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If you think using a machine to evaluate how well a human is showing empathy is a good idea, you probably shouldn't have any position of power.
by neaden 2mo ago
If you think using a machine to evaluate how well a human is showing empathy is a good idea, you probably shouldn't have any position of power.
- BeetleB 2mo agoIf you employ a few hundred nurses, how exactly would you evaluate how well they show empathy? You can't rely on asking the customer. When they're upset (they often are in these calls), they'll lean towards the negative regardless. I don't know how well these AIs evaluate, but if they're even a little bit good, it makes sense to use it to screen for outliers, then have a human listen to those outliers and judge.
- malfist 2mo agoActually, you can rely on the customers. They're the only ones that can tell you.
- lostlogin 2mo ago> you can rely on the customers. Patient or customer? I even struggle with that, but I guess that’s what people are in a privatised healthcare system.
- munk-a 2mo agoMost of the folks here on HN are dealing with customer feedback in systems automation in one form or another - it's pretty unavoidable in this age of LLM trendiness. The customers of healthcare (in both private and publicly funded systems) are the patients. So while the term might not be super natural it's an understandable one to use.
- datsci_est_2015 2mo agoPatients are not customers, or at least I don’t want to live in a world where patients are considered customers. Customers and vendors are usually more of a symmetric relationship: price transparency, alternatives, lack of urgency. These are all characteristics of transactions that healthcare often lacks.
- fn-mote 2mo agoThe customer has more power than a patient. I definitely want to be a customer.
- markdown 2mo agoIf the hospital is owned by private equity, the owners definitely think of the patients as customers. Doctors and nurses shouldn't, but the owners do.
- deejaaymac 2mo agoCustomer, user, patient...it's all the same.
- groby_b 2mo agoBut they don't want to, because figuring that out is your job as a supervisor. If you outsource that work to customers/patients, you'll end up with the car dealership model, where the sales rep begs you to give a 10 on every single question including on the interior design so they don't get fired. That's the part most of this discussion misses. Supervisors exist for a reason. Congrats on your flat org structure, you fucked up an important feedback channel.
- BeetleB 2mo ago> where the sales rep begs you to give a 10 on every single question including on the interior design so they don't get fired. Oh yes, and the nurses did employ strategies like that pre-LLM (don't know if they still do). They had to be very strategic about it (you can't just say "Rate me a 10.")
- ak217 2mo agoYeah, this whole discussion cracks me up. I have a number of direct experiences with Kaiser nurses. They repeatedly got into arguments with doctors in front of me, tried to countermand doctors' instructions, ignored their patients, and complained to each other about their patients while they were right there. Repeated unprofessional behavior with no discernible change after trying to address it. My take is that the Kaiser nursing org has a serious discipline and customer (patient) focus problem.
- drknownuffin 2mo agoTo one degree or another, this is endemic among nurses. It's part of a broader cultural element: nursing programs have entrenched a culture of nurses vs. doctors. There are literally questions on their licensing exam to the effect of "which of these orders from a doctor should you refuse to enact?" (rather than, say, "which of these orders should you contact the doctor to seek clarification on?" or some other collaborative take). Nurses are taught their job is to protect patients from physicians. Given they don't have the expertise to do that , the general result is more broadly a power struggle in the guise of patient care.
- ak217 2mo agoI agree (with the obvious qualification that there are excellent nurses out there who do a great job and don't let this stuff get in the way of helping their patients, some Kaiser nurses included). But I also see a marked difference in behavior and outcomes in other hospitals I've been to. Yes, there are still some unprofessional nurses in those networks as well, but judging by the outcomes, the hospitals don't let them do damage.
- fn-mote 2mo agoI think this is an unfair take. The necessity of teaching nurses that doctors orders are not sacrosanct comes from the bitter experience of doctors giving orders that are wrong. Asking for clarification is great, but doctors can be very reluctant to hear. The bottom line is that the nurse must not do certain things and the certification exam is there to make sure they know it. Think of it in relation to the “anybody can stop the assembly line” part of quality control.
- ImPostingOnHN 2mo agoNot asking the customer because you're afraid they'll tell you they're upset is a good indicator that you should do it more, and fix the issues. You can ask the customer enough times that unreasonable customers or surveys are averaged out. A good question might be "why are you upset?"
- weard_beard 2mo agoIsn’t it a running joke at this point that if you do what customers ask instead of focusing on the highest quality of service you get worse outcomes and the customer is still unhappy?
- gusgus01 2mo agoI thought that was more about correctly interpreting their asks, and not just actioning without consideration. If all your customers are saying your chair could use a cushion, it doesn't mean add a cushion, it means the chair is uncomfortable and you need to investigate why.
- ImPostingOnHN 2mo agoIf all your customers are unhappy, then you probably aren't providing the high quality of service you think you're providing. After all, they're the judge, not you.
- kulahan 2mo ago"You can't ask people because the experience is so universally terrible they'll just tell you it's terrible" isn't really an argument against surveys, it just means you need more specific questions they'll be fired up to answer
- BeetleB 2mo agoLet me suggest the following: Ask the nurses if they want the customer to rate them. A significant fraction of the calls they answer are patients shouting at them because of: - Long wait times - They don't like their doctor - They don't like the advice they're given (sorry, but we're not going to book you as a high priority appointment if all you can tell me is you have a headache. Sorry, we're not going to prescribe a narcotic for a scraped knee.) - Several reasons that have nothing to do with the nurse, but the customer will still blame the nurse.
- deleted 2mo ago[deleted]
- TheOtherHobbes 2mo agoClassic "1 star review because UPS lost my delivery" metric. I'd guess most people have had a situation where there's a corporate problem, the support person you talk to literally doesn't have the tools or the agency to fix it, but then you're asked to rate their performance on whether or not they solved the issue, with no option to say "Actually they did their best but this isn't their fault."
- fn-mote 2mo ago> with no option to say "Actually they did their best but this isn't their fault." In this case, the lack of such an option is obviously a flaw in the assessment system. How to fix that? Major political issue, I suppose.
- johnnyanmac 2mo agoEbay solved this decades ago. You can rate the seller and product separately. adding 2-3 ratings won't fix everything of course, but it would be a start. I suppose it is political because these companies rarely want accurate assessment of their labor to begin with. They want any justification needed to lay anyone off at any time while minimizing legal liability.
- lostlogin 2mo ago> how exactly would you evaluate how well they show empathy? How would you want yours rated? By someone you have communicated with, or some data centre somewhere?
- BeetleB 2mo agoBy a knowledgeable/skilled person who listens to the call. (Which the AI solution provides). I suppose you could do that with the survey as well. It'd be an interesting study to see which is more reliable.
- AlotOfReading 2mo agoBy a knowledgeable/skilled person who listens to the call. (Which the AI solution provides). Can you point me to the information you evidently have about which models Kaiser is using? All I can find is that they're using innovaccer, which can use any of anthropic, openai, and meta models on AWS or azure. Even their published papers don't seem to specify a particular model or capability level, just "AI". For all we know it's a gpt mini or similarly cost-effective model that has the context awareness of a Labrador hearing the word "walk".
- lostlogin 2mo ago> By a knowledgeable/skilled person who listens to the call. (Which the AI solution provides). Are you saying that the AI is the same as a knowledgable/skilled person?
- kxrm 2mo agoI am quite heavily in AI, and I would say I am pro AI. However this use-case for AI is putting AI in the wrong position. AI should be in service to all humans. An administrator building out a middle management KPI based on AI is a misapplication of AI. Hospital systems are incentivized to avoid the real problems with healthcare. People want timeliness and they want quality care which hospital systems are not incentivized towards in the US. The incentives are profit, which given budgets means corners cut. Triaging is an opaque system to the patient. It's an important process to doll out finite resources but it also very frustrating to be told, "soon" when you've been waiting 15 hours to see someone. Frankly, if I were King for a day, the first thing I would do is break up the monolithic hospital systems and build out more urgent care. I would also try to find a way to facilitate transferring less critical patients from ERs to urgent care centers. Right now a hospital won't take the risk, especially if you are sitting in waiting room because beds are full. You can't easily punt a patient because them leaving would be against medical advice.
- wisty 2mo agoThere's a great academic book called "Stupid Rules". Excessive rules (or KPIs - often rules in disguise) exist because we don't like authority. Get the doctor to assess the nurse. Or the head nurses if you don't trust doctors. The nurses have managers, and if none of the doctors or head nurses can be trusted with a simple matter like assessing whether nurses are doing their jobs then you got bigger issues. Oh no, the boss might play favourites if it's not an objective measure! Oh the injustice /s But stupid rules or KPI also allow favourites. You can use an officious 30 point checklist and play favourites while ticking boxes. You can even rig "objective" data by controlling other factors (e.g. giving someone difficult customers do deal with). Yeah, data driven would be nice, if you have good data. But data driven is a power tool. You don't measure SLOC or reward token use in software because of perverse incentives.
- xp84 2mo agoWhen reading the headline I was thinking we were talking about evaluating things like whether a nurse asked the right questions of the patient from a best practices point of view (say you have <insert condition> and the best practices for that are to ask the patient about pain level and which side it's coming from and check in with them every X hours). But evaluating tone and empathy? Great, now every nurse is gonna be wasting their time and energy making sure to recite the best canned, optimized text-adventure incantations for the KPI every time they enter the room instead of using their brains to see what the patient actually needs. "Hello Mr. Smith our patients are our top priority at Kaiser and your nursing staff here at Kaiser Raccoon City are here to make sure you are cared for, comfortable, and safe. If you have any concerns or are feeling anxiety be sure to press the nurse button and we will be happy to assist you, we appreciate the trust you place in us and are eager to celebrate your recovery with you." < nurse now realizes Mr. Smith has been choking and losing consciousness while she was reciting that spiel >
- BeetleB 2mo ago> Get the doctor to assess the nurse. Definitely don't do this. I know doctors. I know nurses. Plenty of doctors view nurses as their slaves. And besides, doctors aren't qualified. These are different roles.
- ClumsyPilot 2mo ago> You can't rely on asking the customer It’s not even been five years of AI, and we’ve already arrived at the point where the human is wrong and the AI is right. Mind you this is in an area where the benchmark is the opinion of the human ! So if the customer is saying you’ve shown enough empathy but AI says you haven’t, then you take opinion of the AI? Soon we’re going to have a situation where the patient is breathing, but the AI says he’s dead.
- charlieyu1 2mo agoI mean the same KPI crap has existed for decades
- inigyou 2mo agoPower is based on wealth extraction, not merit.
- thin_carapace 2mo agoisn't that exactly what a class terrified of the guillotine would want underclasses to believe?
- optimiz3 2mo agoIn the future that class will control the guillotines in the form of Boston Dynamics guard dogs.
- deleted 2mo ago[deleted]
- sscaryterry 2mo agoÊtes-vous français?
- datsci_est_2015 2mo agoIncreasingly true in Trump’s America. It’s somewhat the point of democracy to maintain a limit on rent seekers’ and wealth extractors’ power on the political process. It should come as no surprise that the individuals who have grifted and extorted their way into power are also fiercely antidemocratic. The xenophobes and bigots that have hitched their wagons are equally deplorable.
- forgetfreeman 2mo agoI'ma keep it creamy with you, both parties have had the kind of political majority required to clamp down on the corporatization of our society, and neither have so much as paid lip service to doing so. You want to be mad at the current administration by all means there's fertile ground, but don't waste anyone's time blaming them for a situation that's been decades in the making with both major political parties pushing in tandem to realize it.
- caycep 2mo agosadly, this is happening more as medicine and healthcare become more and more corporate. Seeing this as hospitals all get acquired into these mega health systems (ostensibly to fight the now merged mega health insurance companies), that then like to throw their weight around.
- cj 2mo agoThank you private equity.
- ai_fry_ur_brain 2mo ago[dead]
- Xeoncross 2mo agoI can't imagine why people are looking into alternative healthcare
- jagged-chisel 2mo agoWhat alternative?
- markdown 2mo agoBloodletting works well, particularly agains the vapours.
- mring33621 2mo agoBut will it help with Flamsy?
- SoftTalker 2mo agoAnd expunging the PFAS chemicals from your body. Really.
- ElProlactin 2mo ago
- avaer 2mo agoMaybe we should replace those people in power with machines that show empathy.
- LastTrain 2mo agoWhy not? This is the tier that AI would replace best
- gyanchawdhary 2mo ago[flagged]
- api 2mo agoThat project was cancelled. This is mostly about workplace surveillance. Most of the replies are large pop subReddit level junk.
- akudha 2mo agoIf a human’s performance for 40 plus hours a week can be reduced to a performance score, that too in a field like healthcare, that alone feels weird. Sure there needs to be some way to reward people/evaluate their work etc, but I dunno if management by metrics is the best way, especially when those numbers are calculated by an algorithm. Where has all the empathy gone? And common sense? :(
- noisy_boy 2mo ago> Where has all the empathy gone? And common sense? :( Contrary to popular belief, I don't think common sense has gone away. It just has been deprioritized at the altar of profit. It'll be visible loud and clear the very instant if/when the lives of the assholes chasing profits was on the line.
- AdieuToLogic 2mo ago>> If a human’s performance for 40 plus hours a week can be reduced to a performance score ... >> Where has all the empathy gone? And common sense? :( > Contrary to popular belief, I don't think common sense has gone away. It just has been deprioritized at the altar of profit. Or perhaps it has been left to starve due to apathy and an unrelenting pursuit to reduce the difficult job of leadership into a much simpler one based on arbitrary numeric values which are defensible to those higher in the managerial food chain.
- noisy_boy 2mo ago> arbitrary numeric values which are defensible Defensible on account of discharging their relentless duties of generating shareholder value within legal limits... i.e. profit. The fact that it is done in a lopsided way at the expense of everything else is just sign of societal decline due to deification of money and letting the tiger of capitalism roam without boundaries.
- johnofthesea 2mo agoCommon sense would be not prioritising inefficient technology to automate few things and instead invest in people?