ChatGPT and Epic Systems

This year’s buzzword in academic and now business technology is ChatGPT. Epic Systems, Microsoft, and OpenAI (the owners of ChatGPT) have announced the release of the next evolution in artificial intelligence (AI) called GPT-4. This new system integrates AI with electronic health records with the hopes of advancing medical care and associated services.

In-basket messaging is the first section of electronic health records that will be significantly changed. Typically, provider emails, phone calls, and patient messages are loaded in chronological order. With the integration and advancement of AI, in-basket messages are prioritized and distributed to make the most efficient use of provider time.

Presenters at HIMSS 2023 lectured about the potential application of language models like GPT-4 for automating clinical documentation, decision support, and prescribing. This advancement is done by software that has been trained using a language model on a large dataset of health care-related messages and responses. Eventually, it may be possible to develop a system that can generate appropriate responses to different types of in-basket messages automatically.

However, it is important to note that the use of such systems would need to be carefully monitored and controlled to ensure that patient privacy and confidentiality are maintained at all times. Additionally, a health care provider must carefully review any automated response generated by a language model to ensure that it is accurate and appropriate for the specific context.

Mixed reality (medical extended reality)

Medical extended reality (MXR) or the use of virtual, augmented, and mixed reality technologies in health care is a relatively new field that is being explored for its potential to improve patient care and medical training. Exhibits at the conference demonstrated a variety of ways that MXR can be used, such as medical training, patient education, pain management, and patient rehabilitation.

In the realm of medical training, MXR can be used to simulate medical scenarios and procedures for training purposes. Medical students, nurses, and training allied professionals can use virtual and augmented reality to practice surgical procedures, diagnose medical conditions, or learn about human anatomy.

Medical extended reality can also be used to educate patients about their medical conditions and treatment options. For example, virtual reality can be used to show patients what happens during a surgical procedure or how their medications work in their bodies. It is hoped that using this advanced technology can help in some of the most pressing aspects of modern medical care, such as pain management. For instance, it can be used to distract patients from pain and discomfort post-medical procedures, similar to using a mirror box to relieve a patient’s pain after a limb amputation.

Lastly, MXR has the potential to aid in the rehabilitation of patients. Virtual and augmented reality can be used to simulate real-world scenarios and activities to help patients recover from injuries and improve their motor skills. There are a number of potential ways to improve patient outcomes and enhance medical education and training. However, it is important to note that MXR is still in the early stages of development, and more research is needed to fully understand its potential benefits and limitations.

Robotics (Cobot)

ChristianaCare has integrated “cobots,” short for collaborative robots; it is a type of robot designed to assist their medical staff. Cobots complete various tasks throughout the hospital, including reducing the need for human workers to move heavy or bulky items. This can help reduce the risk of workplace injuries and improve efficiency. Cobots are also being used at pharmacies to automate tasks such as medication dispensing and inventory management. It is theorized that this type of automation can help reduce errors and improve efficiency. Overall, cobots are not replacements for human workers but rather a tool to augment their capabilities and improve their working conditions.

Fast Healthcare Interoperability Resources (FHIR)

Fast Healthcare Interoperability Resources intend to deliver the exchange of health care information between different EHR systems. This product helps existing EHR software come into compliance with the EHR interoperability requirements created by the 21st Century Cures Act. Unfortunately, there needs to be much improvement for FHIR to be more meaningful.

Another exciting advancement announced at the HIMSS 23 conference was the partnership between Oracle Health and Athena Health to explore the potential use of biometrics (face recognition directory) to verify the identity of providers. This could be used to increase efficiency for prescribing controlled substances. Many of these exciting developments are still in the planning stages and may not come to fruition.

Afua Aning is a physician informaticist.