have tuned specific models for separate disciplines. This included thousands of documents ranging from textbooks to scholarly journals along with thousands of recordings of professionals saying the words in a variety of accents and dialects so it can understand the difference between very important and very different sounding words, my wife is pregnant, so amnioitis and amniocentesis come to mind. They are close enough sounding that a general model might mistake them, and that being transcribed wrong could spell real problems when others may look at the patients chart if there are complications.
Also, most models are run in the cloud because the calculations can he very taxing. I run Stable Diffusion and other AIs locally on my beast of a machine and it struggles at times. Realistically, the cloud machines are just bugger than you can get as a desktop. Also, under the most ideal circumstances, the audio of your notes does not live in the servers, it is transmitted, stored on a virtual machine (VM) while it is being processed, then after the results are completed the VM is destroyed and the audio recording goes with it. Nothing is kept. Of course, that is where you need to be sure to do the work, making sure that your situation is “ideal”. One of the biggest controversies in with AI right now is that data is being stored for doing reinforcement training on the AI models. Example, you send your recordings and the AI returns the transcript. You mark any corrections and go on with your day. The company takes those recordings and feeds them back into the general model with the corrections you made and tries to tell the AI what it got wrong. You are going to want to be sure that you are allowed to opt-out of your data being allowed to be used as training data (beyond the fine-tuning to help it learn your voice).
I would have work sign a legal discharge that from the moment I use the technology, none of the recordings or transcription of me can be used to incriminate me in case of an alleged malpractice.
In fact, since both are generated or can be generated in a way that both sounds very assertive but also can be adding incredibly wild mistakes, in a potentially life and death situation, they legally recognise potentially nullifying my work, and taking the entire legal responsibility for it.
As you can see in the most recent example involving Air Canada, a policy has been invented out of thin air. Such policy is costing the company. In the case of a doctor, if the administration of the wrong sedative, the wrong medication, or if the wrong diagnosis was communicated to the patient, etc; all that could have serious consequences.
All sounding (using your phrasings, etc) like you, being extremely assertive, etc.
A human doing that job will know not to derive from the recording. An AI? “antihistaminic” and “anti asthmatic” aren’t too far off, and that is just one example off of the top of my head.
Will they allow you to use your own non-cloud solution? As long as you turn in text documents and they don’t have to pay a person to transcribe, they should be happy. There are a number of speech to text apps you can run locally on a laptop, phone, or tablet.
But of course, it’s sometimes about control and exercising their corporate authority over you. Bosses get off on that shit.
Not sure which type of doctor you are, but there’s a general shortage of NPI people. I hope you can fight back with some leverage. Best of luck.
It will not be possible to use my own software. The computer environment is tightly controlled. If this is implemented my only input device to the medical records will be the AI transcriber (stupidity).
I’m a psychiatrist in the field of substance abuse and withdrawal. Sure there’s a shortage of us too but I want the hospital to understand the problem, not just me getting to use a old school secretary by threatening going to another hospital.
I was afraid that might be the case. Was hoping they would let you upload the files as if you had typed them yourself.
Maybe find some studies / articles on transcription bots getting medical terminology and drug names wrong. I’m sure that happens. AI is getting scary-good, but it’s far from perfect, and this is potentially a low-possibility-but-dangerous-consequences kind of scenario. Unfortunately the marketers of their software probably have canned responses to these types of concerns. Management is going to hear what they want to hear.
Thaks fot he advice but I’m not against using AI-models transcribing me, just not a cloud model specifically trained on my voice without any control by me. A local model or more preferrably a general local model woulf be fine. What makes me sad is that the persons behind this are totally ignorant to the problem.
I understand, and we’re basically on the same page. I’m not fully anti-AI, either. Like any tool, it can be used for good or evil. And you are right to have concerns about data stored in the cloud. The tech bros will mock you for it and then… oh look, another data breach has it been five minutes already. :)
Yes I agree. Broadening the scope a little, I frankly just wait for a big leak of medical records. The system we use is a birds nest of different softwares, countless API:s, all sorts of database backends. Many systems syem from MS-DOS, just embedded in a bit more modern integrated environment. There are just so many flaws and I’m amazed a leak hasn’t happened (or at least surfaced) yet.
Do we work for the same place? 😆
I take this as humour - I understand my situation and IT suite isn’t more insecure than many others :)
my only input device to the medical records will be the AI transcriber
I understand that you keep steering away from legal arguments, but that can’t be legal either. How could a doctor not have direct, manual access to patient records?
Anyway, practical issues:
You need some way to manually interact with patient records in the inevitable event the AI transcription gets it wrong. It only takes one time messing up transcription on something critical and you have a fucking body on your hands. Is your hospital prepared to give patients the wrong dosages because background noise or someone else speaking makes the AI mishear? Who would be held responsible in the case of mistreatment due to mistranscription? Is your hospital willing to be one of the first to try and tackle that legal rats nest?
A secretary is able to do a sanity check that what they heard make sense. AI transcription will have no such logic behind it. It will turn what it thinks it heard into text and chuck it wherever it logs to. It thinks you’ve called for leeches when you said something about lesions? Have fun.
Whenever there’s an issue with the transcription service you’d be screwed too. That could mean network outage, power outage, microphone breaks, any part of this equipment breaks, and this whole system falls apart.
The problem with incorrect transceiption exists with my secretary too. In the system I work in the secretary write my recordibg, sends it to me, I read it. I can edit the text at this point and then digitally sign it with a personal private key. This usually happens at least a day after being recorded. All perscriptions or orders to my nurses are given inannother system besides the raw text in the medical records. I can’t easily explain the practical workings but I really don’t see that the AI system will introduce more errors.
But I agree that in the event of a system failure, there will be a catastrophic situation.
Stop using the digital voice recorder and type everything yourself. This is the best way to protect your voice print in this situation. It doesn’t work well as a protest or to educate your colleagues, but I suppose that’s one thing you can use your voice for. Since AI transcription is a cost saving measure, there will be nothing you can do to stop its use. No decision maker will choose the more expensive option with a higher error rate on morals alone.
Unfortunately the interface of the medical records system will be changed when this is implemented. The keyboard input method will be entirely removed.
I had another idea. You might be able to use something that distorts your voice so that it doesn’t sound anything like you, but the AI can still transcribe it to text. There are some cheap novelty devices on amazon that do this, and also some more expensive pro audio gear that does the same thing. Just a thought.
Sure but what about my peers? I want to get the point across and the understanding of privacy implications. I’m certain that this is just the first of many reforms without proper analysis of privacy implications.
I agree that getting the point across and having them rethink this whole thing is a much better way of handling this than using a tech solution. I am just pessimistic you can change their minds and you might need a plan B.
Ironically, GPT can kinda get you started here…
To present your case effectively to your bosses and colleagues, focus on simplifying the technical aspects and emphasizing the potential risks associated with using a cloud-based AI transcription service:
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Privacy Concerns: Explain that using a cloud-based solution means entrusting sensitive biometric data (your voice) to a third-party provider. Emphasize that this data could potentially be accessed or misused without your consent.
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Security Risks: Highlight the risks of data breaches and unauthorized access to your voice recordings stored in the cloud. Mention recent high-profile cases of data breaches to illustrate the potential consequences.
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Voice Cloning: Explain the concept of voice cloning and how AI algorithms can be trained to mimic your voice using the data stored in the cloud. Use simple examples or analogies to illustrate how this could be used for malicious purposes, such as impersonation or fraud.
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Lack of Control: Stress that you have no control over how your voice data is used or stored once it’s uploaded to the cloud. Unlike a local solution where you have more oversight and control, a cloud-based service leaves you vulnerable to the policies and practices of the provider.
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Legal and Ethical Implications: While you acknowledge that there may be existing recordings of your voice online, emphasize that knowingly contributing to the creation of a database that could potentially be used for unethical or illegal purposes raises serious concerns about professional ethics and personal privacy.
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Alternative Solutions: Suggest alternative solutions that prioritize privacy and security, such as using local AI transcription software that does not upload data to the cloud or implementing stricter data protection policies within your organization.
By framing your concerns in terms of privacy, security, and ethical considerations, you can help your bosses and colleagues understand the potential risks associated with using a cloud-based AI transcription service without coming across as paranoid. Highlighting the importance of protecting sensitive data and maintaining control over personal information should resonate with individuals regardless of their level of technical expertise.
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So what’s your concern? I’m a bit confused.
- Using cloud to process patient data? Or,
- Collecting your voice to train a model?
Personally I’d be more worried about leaking patient information to an uncontrolled system than having a voice model made
Thats another issue and doesn’t lessen the importance of this issue. Both are important but separate. One is about patiwnt data, the other about my voice model. Also in thsi case I have no control over the mesical records and it’s already stored outside the hospital in my case.
