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Hi, I am Dr. Mark Studin. And first, I’d like to thank ChiroSecure for giving me the opportunity to share with you cutting edge information about what’s going on in our industry. Today we’re gonna talk about ai. And what AI is doing to our industry, and it’s about the most important but least favorable thing we do in our practice, which is documentation notes.
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It’s a pain in the butt, it’s drudgery. We all hate doing it, and we think artificial intelligence is the solution and guess what it is, but there is a problem, artificial intelligence. Really, as far as notes go is not ready for prime time. It just isn’t. And artificial intelligence, the formal name is a large language model.
Now, for instance I have a company called Verta. It’s about x-ray digitizer. So we went to put AI in there and I said, oh, great. We’re gonna put an AI module in and it’s gonna automatically pick out the data the points for us and the. IT team that I hired to do that who are AI specialists says when you start, it’ll be about 40% accurate.
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And then as you move on and you have millions of points, then it’ll go to 60, 70, 80, 90% accurate, but you’re gonna need millions and millions of points to get to be accurate. I said, why can’t it just know? It says, because it learns from what you do. It’s a large language model and it needs a lot of language in there.
So truthfully, we chose not to do that because upfront 40% accuracy doesn’t cover it at any level. As a lot of I have a company that I created and it’s called EMR Chiro. And it’s an EEHR program created because I was tired of the chiropractic nonsense and I wanted AI in the worst way.
And the company that I partnered with, which is a medical platform, promised they have ai and I waited a year for it and they finally put it in there and I was so excited. And it was junk. It was garbage. It threw it out. And I said, it doesn’t look anything like our computer processes. And in your notes you have macros that you create that are perfectly structured sentences.
You have to remember your documentation is about two things. It’s about reputation and it’s about compliance. Reputation is how the world sees you. That has to do with your referrals, but it’s about your compliance. And if your compliance is not right, it can cost you three things, your money, your license, or your freedom, and it has to be accurate.
And are you dealing with just an average patient who bent over and hurt themselves? Are you dealing with an asthmatic? Are you dealing with a slip and fall? You’re dealing with a car accident case. They all have different needs, but it also has to be grammatically correct and AI is not there yet. To give you exactly what you need.
So let me show you an example. Let’s look at a report. So when we look at this report, this is the initial evaluation. This is one of the things I got from E and Mark Chiro, just to let you know where I’m showing up from. It’s a sample, but look at this beautiful mechanism of injury. Look at this paragraph.
It’s written like you would expect a neurosurgeon, neurologist, or orthopedic surgeon, pain management specialist to do. Now, do I want you to be a neurosurgeon? No. I want you to be a chiropractor. We love chiropractic, but you are judged by that standard and it has to be accurate. So if we look at what AI does, and this is an AI model, okay?
This is the exact same language we have here, and I just put this in chat g, pt, and I put rewrite and look what AI did it put it in tabular format. You never see this. I don’t wanna use the word never. You rarely see this from a medical specialist, so now you’re being judged and you know who does it A lot like that.
Physical therapists. Now the world already perceives us. Our referral source is somewhere below a PT and somewhere above a massage therapist. That’s what they perceive us, which is absurd because chiropractic has, gosh, a 313% better outcome rate. Then then physical therapy for disability. As far as opiate goes we’ve got like a two to one ratio for lowering opiates.
It just, I can just go on and on about statistics, but when you look at this, it’s in tabular format. This is what AI did, and it’s not good. First of all, let’s look at accuracy. The patient reported the following, full colon. Now, everything after that is what the patient said. Here, AI wrote, the patient was a driver of a compact car that was stopped when it was struck from the rear by another vehicle.
This is written in first person, meaning you observe that to occur. So if this is a PI case and you’re on the witness stand, the attorney’s gonna say, doctor, did you watch that happen? No. You didn’t say any here that the patient reported nowhere. So it’s written in first person. So you’re writing that says you wrote it.
Now you’re not only in reputation, you’re in compliance because that could be constituted as perjury. You’ve lied. You didn’t see that. Okay. Airbag not deployed. Seatbelt one at the time of impact. It’s written like a computer is reporting it. It’s not in flowing sentences. Is it accurate? No, because.
This isn’t accurate. The rest is accurate, but it’s an issue. You had no intention of doing it this way. Your intention was to give a nice flowing report, and that’s very important. Proper sentence structure, proper paragraph structure. You are a learned, articulate expert, and that’s what you are, and your documentation has to reveal that.
Now, I’ve just given you one example. In the AI components right now, some of the services, some of the EHR programs, you’ll highlight what you want AI to do and you’ll and then you click ai and then I’ll give you choices and you pick one of those choices. One, you have to hope it fits properly in that sentence structure.
But number two, now, let’s see. Take a soap note now. We got our soap notes down between 30 seconds and a minute. Usually closer to 30 seconds once you’re familiar with it, but now you have to do your soap note, highlight it, pick ai, plunk it in. Now you have to read it and hope AI says exactly what you want it to say, and you might have to change it.
You’ve just increased your time, probably three or 400%. Writing that same soap note. So computer processes with macros provided you’ve randomized your text. Because truthfully, I’ve been leading the bandwagon for decades on randomized texts based upon the attorneys from the insurance company who explained to me that is one primary.
They’re going after doctors for what they call predetermined treatment plan. It’s all the same. You’ve gotta randomize it. It can’t always be the same words, or you’re in trouble, you’re gonna be in trouble. It’ll, it’s not about if they’re gonna come, it’s when they’re gonna be knocking on your door. But you’ve gotta take now instead of 30 seconds to a minute, three and a half to four minutes to get that sotol done.
So let’s say you’re seeing 150 patients a week times three extra minutes is 450 minutes divided by 60, you’re spending seven and a half hours a week. Just trying to get AI to fit into your notes. It’s absurd. It’s not saving you time yet. AI is not here yet. The company we’re working with the parent company and they’re a wealthy company.
They’re, they’ve been doing this for a long time. They’re the largest non-hospital medical group that I spent 16 months building chiropractic templates in, but they’re spending tens of millions of dollars. On getting AI correct and doing it. And we’re not the, they’re not the first to the market.
So we’re not, we’re lagging because I don’t want the garbage, I don’t want this garbage on my doctor’s reports. You don’t want this garbage on your reports. It’s inaccurate. It makes you look somewhere below a physical therapist. It’s not what you want to see. So you have to handle reputation and compliance.
So let’s go back and just chitchat for a minute now. Be very careful in what you get and look at the time it takes you. Computer processes is using macros now. I spent over a year developing macros that fit in. You have to spend the same time. Because I could tell you right now, there is no EHR system in our industry that has that level of macro for you.
You’ve gotta create all that. It’s gotta work for you. You’ve gotta customize it so you know and it’s important. You have to have programs that are written by chiropractors for chiropractors, because all of you have programs written by programmers, not doctors who don’t understand what you need. I know what it takes.
I was the one that did it. You’ve gotta do it for yours. You can’t rely on others. Your reputation is at stake. Your license is at stake, your money is at stake and your freedom is at stake. None of you have probably heard of a doctor being taken down for rico. None of you. Why? If you were sued for treble damages at $6 million, which leaves you an $18 million exposure plus legal fees of over a million, probably close to a million and a half, who would you tell nobody?
I’m the father confessor. Everybody calls me and says, mark, what do I do? I’ve been served. I have a standard answer. It’s a kneejerk reaction already. You have to call a criminal defense lawyer. You’d be astounded at how many doctors are going down because they haven’t paid careful attention. This isn’t a fear message.
This is an inspirational message to do it right front, to get it right up front. I have spent. Years getting it right. You need to spend that time. You need to put references in there because it’s part of what they call the Daubert standard, which is a federal standard. All carriers look at whether they’re going to either pay or create a lawsuit or deny.
So if you handle all of those issues, you’re golden. It has to be built into your notes. You need to have compliance guardrails built into your notes. Are you doing the little things? Are you doing your vitals? Which are vital, by the way. Vitals are vital. High weight, blood pressure, pulse. You need to do those things because that’s part of the standard of your license.
That has to be built in as guardrails to your EHR system. And if you are a corner cutter in your blow past them, shame on you. Eventually corner cutters get in trouble. So there’s a lot going on. So we’ve got other programs and primary spine care conferences. There’s a lot of things we could share with you.
Gimme a call anytime you want. I’m just Google me, mark, Studin. I’m all over the internet. My cell phone number’s there at (631) 786-4253. If you want to call and chat about your practice, your notes, 6 3 1 7 8 6 4 2 5 3. Listen. I’m so appreciative to be able to share this information with you.
Again, thank you ChiroSecure for the opportunity to do that. We’ll catch you on the next topic.
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