AME: Better Chart Notes with AI

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[00:00:55] Armed with an obsession to bring entertaining and informative content to the dental world in a way that's never been done before, I give you The Alan Mead Experience. Well, hello and welcome to another episode of The Alan Mead Experience. I'm your host, Dr. Alan Mead. I'm a dentist, a podcaster, and a consumer of fine earbuds.

[00:01:20] There's a good story behind this. I was going to say a connoisseur of fine earbuds, but the reality is I'm a consumer of them. I have a long, weird relationship with my earbuds. I love Bluetooth earbuds and I hate Bluetooth earbuds all at the same time. So, interestingly, I've tried a lot of different earbuds over the years because between myself and my oldest son,

[00:01:48] we either break or lose earbuds at a very high rate. Higher rate than normal, I'm going to say. I don't think earbuds are supposed to fail or be lost at the rate that we do, but here we are. So, actually, my son was at prom earlier this year and dropped his earbud case. Why he needed earbuds at prom, listen, I don't know.

[00:02:13] Yeah, I don't know, but he had his earbuds and he dropped them and it was dark and I think I might have told this story. He picked the case up not realizing that the earbuds had fallen out of them. The place that he went to prom, they found one earbud, one of his earbuds, not both of them. And to this day, we don't know where that one left. So, I was a huge fan of these earbuds. Jabra is the name of the company.

[00:02:40] And I think the finest earbuds that I've ever owned are the Jabra Elite 85Ts, which are no longer made. I've literally bought some from eBay for a ridiculous amount of money. They're fantastic, but also sometimes they just stop working or they'll stop charging or whatever. So, like I said, love-hate. I really think feature-wise they're my favorite. They sound the best. They have the best features. Also, I've gone through many pairs of these things over the years.

[00:03:09] So, I recently got a pair of Jabra Evolve 2 earbuds, which are like – they're similar to the Elite 85Ts. They're a newer version and they come with a little USB-A or USB-C dongle you can plug into your computer or your phone or whatever and it connects them.

[00:03:32] You can connect them like normal Bluetooth, but you can also have them connect directly with this dongle, which is kind of a nice feature. You can just plug it directly into your – whatever computer you're using if you wanted to. So, they're good. I don't think they're as good as the 85Ts, but they're good. They're fine. Their case was a little funnier shaped. And so – but I was – I had settled in to enjoying these earbuds. And then two weeks ago, I lost them.

[00:04:02] Like, lost them. And I was – like, they were just gone. I looked everywhere. I think I was in my wife's car. I looked everywhere. I couldn't find them. So – and we had been at like a baseball game. And I'm like, man, you know, I bet they fell out at the baseball game, blah, blah, blah. So, I went through a period of mourning for my earbuds, but also, like, when you buy as many earbuds as I've bought over the years for myself and my son, you're like, I'm not doing it anymore. I just can't do it.

[00:04:28] So, I have some, like, athletic – some athletic – the shocks that go around you. I swear to God, we've owned every kind of earbud. We have just a pile of them, and we just run through them like crazy. So, anyhow, for my son, I ended up getting a pair of less expensive earbuds that actually are pretty good. And then – and he's using some other ones that I've had that I didn't really like that much.

[00:04:55] I was using my shocks athletic ones, which were open ear, which kind of sucks when you're mowing the lawn because you can – like, noise canceling is nice for that. So, well, then lo and behold, my son lost his glasses. There's a theme here with meads. We seem to lose things. That is – I'm not proud of that, but here we are. He lost his glasses, and he didn't have his glasses on Friday, and we were looking for them all over the place. And, of course, they ended up being in the drawer in the bathroom or something stupid like that. So, he did find them.

[00:05:24] But we tore apart her car, and she found my earbuds. It had been like two weeks that I'd been without earbuds. So, now I'm just that much more grateful to have the earbuds because I had settled into the idea that I had lost those earbuds. And I'm like, I'm not dropping another couple hundred bucks on a pair of good – these are decent earbuds. I put some money into them all – years after years. I bought a ton of these things. I'm sure I'm into earbuds for thousands of dollars over the years. I'm just like, I'm just not doing it anymore.

[00:05:53] I can't be trusted. I lose them or they break or whatever. So, I'm sitting here extra grateful having my wife found the earbuds. I should ask her. I don't know where she found them in the car, but she says, oh, there's some earbuds in here that – you know. So, I was very excited that I got my earbuds back.

[00:06:09] So, you don't – if you want to really appreciate the things you have, lose them and go through that period of mourning where you think you've had it and you literally don't even trust yourself to buy another pair of them because you've lost so many of them or they've broken or whatever. And you're like, you know what? I'm just not doing it. I'm not going to – and we found them and now I'm extra grateful that I have my earbuds. So, yeah, we are consumers of earbuds. We're not users as much as consumers.

[00:06:38] We literally work through them at some point. So, hopefully I will hang on to these for a little while. So, that's my earbud story. Sort of similar to the earbud story. I have been kicking around the idea of having an AI scribe type situation where I use AI to help with chart notes.

[00:07:02] Because, honestly, chart notes are doing really excellent chart notes. I think a really good dentist should have really good chart notes and this is something they should be good at. But I got to tell you, and you may – if you're doing that, you're spending a lot of time. Like if you do it manually, even if you have really good templates in your software, you're spending some time doing that. And so, the reality is like even if you commit to really being excellent at that, that's hard work.

[00:07:31] It's a big commitment and it's hard to keep up with them. It's hard not to sort of slack on them. So, what I found is that – okay. AI – who knows? AI is probably going to control our whole lives soon enough. I know. And I am not a doomer, definitely, because I use AI. I have a lot of use for AI. I actually have a Gemini account that I have a – I pay, I don't know, 25 bucks a month or whatever. I use Gemini. I use it a lot. I use it a lot, a lot.

[00:08:00] And it turns out as I was looking, I wanted to see how much of my Gemini – how much until I'm going to have to pay more. And I was like at 1%. So, I guess I would have thought I was a Gemini power user. I am not. I don't use it that – I feel like I use it all the time for lots of things, but I am not a Gemini power user.

[00:08:19] So, clearly, AI is – it's become a big thing in our lives, whether we – it's really funny, because even if you don't use it, you know, like you're like, I don't go to Gemini and ask it to do things for me. If you do a Google search at this point, your first – your top results are almost always AI. I think you can probably switch that off. But essentially, now you're using Google. It's essentially using Gemini AI to generate whatever you're getting from it. So, AI is kind of everywhere.

[00:08:49] And so, I have been enamored with the idea of helping – having these AI recorders to help me organize my life. And I've literally – I've bought a couple of these things. I had one called the Plod AI pin. Kind of cool, but honestly, it's really funny. This is a really dumb thing, but I could never tell if it was recording or not. Like, it's – I still have it, but it's supposed to vibrate when you push it, and you know it's on and off, but it's not obvious if it's recording or not, right?

[00:09:18] Which is – I have another thing in my life. The microscope that I had before, the one I'm using now, has a video recorder. And, you know, if you don't know that it's recording, you don't know if you're, like, literally recording a bunch of dead air. I mean, when you record off that microscope, those huge video files. You're just like, ah. So, these things need to have an indicator that they're running, right? Like, so the Plod AI, I think it was a pretty neat thing.

[00:09:46] The concept is they can record phone calls or they can record meetings or they can record whatever, and they transcribe it essentially perfectly. And then you can either take the transcription and just use that alone or it can – a lot of these places have software sort of built into them so they can automatically generate a summary or whatever. And you can customize them like crazy. So, the Plod AI was fine. I found – Instagram threw some ads at me for something called the HiDoc P1.

[00:10:15] I'm like, ooh, that is fascinating because the HiDoc P1 was kind of cool. It's a little bit bigger. It looks more like a more conventional digital recorder. I'll put maybe a picture of it in the show notes. I definitely will give you links to all these things if you're interested. I bought the HiDoc P1 thinking this is – this thing's really cool. And I got it. I got out of the box and it was – I couldn't figure out – like, there was no record button. Like, it was not – okay. I guess I need it really spoon-fed to me something.

[00:10:46] I had this thing for a while and you charge it with a USB-C cord. You connect it to your computer and all this stuff. But it wasn't obvious how it worked. And the reality is I didn't know when it was recording and when it wasn't. So this HiDoc thing is really interesting because you can – it can record a room. It's got microphones so it can record like a meeting that you're in a room. It can connect to Bluetooth your – like your earbuds or whatever. And it can record a phone conversation very well.

[00:11:15] Apparently, that's what it's really known for. And apparently, it's very easy to connect to Bluetooth. It can connect – there's a mute button. But anyhow, the controls on it are not obvious, right? So I got this thing. Thought, man, this thing's really cool. And then I promptly didn't use it because I'm like, I don't really know how this works. So finally, like a couple weeks ago, maybe a week and a half ago, I finally pulled it up and I said, I paid like $160 for this thing. I haven't really used it. I don't know.

[00:11:43] So I found a YouTube video of it. And of course, that's the thing. The instructions were not good. I mean, I don't want to come off as – okay. So I think this thing is probably manufactured in China. And the instructions, like many things manufactured in China, they're actually really well put together. But a lot of times, the instructions for an English speaker are not excellent. And that's what was the problem with this.

[00:12:11] The instructions were essentially useless that came with it. And so I couldn't figure it out from the instructions that came in the box. And I just gave up. And literally, it was like in my car. I'd look at it in my car and I wasn't figuring it out. I'm like, geez, you know, it's supposed to be, you know, like a digital recorder. I could record my thoughts. I could do – if I had meetings or whatever, this sort of thing. So I finally found a YouTube video or two. And I think I'll link to the YouTube video that I found very helpful because all of a sudden, he showed me how to use it on this YouTube video. It was super easy. I'm like, oh, this is a piece of cake.

[00:12:40] This thing is not hard to use at all. So last week, we had a meeting for the chaperones of the upcoming Disney – as I've said before, I'm going to be chaperoning a bus trip down to Disney in a few weeks here. It's like less than three weeks, actually, that we'll be going. Yeah, it's like two weeks. Holy cow. Is that right? It is. Holy – I'm leaving in two weeks. Anyhow, so this episode comes out on Memorial Day.

[00:13:08] So, yeah, there's like two weeks I'll be on my way to – or maybe even in Disney by then. Anyhow, so I wanted to record this chaperone meeting to make sure that I knew everything, you know, what my responsibilities would be, what to expect, all this stuff. And so I brought this HiDoc P1, and I brought it to the meeting, and I hit the record button, and I just set it on a chair. And I'm going to tell you what. It did transcribe the whole meeting.

[00:13:38] And even though there were some of it that was, you know, that was not particularly important to the meeting, you know, you could hear people talking. It kind of picks up everything in the room, even if it's not – but it seems to understand context when you put it in. It was pretty great. So not only did I use the software that came with the HIDOC P1 to give me an outline, I also took the transcript and threw it over into Google Gemini and asked it to do – and so I've got two different meeting summaries, both of them quite good. So these recorders are legit. They are – they're very legit.

[00:14:07] They do a really nice job with – they can record a period of time, and then they can transcribe it, and they can generate stuff. In other words, they can take the junk out and make it a really good outline. This is like a huge – in the same way that – that AI is able to listen to a podcast episode and make a really good outline out of it. It's like it can listen to it and understand it in a way that –

[00:14:35] and it's just like that's much harder for me to do than this AI. It's just really good at this stuff. So anyhow, I'm like, why in the world am I not using this for chart notes? And I've come to realize the reason I'm not using it for chart notes in this exact way where I bring it into the operatory with me and record everything is that HIPAA, patient confidentiality is the problem here. Crazy Dental already has the lowest prices on dental supplies anywhere.

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[00:15:31] and I have to tell you, I have done this a few times, and it generates a really good note. You could choose to not bring it in the operatory with you. You could dictate what happened just right after it happened. It doesn't matter how good your dictation is. It's not like you have to be perfect. I mean, I was never a guy who dictated chart note stuff very often, but the reality is, like, if you do it right as it's happening or right, it generates a beautiful chart note off just what you said happened in there.

[00:16:01] It's kind of unbelievable. And what's great about it is I don't feel like the HIPAA is such a concern. The privacy issues aren't such a huge concern here because you're not, you don't enter any actual patient identifiers whatsoever. You don't give any names, you don't give any dates, birth dates, nothing like that. If you were to take this into the operatory with you and record it, there's identifiers. And as soon as you're, as soon as,

[00:16:28] the reason these recorders work so well is there's AI involved with it. So AI is listening and transcribing, and AI is then outlining and creating your note and that sort of thing. The problem is, is that if you don't have an agreement, the privacy agreement with that AI company, then you're breaking the patient confidentiality or there's a potential, the liability for any, any confidentiality stuff falls on you because you have not contracted with, you know, high doc P one or Google Gemini or whatever. So the reality is,

[00:16:56] is like any patient identifiers put you in a position of liability. So you're like, Oh, well, that's great. Except so you're seeing if, if you're on Facebook or Instagram or anywhere, you're seeing lots and lots of different medical, dental AI scribe technology out there. You see, I have to say, um, I'm going to throw a few of them out there that I've seen. And I'm beginning to understand why, like, like there's a part of me that goes, well, shoot,

[00:17:25] why should I pay $600 a month for overjet AI, which does, you know, which does the, the cool can, you know, help you with your x-rays and make your x-rays, you know, it put its AI algorithm on your radiographs and, and show you in a proximal decay or, or radio lucencies or whatever, which is really cool. But it can also, it can also help you with your chart notes. And you literally, I've seen, I've seen the, I know that some people are using it. It's, you wear a microphone on you and, and it,

[00:17:53] the microphone is connected directly to your computer in that operatory. And literally it generates your notes from that. And I am, I have no doubt in my mind, it does a great job and your notes will be generally well. It's like 600 bucks a month though. So you're talking, I mean, that's, that's, you know, $7,000 a month or a year to do that along with your x-ray things. Maybe that's worth it. And, and, and my guess is that we're still early enough on in this AI stuff that, that we're not exactly sure where all of this is going to go.

[00:18:23] But I, I am now understanding the expense is, is not that the AI can do this stuff, particularly for chart notes, because frankly, I think, I think if you are able to use a recorder, like I'm describing with this high doc P one in your, you know, in your office where you just dictate what happened with no patient identifiers, it'll make you a great note. It'll make you a great note. However, I believe the magic is going to come when you, it literally records the, the actual patient interaction. It just records the whole,

[00:18:53] the whole appointment. And it just generates the note directly from that. Here's the thing. A couple of things have to happen. First off, you have to have, you have to have the privacy stuff in place. And, and there's a significant expense where they, the people who are grabbing your, your grabbing and transcribing and making your note, the liability for, for privacy is on them. And that costs money is, it's called a signed BAA,

[00:19:23] a business associate agreement, which basically, you know, that's the, that's what you're paying for in, you know, any third party vendor that touches stores or transmits patient identifiers on your behalf, must sign a business associate agreement to BAA. So here's the deal. Well, the fact that they take on that liability and take it off of you, you're paying for that. So there's something there. And all these, all these medical AI scribes that are like legitimate medical AI scribes,

[00:19:52] they're charging you for that. There's, you know, there's money for that. There's, you're paying money for that. And then the other thing is, is that as soon as, as soon as the note is created, the recording is deleted there. So in other words, they never, it's never stored anywhere. And that's also a big deal. In other words, they're like, there's, there's a lot of rules about privacy that a regular old dentist isn't necessarily thinking of unless they're expert in this particular field, which I get. And so all of a sudden me complaining, well,

[00:20:21] this is really expensive and AI could do well. The story is you're for, for your medical, for the liability aspect, the legal aspects, you really need to do this the right way. So if you want to do it on the cheap, you're not going to be able to record the patient interaction. You're going to have to be able to, to dictate something with basically no patient identifiers and, and then do that, that cut and paste. So, but I have to tell you that I, I am a big fan of this, this high doc P one. I think it's a very cool piece of equipment.

[00:20:51] And then I'm like, why don't they have something like this, that this piece of hardware? Cause I don't, what I'm going to tell you is I don't want to have my phone in my pocket. I don't want to have to remember to, to record, you know, hit record and do credit. And I don't really want, I want, I want it to be, if I'm using it in the operatory, I want it to be unobtrusive. I want it to be not obnoxious, not, not something where I'm playing with the buttons or anything like that. I want it to be something.

[00:21:20] And so, but I also want it to be hardware. I don't really want to have to do it directly into my, my operatory computer. Cause to be honest, my operatory computers are sometimes a little buggy. Like sometimes they get hung up and I'm like, I don't want, I don't want to have to rely on my operatory computer always being right on the money either. Because listen, I've owned a practice for a long time and sometimes you have to restart, you know, okay, this computer's not taking any x-rays. I'm not sure what's going on. Let's restart it. Well, I can't,

[00:21:47] I don't want to not have the chart note because my computer's not running right or whatever. So I don't really want to rely on, on my operatory computer either only because they've been squirrely before. So I love the idea of having a recorder. That's a hardware thing that, that you either have in your pocket or you're laying it out on the counter where, where it's not, you don't have to mess with it a ton. So anyhow, I'm thinking to myself, I'd love to have this, like this recorder, but my,

[00:22:13] my HiDoc P1 recorder is not privacy compliant. It doesn't have that. Like a recorder that can be offline and not, not on the internet all the time. In other words, it's not just a microphone that's transmitting to a computer is called the HiD remote. HiD is a, is a medical scribe that actually claims to be a dental scribe. I, I'm not saying I'm not at a point with this where I'm recommending this yet. I may try it.

[00:22:43] I think I'm going to try it. Um, I might reach out to them and maybe see if I can have someone come on the podcast and explain how it would work. Maybe, I don't know. I'm not sure. I'm going to see. Uh, I like the idea of a hardware solution where it's actually records and then it uploads to whatever AI to, to, to translate your note and then it deletes it. And I like the idea that they're, they take the legal, uh, liability of, of the privacy aspect, which is not,

[00:23:13] like I said, a regular AI recorder that can do some amazing stuff. You're, you're kind of not covered in this in the same way. And I don't, I don't know what would happen if you did that. I think it's not smart. I think it's not a smart move to, to do this, uh, this kind of charting where you're actually recording in the operatory. I think it's not probably a smart thing to do. I think, I think you're breaking some rules there and that could come back to bite you. It sounds like, in other words, a lot of these companies that have AI charting, you know,

[00:23:43] where they're medical and they're all official. I think they've done the legwork. So you don't have to worry as much about that stuff, but I'm going to tell you that the notes that you can create with this stuff are just spectacular. They're very good. They, they catch essentially everything. My suspicion is when you're in the operatory, you're going to be more explicit about what you're doing and what, you know, making sure that you, you've described it. I love the concept actually, because if the patient knows, Hey, I'm in order. I can,

[00:24:13] so I can actually pay attention to you and what I'm doing. I, my chart note is going to be spectacular, but I'll be recording this. So you have to get consent from the patient, but you can word that in such a way that patient's not going to be wigged out by it. And it's not recording you. I'm not recording you, the patient I'm recording our interaction. So it can make sure to keep track of things. And then it would be on you to make sure you're saying things kind of explicitly like, like, okay, so we're going to do a crown today. We have to actually two crowns on, on tooth, 18,

[00:24:41] that's a lower left back to teeth. That's what you were expecting. Right. And you can have it. Basically you can almost do your informed consent. That way you can explain the diagnosis, all that stuff. And your notes going to come out with all that stuff. You don't have to do anything extra. You just like, basically you're explaining what you're going to do, do step-by-step to the patient. And it doesn't have to be super obnoxious to do it. You don't have to go out of your way to do it. It's pretty cool. It's it's I, the concept is there. So what I'm laughing about, I was probably in five years from now,

[00:25:08] I will listen to this and it will sound so quaint and antiquated that I'm like, I'm very excited that AI can create a note. I think probably it'll be built into everything, but I think we're, we're at that time where it's still kind of finding its legs a little bit. I do like the fact that they, we have some options that cover us, cover our liability for privacy. I like that they're doing that. And I think one of the issues prior to this is we weren't really sure what was happening there. Well, yeah,

[00:25:37] I get it now because if they're uploading to a server in order to transcribe and make that note, that's got it. You got to have that. That's patient information. Even if you're trying really hard to make sure there's no identifiers, it's still, it's still pretty sketchy. And I also like the fact that once the recording is, is transcribed and, and, and the note is made, it's deleted. So it's gone. I love all those things. So I'm, I'm thinking I'm going to try this Heidi remote thing, but in the meantime,

[00:26:04] I have to tell you that this high doc P one is not an expensive thing. Shoot. I think I saw it on sale too, maybe recently for, for even less than 160 bucks. Um, it is very cool. I feel like I'm going to have it with me everywhere because I'm, I'm going to, uh, it, it's amazing. It records your thoughts, but then you don't have to go back and listen to them. It records your thoughts and then it will like make a to-do list or make a, make a, uh, you know, action items. It's, it's really cool.

[00:26:34] Like these AI digital recorders have a lot, like they could really help someone like me, who's not super organized about stuff, be more organized. And, and you can see in, in using them, you can see the power that they might have with creating a chart node or doing something like clearly there's a lot that's going to come out of this stuff. I'm excited to hear, but like I said, I, I know that overjet AI is, is marketing heavily to dentists and, and it used to just be overjet was like, Hey,

[00:27:03] look at the, look at the filters we can put on your x-rays. We can show you, you know, where you might be missing some diagnostics. Well, now they've got it where it's built in, where they're, it's doing your chart notes too. Again, I have not seen that yet. I've not seen a demo yet. Uh, maybe I'll get someone on the podcast to talk about it. Cause I'm kind of fascinated by it. So it, it's funny. It's, it, if you've used any of these AI, AI is from, you know, whether you've transcribed it from a, uh, a recording or, you know, you've typed something out, it can really generate stuff. That's, that's quite excellent.

[00:27:33] You can see where that's going, but you do want to make sure that you're, you're covered with the, the liability for privacy information. That's, that's pretty serious stuff. And so I, they've done the legwork on the medical aspect of it. I think it's pretty cool. I'm excited about it. Uh, there's a lot about AI that people are worried about. This feels like, doesn't feel quite as experimental. It's pretty consistent. Like I've been using probably for the last year or so. I've been using it, um,

[00:28:03] to help generate stuff for the podcast and it's, it's bulletproof. It does a really good job. Uh, but it is interesting how, you know, I don't have to worry too much about privacy issues from when I'm transcribing a podcast or transcribing a meeting for my Disney chaperone stuff. But I understand now that, that the privacy issues need to be taken into account. And that's where the, that's why it's more expensive to do it for your dental office. So worth of, worth of thought though. I have to say that the notes generated are pretty impressive, even off of me just, uh,

[00:28:34] talking into the, the recorder myself without giving any patient identifiers. I feel like if it's built into the process where you can actually record right in the operatory next level, I think that's going to be where, like I said, in five years, it's all, no one will be writing any notes out. No one will be typing it out. No one will be using templates because everyone's just going to use this stuff. Piece of cake. That's what I'm thinking. That's where I think it's going. All right, folks, if you haven't gone to the very dental Facebook group yet, you need to go and become a part of it. This is where we talk about stuff. It's not, it's, it's not the most active group, but it's also not a garbage fire.

[00:29:04] I promise you, uh, regular folks that listen to the podcast. I would love if you would join there. You go to very dental and I'm going to, uh, I asked you to give me a password, which tells me that you listen to the podcast. Cause I only give the passwords out on podcasts. So, uh, passwords would be Lipscomb, Timmerman, McQuethy, BioClear, Gary, Frank, Papa Randy, Hornbrook. Well, there's eight of them. I don't, there might be more. I know I've made more, but there's a lot. I'm giving any of those and you can get in. We can have conversations there.

[00:29:33] I really appreciate you guys listening to the podcast. I would love it. If you guys would tell me who you think I should talk to, who should I get in touch with that would be useful for you for me to talk to and what questions I should ask. If there's topics I need to cover, I I'm fascinated by this. So I thought this would be a really good topic, but there's a lot of technology that's moving pretty fast that, that isn't necessarily a super huge expense. Like when you think about technology, you're like, Oh, new scanners, new, new printers. I love that stuff.

[00:30:02] But also I would suggest that maybe this kind of stuff might change the way your workflow goes more than almost anything. So kind of cool. I hope you guys appreciate, uh, appreciate this stuff. If you, if you're liking it, let me know if you have any suggestions. Thank you again for listening and we will catch you next episode. Bye.