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Comment by kharms | Hacker News Reader

>>Glass is also helping healthcare professionals. Doctors at Dignity Health have been using Glass with an application our partner Augmedix calls “a remote scribe”.

My primary care doctor has a human scribe. The scribe is a recent graduate (BS), planning on going to med school next year. Being physically in the room, watching the doctor work is a great benefit to her. I'm not sure she'd benefit as much from watching a live stream.

Additionally, as a patient I wouldn't be comfortable being recorded.

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Just disrobe while I record you with my cyborg glasses. Now, please describe your embarrassing medical problem. (However, it seems like a great idea for other situations.)

I wonder if there would be room for a public key / dual encryption for the video produced that both the doctor and the patient would need to sign off on to view the video, or something like that, to add some kind of viewing trail/authentication/authorization.

I mean, who's to say any given doctor's office doesn't have a hidden camera/microphone somewhere anyway.

> I mean, who's to say any given doctor's office doesn't have a hidden camera/microphone somewhere anyway.

If you're having paranoid delusions, visiting a doctor's office may be a good start, despite the small possibility of hidden cameras and microphones.

Well, you have a reasonable expectation of privacy in a doctor's office (when the door is closed), so even in single-party recording states this would be illegal. Also, HIPPA wouldn't allow this, so the doctor's office would be fined pretty heavily for every patient recorded.

Ha yeah that's not gonna work.

Well, I say that, but thinking long term, it does kind of seem inevitable. Somehow we're going to have to come to terms with having every embarrassing moment of our lives outside of our home being recorded. Unless the UN comes up with an effective digital bill of rights this is an espionage disaster waiting to happen.

My primary care doctor struggles to take notes while talking to me in the 10 minutes we have allocated for an appointment. This would be a huge win.

I do share your concern about being recorded as a patient though.

I'm not sure about that. What is your expectation? That the doctor or someone else will take the time to re-watch the recording of your interaction? How is that better than just extending the interaction?

As an aside, is this a common thing? I had an appointment to get a tdap booster a few weeks ago and spent a good 30 mins. chatting with my doctor.

Honestly I don't know what I would prefer. certainly I would prefer more quality time with my doctor, but at what cost, I don't know.

Here at least (uk) yes. Al of the practices I've visited have strict 10 minute appointments and the doctor will cut you off at 10 minutes. If I go in for a flu jab(I'm asthmatic and at high risk), I expect to be in and out in about 2 minutes, and I don't see the doctor; it's normally a practice nurse that does it. You then get sent back to the aaiting room and told to sit tight for 10 minutes in case you feel weak, but that's it.

For consultants in hospitals it's different, though.

Interesting. I probably have a skewed view because I currently have very good employer-provided health care (US). I don't think I've ever spent less than 15 minutes with my doctor for an appointment. She also takes calls and texts and I have made same-day appointments (within hours) in the past.

However it is perhaps worth noting that the practice charges a $250/year "concierge fee" and from what I've read that's a very low fee comparable to other offices that use that model. Perhaps I would be less likely to go there if I had a high premium to pay in addition.

But even with previous employers and plans across the US, I can't recall a doctor who has ever rushed me out of appointments.

My doctor is an NHS practitioner. If I have an "emergency" and need an appointment, I can get one that day. Otherwise normally it's a weeks notice give or take. I don't pay anything to the doctor, or to the practice, (other than my National Insurance contribution which is taken out ore tax).

I do have private health cover but it doesn't help much if I have a chest infection. If I need an MRI or to see a consultant, I can effectively skip the waiting lists and go to a private hospital, but if I have a heart attack or any immediate emergency, I'll be going to an NHS hospital regardless.

> I don't think I've ever spent less than 15 minutes with my doctor for an appointment.

It's always going to vary wildly based on what you need to discuss - a shot takes a minute or two of lead up, being diagnosed with a chronic ailment may take 3+ visits with 30 minutes of discussion each time.

Either way, I'm not comfortable with my doctor wearing a wire into the room. It's hard enough to trust that the notes they take in confidence will stay confident without throwing faulty computer security into the mix; yes, I am already weary of electronic medical records for exactly the same reasons.

> That the doctor or someone else will take the time to re-watch the recording of your interaction? How is that better than just extending the interaction?

You can outsource the data entry parts of the job to someone in a centralized location, who can be assisted by voice-recognition on an initial pass. This saves time for the doctor and patient, and lets the doctor focus on the patient rather than data entry.

Incidentally, you might not currently be recorded on video in the doctor's office, but there is already a very good chance your doctor is dictating notes describing your medical history using scribes in India or elsewhere.

The doctor would probably be even more uncomfortable being recorded, for the same reason that cops don't like wearing body cameras: Any mistake is recorded and can be replayed at trial.

As a patient I would be quite happy for doctors and nurses to wear body cameras if it was part of a systematic approach to eliminating errors (similar to the way airplane cockpit voice and data recorders have been instrumental in reducing plane crashes).

I suspect that it would only be recording audio; video recordings chew through the battery and would be unnecessary in most cases like this (perhaps the occasional photo of some symptoms would be very useful). I'm totally happy for the doctor to record my conversations with her; they'd be more reliable than the notes typed up hurriedly during or after the consultation.

> as a patient I wouldn't be comfortable being recorded.

Also sent to google, so then when you get home you get relevant ads for your medical issue. Yay!

But the point here is to reduce the time doctors spend on mundane tasks.

I would be totally cool with being recorded. I think its beyond time we get past the ridiculous false modesty that seems to be considered a virtue, but with no real benefit.

It has less to do with "false modesty" and more to do with the fact that a recording of you is being sent somewhere, probably a Google server, which leaves the door open for someone to get a hold of it. That doesn't concern you at all?

Your medical records would be far more secure on Google's servers than almost any hospital server.

That kind of information should never, ever leave the hospital/doctor's office LAN in the first place.

How does that make any sense?

So when you go to another hospital, your records should be unavailable?

In the US, a lot of the time you can digitally access your records yourself

Unfortunately it can and it will. At this point in time, while the best option would be not to get recorded in the first place, I'd trust Google servers much more than anything a hospital deployed with help of random contractors.

Don't records and info need to be available to other medical personnel? What if you have to go to your local hospital? Having all that info on your doctor's office lan won't help you at a potentially crucial time. Or am I missing something?

If everyone fell under the same umbrella, I would agree (I would even potentially argue that we would all be better off for it). But I fear there will be a large class divide between who we can see naked, and who we can't. Additionally, I wouldn't mind so much because I'm quite happy with my body. Many people aren't, and I'm not sure that modesty is false for them.

It's not "false modesty" to desires some privacy away from cameras when you're getting medically diagnosed with a condition.

Just because you're fine with it doesn't mean that there are people with sensitive medical conditions who would rather not have a video recording of themselves being examined.

You sound like you live in a country where evidence of a pre-existing condition isn't a huge liability. In the United States, a recording of you admitting you've been sick for a while can literally bankrupt you (well, not while we still have ObamaCare but a repeal is too likely for us to let our guard down).

The desire for privacy is not "false modesty"; given the sentence you just uttered, I'm not convinced you even know what false modesty even means. People have a hard enough time even talking to doctors about embarrassing or sensitive issues, put a camera in the room and they simply won't, privacy is a need for most human beings, it's not false, it's not fake or done out of a desire to appear a particular way, it's a psychological need. Most people are not exhibitionists, they do not like being watched, they do not like being recorded, and it's not remotely something they do for appearances, a.k.a. false modesty.

Right, and it also prevents positive outcomes. People chronically lie to their doctors about their actual lifestyle behavior and then are surprised that the Dr. didn't catch all the warning signs for some disease.

More data = better outcomes.

Cameras won't add more data as they'll simply discourage people from admitting anything or even going to a doctor. I would not allow my doctor to film me, nor would I imagine most sensible and normal people who have an ordinary sense of privacy. Your doctor works for you, not the other way around, you decide what is acceptable behavior, not them.

The engineers at Google also don't seem to understand how the vast majority of people want to be treated.

It's not about benefiting the graduate

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