Mastodawn

The Zen Lady 1d ago

PSA:

If you are wearing smart glasses and come to the ER, the smart glasses people are going to get a recording of my history, exam, and discussion of your results. You wouldn’t believe how often I unexpectedly find cancer, or syphilis, or other conditions you may not want big tech to immediately be privy to. Meta isn’t subject to medical privacy laws. It also isn’t my job to recognize your camera and give you a heads-up. In fact, big signs in the ER tell you recording is not allowed.

Sham 🏳️‍🌈May 22

@mcnado How often have people come in with smart glasses on? I'm not sure I've even noticed anybody wearing them around me yet, but I figure everyone has to go to a hospital eventually

McNadoMD May 22

@shammers so far I’ve noticed 2. How many did I not notice? Who knows? If it weren’t for being on here, I would never have realized that’s what they were because I have no other contact with meta advertisements.

@mcnado a risk many men will gladly take to be able to secretly film naked women!

AlexanderVI May 22

@hllizi @mcnado

*any* women

@AlexanderVI @mcnado true

🇺🇦 haxadecimal 🚫👑May 22

@mcnado
I have taken a few photos in the ER, violating the policy, but I only took photos of parts of my own body. No photos of staff or other patients.

Kat Kimbriel May 22

I was thinking, "I should ask if I can quote him as an anonymous ER doctor and share this."

Then I realized it will take until some techie idiot gets a cancer diagnosis in ER, his company fires him under weird circumstances, he tries to sue the company & ER, and the ER lawyers destroy him in court. Then, the journalistic reports spread.

Only then will some of those guys not wear their glasses into the ER. :(

McNadoMD May 27

@KatKimbriel hah. Yeah, my guess is that someone’s kid’s healthcare will get recorded and that will be the end of it.

Kat Kimbriel May 27

Good chance that would deep six it, too.

wy knott May 22

@mcnado please do also tell your interns that, no, they can't use chatgpt "just to summarize" our interview, since that is a direct and immediate violation of my HIPAA rights.

McNadoMD May 22

@wyatt_h_knott functional health systems are training people to use the embedded AI that is supposedly sandboxed. I don’t use it because I don’t believe that it is actually safe in any way. The lawsuits over leaked training datasets are going to be interesting.

wy knott May 22

@mcnado I think I told you about this already, but I had an intern get annoyed with me during my last ER visit. He pulled out his phone and before he could even ask if it was "ok to record" I asked him "is that chatGPT?" and he did not say it was a local sandbox instance, he just nodded. I told him to turn it off. He started to argue that it was just for summary purposes but he could see I wasn't having it so he said "but I can turn it off if you want."

wy knott May 22

@mcnado And all it takes is one person to sue, and then all of those supposedly private records are going to get dragged into the legal battle, which has already happened with an AI mental health app.

Flaming Cheeto May 22

@mcnado @wyatt_h_knott

I saw a podiatrist the other day and he asks to record audio for summary. I said fine as long as I could too. He said I wasn't allowed to. So I asked if he could send me a copy of the recording before it is deleted (the health system policy is to delete after the visit summary is produced). He said he didn't think they had the ability to do that.

Flaming Cheeto May 22

@mcnado @wyatt_h_knott

But they must have access to the recording because they have to sign off on each summary. If something didn't read right to him, he has to be able to reference the original to correct the mistake. I guess they can't extract it. Frustrating. So only the machine's version of the "truth" remains, lightly confirmed by the doctor.

Greg Wellman May 23

@PizzaDemon @mcnado @wyatt_h_knott No, they sign off on the summary the same way they used to write the notes before - from memory, and/or scribbled notes.

here for making friends and learning 🏳️‍⚧️ 🏳️‍🌈♾️May 22

this happened to me recently with a full doctor. He's like "mind if I have AI record this visit?" and I'm like "Yes I mind"

aria.DNE May 22

@wyatt_h_knott @mcnado

The CBC recently published an article about an analysis of AI scribes intended for recording medical appts.

https://www.cbc.ca/news/canada/toronto/ai-scribe-system-hallucinations-9.7197049

AI transcriber for use by Ontario doctors 'hallucinated,' generated errors, auditor finds | CBC News

Artificial intelligence note-taking tools intended for use by Ontario doctors provided incorrect and incomplete information or demonstrated "hallucinations," and were not evaluated adequately, the province’s auditor general says in a new report.

CBC

McNadoMD May 27

@grim_elsewhere @wyatt_h_knott I asked the sales guy that was hyping the version in our EHR, noting that various studies estimated AI hallucinating 1-2% of the time. He noted that was in the ballpark of what they were aware of, and put it on the user to proofread the notes (which I guarantee is not happening).

aria.DNE May 27

@mcnado @wyatt_h_knott yeah, that's the problem with "almost always functional." When it fails, did anyone notice?

ℵ₀ 🏳️‍⚧️🏴‍☠️May 22

https://github.com/yjeanrenaud/yj_nearbyglasses
https://play.google.com/store/apps/details?id=ch.pocketpc.nearbyglasses
This is effective in detecting them; the likelihood of false positives is lower in that environment, and can be cross-correlated and scrutinized more readily. It seems likely that the usual disclaimers would not apply in that circumstance, either.

Disisdeguey🍉🔻PalestineAction🇵🇸May 22

@null_aleph @mcnado Have you tried this app?

ℵ₀ 🏳️‍⚧️🏴‍☠️May 22

@disisdeguey @mcnado yes, I can confirm that it works.

Disisdeguey🍉🔻PalestineAction🇵🇸May 22

@null_aleph @mcnado ok thanks.

Jeffrey Rogers 🏴󠁧󠁢󠁷󠁬󠁳󠁿May 22

@mcnado @disisdeguey @null_aleph That’s handy. Thank you.

Morgan Pimentel May 22

@mcnado Great PSA! 😎 I where Smart Glasses sometimes, but for me they are an Assistive Technology device (reading/navigation/descriptions - lo vision/blind human 🦯), not something I where or use to simply look cool and snap pretty bird pics for FB and IG.

That said, I always take them off in doctors offices for this reason.

Plus, I just feel it's rude to wear this tech during an exam. Unless your Meta Glasses double as your regular glasses (RX built-in), why on earth would you want to wear these during an exam?
Maybe I'm just ignerent on this matter 🤷‍♀️

Also have thoughts on those who do choose to have their glasses RX built into these, but that's another story. My regular glasses RX are separate.

iced_spiders May 22

@mcnado Perv glasses or pervert glasses. not smart.

ClickyMcTicker May 22

@mcnado I don’t own smart glasses, I don’t like smart glasses, but I also know that glasses owners typically don’t carry multiple redundant pairs with them. I don’t plan my ER visits - I suspect many people don’t - so there will be people who have one pair of (smart) glasses and have to choose between the camera being present and *being able to see*.

It reminds me of the time a friend broke their glasses on a trip and had to alternate between prescription sunglasses and no glasses to stumble through two days of travel and two airports. I suspect most owners don’t give a damn about anybody’s privacy, but there could be some who got hit by a car and don’t have any good options.

That said, you’re the ER doctor working every day of the year and I’m thankful that I haven’t been in years.

@ClickyMcTicker @mcnado I expect you don't know the answer as a non-owner but please tell me you can turn the glasses off? SURELY you can turn the glasses off? Whether people do or not is another issue, but there has to be more than a binary choice between "blindness" and "Black Mirror"?

Otherwise just shut the fucking Internet down already, it was a fun experiment but it's run its course.

Billy Smith May 22

@_calmdowndear @ClickyMcTicker @mcnado

It's hardware made by Meta.

How do you know that the "Turn Off" button actually does what it says? :|

@BillySmith @ClickyMcTicker @mcnado also true, I guess. Based on my child's experience with Quest headsets, you're probably better off just hoping your smart glasses break at the right time when you go into the ER.

LukefromDC May 22

@_calmdowndear @ClickyMcTicker @mcnado Tape on the camera lens while leaving the main (eye) lenses unobstructed should work

deftpunk: your worst daydream.May 22

@LukefromDC @_calmdowndear @ClickyMcTicker @mcnado do they not have a mic as well?

LukefromDC May 22

@deftpunk @_calmdowndear @ClickyMcTicker @mcnado No idea, but if they do wearing them can be a major criminal offense in states with "two party consent" laws for audio recording of interactions

@LukefromDC @deftpunk @ClickyMcTicker @mcnado I'm pretty sure they do have a mic, but what chance does someone being filmed in the street have against Meta's lawyers and lobbyists?

Ash-Miw-Re May 22

@ClickyMcTicker @mcnado I think the point might be less to shame people who are already stuck with them for whatever reason and more to warn, "Avoid buying these kind of glasses. If you're thinking about it, here's one more problem to add to the pile of trouble they can cause,"

Snake Oil Salesman May 22

@mcnado wait, people actually wear those things??

@mcnado @briankrebs wait... It's common to just randomly find syphilis? Really?!

Mx Verda May 22

@Wesche
A year ago: https://www.youtube.com/watch?v=3w8V01rnt9U
Last month: https://www.youtube.com/watch?v=p6jITJbnUbs
@mcnado @briankrebs

Syphilis Is Evolving Like Never Before.. In Michigan

YouTube

McNadoMD May 22

@Wesche @briankrebs guess it depends on how you think about “common”. I diagnose a few cases a year out of thousands of visits, but I most commonly find it in asymptomatic patients when I am ordering screening for various sneaky public health threats people walk around with. Rates are increasing currently.

@mcnado that's crazy. I had no idea it was common to find it in people who were asymptomatic.
As someone who has never had a blood test before I now will have a new anxiety lol

@mcnado and any decent ER will enforce that by forcing the recording to be deleted and stopped or they'll kick out people.

2something May 22

@mcnado

I hope your hospital also has a policy banning those AI recording apps that some medical providers use. I have encountered waaaay too many medical providers whose attitude towards recordings is "You aren't allowed to make a recording of us that you own and control, but we are allowed to make a recording of you that you can't access."

Fish Face May 22

@mcnado realistically, this is only going to happen if you come in and record with them. They are not always recording; no device that small has sufficient battery.

Jonathan May 22

I mean you might find that you diagnose syphilis every single time somebody is wearing meta smart glasses. Who knows. It's a crazy new future.

😉

Todd Knarr May 23

@mcnado And frankly I _wouldn't_ be using any kind of smart glasses that sent raw data anywhere not under my control.

I find myself divided here. I absolutely am creeped out at continuously sending raw video/audio to some third party. OTOH, far too often I find myself wanting video/audio of situations I was in and only realizing this after the fact. The only solution seems to be continuous recording so I can decide later what I want to keep a record of.

@tknarr @mcnado I absolutely get the desire, but this feels like one of the situations where there's just no ethical way to get what you want.

Todd Knarr May 23

@Teskariel @mcnado That leads to asking another question, though. I already have a record of everything I saw and heard without regard to the smart glasses. Is _that_ unethical too? I can't see any way to conclude that remembering what you saw and heard it unethical, and the local-storage recording from the smart glasses doesn't differ in any significant way from my memory. So how can one be ethical and the other not?