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Comment by xnorswap | Hacker News Reader

It doesn't need "AI" or a "Scribe" to spot a low platelet count in lab results either, computer systems have been able to do this for decades.

There's a systemic failure that a computer wasn't already flagging up the low count for immediate follow-up.

What I find interesting is that AI (or more specifically LLMs / chat-GPT ) has had such an impact it's broken down barriers from people who previously would be against any computer involvement or automation. People have gone from, "You must not automate anything" to "We should feed everything into chat GPT"..

And from someone who has in the past been interested in statistical modelling, it's dizzying. It's as if statistics were seen as boring and fallible, but "AI" is exciting and wonderful.

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The main issue is that some developer has to be told to make it so that if plateletCount < 25.000 plateletCountColour = "bright red". That is, a big issue in software development is managing requirements.

AI is more flexible and can make up requirements on the go, that is, based on information it has it "knows" that a low platelet count is bad and what the recommended course of action is.

Of course, search engines and public websites do the same thing - "what should I do if I have a low platelet count" or "low platelet count and red skin dots" are valid search queries.

Most modern EMRs will flag results like this. If it happened to arrive in the middle of the night like the author said, the PCP would have just been asleep. I don’t think there are systems for waking up PCPs for concerning lab results.

And nor should there be. PCPs are basically by definition for non-emergent situations. If the PCP was at all concerned that the patient had something that was an immediate threat, they would have sent them to the ER in the first place.

Having someone on-call to deal with routine lab results that just happen to catch a possible imminent threat would be an enormous waste of resources.

I think the suggestion is that the EMR should flag dangerous conditions like this, and notify the doctor on duty to at least take a look at it.

This would be enormously expensive. The number of things an EMR thinks are an imminent threat will vastly outnumber the things that actually are thanks to liability concerns.

So now you need an extra on-call doctor just to filter out the false positives, or the on-call doctor gets notification fatigue and ignores them.

Or in the best case you send a lot of people to ER in the middle of the night for no reason. Again thanks to liability concerns, but this time on the part of the primary care practice.

> I think the suggestion is that the EMR should flag dangerous conditions like this, and notify the doctor on duty to at least take a look at it.

Or a PA or CRN. They are cheaper. As the last resort you can have an AI doing it :-)

Yes, but this doctor in particular doesn't seem to have any such automated system. They seem to reviewing it all manually. From the post,

> I was told I’d receive a response in 2-3 business days

2-3 "business days"? Yea, I can see how LLMs are going to be super helpful in patients taking their health more in their own hands.

Interpreting blood results it not something objective. There are bounds sure but the interpretation is always based on all the available results.

Source: resident in a few months

I believe it's because statistics can be interpreted in different ways and requires analysis (work). "AI" just gives you an answer, even if it's wrong.

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