As a medical doctor I extensively use digital voice recorders to document my work. My secretary does the transcription. As a cost saving measure the process is soon intended to be replaced by AI-powered transcription, trained on each doctor’s voice. As I understand it the model created is not being stored locally and I have no control over it what so ever.
I see many dangers as the data model is trained on biometric data and possibly could be used to recreate my voice. Of course I understand that there probably are other recordings on the Internet of me, enough to recreate my voice, but that’s beside the point. Also the question is about educating them, not a legal one.
How do I present my case? I’m not willing to use a non local AI transcribing my voice. I don’t want to be percieved as a paranoid nut case. Preferravly I want my bosses and collegues to understand the privacy concerns and dangers of using a “cloud sollution”. Unfortunately thay are totally ignorant to the field of technology and the explanation/examples need to translate to the lay person.
You’re going to lose this fight. Admin types don’t understand technology and, at this point, I imagine neither do most doctors. You’ll be loud minority because your concerns aren’t concrete enough and ‘AI is so cool. I mean it’s in the news!’
Maybe I’m wrong, but my organization just went full ‘we don’t understand AI so don’t use it ever,’ which is the other side of the same coin.
I understand the fight will be hard and I’m not getting into it if I cant present something they will understand. I’m definetly in a minority both among the admin staff and my peers, the doctors. Most are totally ignorsnt to the privacy issue.
Personally I’d be more worried about leaking patient information to an uncontrolled system than having a voice model made
Thats another issue and doesn’t lessen the importance of this issue. Both are important but separate. One is about patiwnt data, the other about my voice model. Also in thsi case I have no control over the mesical records and it’s already stored outside the hospital in my case.
Ironically, GPT can kinda get you started here…
To present your case effectively to your bosses and colleagues, focus on simplifying the technical aspects and emphasizing the potential risks associated with using a cloud-based AI transcription service:
-
Privacy Concerns: Explain that using a cloud-based solution means entrusting sensitive biometric data (your voice) to a third-party provider. Emphasize that this data could potentially be accessed or misused without your consent.
-
Security Risks: Highlight the risks of data breaches and unauthorized access to your voice recordings stored in the cloud. Mention recent high-profile cases of data breaches to illustrate the potential consequences.
-
Voice Cloning: Explain the concept of voice cloning and how AI algorithms can be trained to mimic your voice using the data stored in the cloud. Use simple examples or analogies to illustrate how this could be used for malicious purposes, such as impersonation or fraud.
-
Lack of Control: Stress that you have no control over how your voice data is used or stored once it’s uploaded to the cloud. Unlike a local solution where you have more oversight and control, a cloud-based service leaves you vulnerable to the policies and practices of the provider.
-
Legal and Ethical Implications: While you acknowledge that there may be existing recordings of your voice online, emphasize that knowingly contributing to the creation of a database that could potentially be used for unethical or illegal purposes raises serious concerns about professional ethics and personal privacy.
-
Alternative Solutions: Suggest alternative solutions that prioritize privacy and security, such as using local AI transcription software that does not upload data to the cloud or implementing stricter data protection policies within your organization.
By framing your concerns in terms of privacy, security, and ethical considerations, you can help your bosses and colleagues understand the potential risks associated with using a cloud-based AI transcription service without coming across as paranoid. Highlighting the importance of protecting sensitive data and maintaining control over personal information should resonate with individuals regardless of their level of technical expertise.
-
Dunno, maybe collect the news of every private digital data leak in recent years and show how unsafe it really is?
I would suggest that that first action item would be is to ask for (in writing) are 1) data protection and 2) privacy policies. I would then either pick it apart, or find someone who works in cybersecurity (or the right lawyer) to do that. I’ve done it a few times and talked my employer out of a few dodgy products, because the policies clearly try to absolve the vendor of any potential liability. Now, whether the policies truly limit liability would have to be tested in court.
You could also talk about how data protection, encryption, identity and access management, and governance is actually really expensive, but I’d first start poking holes in the actual policies to create doubt.
I would have work sign a legal discharge that from the moment I use the technology, none of the recordings or transcription of me can be used to incriminate me in case of an alleged malpractice.
In fact, since both are generated or can be generated in a way that both sounds very assertive but also can be adding incredibly wild mistakes, in a potentially life and death situation, they legally recognise potentially nullifying my work, and taking the entire legal responsibility for it.
As you can see in the most recent example involving Air Canada, a policy has been invented out of thin air. Such policy is costing the company. In the case of a doctor, if the administration of the wrong sedative, the wrong medication, or if the wrong diagnosis was communicated to the patient, etc; all that could have serious consequences.
All sounding (using your phrasings, etc) like you, being extremely assertive, etc.
A human doing that job will know not to derive from the recording. An AI? “antihistaminic” and “anti asthmatic” aren’t too far off, and that is just one example off of the top of my head.
You tell them they either have a local person transcribe or you will have no choice but to step down. Tell them that the cloud is no place for medical data. It would also be a bonus if you could a bunch of your coworkers on board.
It would be worth finding out more about how exactly the training process works, namely whether or not the AI company stores the training audio clips after training has been completed. If not, then I would say you don’t have anything to worry about, because the model itself can’t be used to clone your voice to any useful extent. Deep neural networks aren’t reversible like that. Even if they were, it’s not just trained on you, it’s trained on hundreds of thousands of people then fine-tuned to you.
If they do store the clips though, then maybe show them this article about GitHub to prove to them that there is precedence for private companies using people’s data to train AI without their explicit consent.
To expound on this, AI models are extremely narrow in scope. One which reproduces audio it is trained on is entirely different from one that understands what is being said. As Mr. Turkalino mentioned, the transcription AIs are built on a combination of speech recognition and incredibly specialized text data that is narrowly defined by your industry (medical in this case). In fact, they may have tuned specific models for separate disciplines. This included thousands of documents ranging from textbooks to scholarly journals along with thousands of recordings of professionals saying the words in a variety of accents and dialects so it can understand the difference between very important and very different sounding words, my wife is pregnant, so amnioitis and amniocentesis come to mind. They are close enough sounding that a general model might mistake them, and that being transcribed wrong could spell real problems when others may look at the patients chart if there are complications.
Also, most models are run in the cloud because the calculations can he very taxing. I run Stable Diffusion and other AIs locally on my beast of a machine and it struggles at times. Realistically, the cloud machines are just bugger than you can get as a desktop. Also, under the most ideal circumstances, the audio of your notes does not live in the servers, it is transmitted, stored on a virtual machine (VM) while it is being processed, then after the results are completed the VM is destroyed and the audio recording goes with it. Nothing is kept. Of course, that is where you need to be sure to do the work, making sure that your situation is “ideal”. One of the biggest controversies in with AI right now is that data is being stored for doing reinforcement training on the AI models. Example, you send your recordings and the AI returns the transcript. You mark any corrections and go on with your day. The company takes those recordings and feeds them back into the general model with the corrections you made and tries to tell the AI what it got wrong. You are going to want to be sure that you are allowed to opt-out of your data being allowed to be used as training data (beyond the fine-tuning to help it learn your voice).
Unfortunately a guy I know works for a gov hospital and they’ve used such technology for over a decade at this point. It seems unavoidable.
Shouldn’t that be a HIPAA violation? Like you can’t in good conscious guarantee that the patient data isn’t being used for anything but the healthcare.
My question is not a legal one. There probably are legal obstacles for my hospital in this case but HIPAA is not applicable in my country.
I’d primarily like to get your opinions of how to effectively present my case for my bosses against using a non local model for this.
Look to your local health privacy laws. Most countries have that tightly controlled in such a way that this use of AI is illegal.
Your question is not a legal one, but a legal argument can be a very persuasive one.
It is until they prove it isn’t, which they might not be able to do. Many trusted 23andme only to see private data stolen. Make the company prove the security in an place and the methods ensuring privacy, because you’ll essentially be liable for any failures of the system from a lack of due diligence.
Voice recognition dictation has been used in the medical field for over a decade, probably even longer. My regional health system of multiple hospitals and clinics has been using an electronic based, like Dragon dictation, solution since at least 2012. Unfortunately in this case op is being overly paranoid and behind the times. I’m all for privacy but the HIPAA implications have already been well sorted out. They need to either learn to type faster or use the system provided that will increase their productivity and save the health system an fte that used to be used on their transcriptionist which can not be used more directly to care for patients.
Voice recording =/= training an algorithm that can simulate my voice and use whatever I say with impunity.
The recording a doctor makes of a patient is a known quantity with known copies for a known purpose. It is a calculated decision from top to bottom that has been sorted. AI training off of doctors’ dictations is not.
I think the issue is moreso that you’re sending confidential health data to a 3rd party, which is where you lose control. You don’t know the intentions of people looking to steal that data, and you need to consider the worst possible outcome and guard against those. AI training is just one option. Get creative, what could you do with a doctor’s voice and their patient’s private medical history?
Simplest solution is to stop the arrangement until the company can prove data security on their end or implement an offline solution on local servers not connected to the internet.
“Overly paranoid”, with the practically-daily breaches of clouds based systems today?
It is true that Dragon and similar apps have been used for years. But I don’t think it’s fair to say OP is being paranoid and a luddite. Data breaches in the cloud are a weekly occurrence, and OP wanting to protect their voice / biometrics is not foolish it’s smarter than the average bear. You can change a compromised password. You can’t change your biometrics or voice.
Also, those products were used on local networks for many years before they entered the cloud. They gradually reduce our privacy over time, getting people numb to it.
Do your patients know that their information is being transcribed in the cloud, which means it could potentially be hacked, leaked, tracked, and sold? How does this foster a sense of distrust, and harm the patients progress?
Could you leverage this information and the possibility of being sued if information is leaked with the bureaucrats?
Stop using the digital voice recorder and type everything yourself. This is the best way to protect your voice print in this situation. It doesn’t work well as a protest or to educate your colleagues, but I suppose that’s one thing you can use your voice for. Since AI transcription is a cost saving measure, there will be nothing you can do to stop its use. No decision maker will choose the more expensive option with a higher error rate on morals alone.
Unfortunately the interface of the medical records system will be changed when this is implemented. The keyboard input method will be entirely removed.
Even if this gets implemented, I can’t imagine it will last very long with something as completely ridiculous as removing the keyboard. One AI API outage and the entire office completely shuts down. Someone’s head will roll when that inevitably happens.
Ah sorry, I mean removing the option of using the keyboard as an input method in the medical records system. The keyboard itself isn’t physically removed from the computer clients.
But I agree that in the event of a system failure the hospital will halt.
Also, if you get the permission of someone in leadership to clone their voice, one angle could be to voice clone someone on ElevenLabs and make the voice say something particularly problematic, just to stress how easily voice data can be misused.
If this AI vendor is ever breached, all they have to do is robocall patients pretending to be a real doctor they know. I don’t think I need to spell out how poorly that would go.
The personalized data model will be trained on your voice. That means that it’s going to be trained on a great deal of patient medical history data (including PII). That means it’s covered by HIPAA.
I strongly doubt the service in question meets even the most minimal of requirements.
This is really weird. Is it common in other countries for doctors to not input the data in the system themselves?
So what’s your concern? I’m a bit confused.
- Using cloud to process patient data? Or,
- Collecting your voice to train a model?
Yeah, I’d be sooooo confident and reassured if I knew my doctor was prioritising the security of their voice of the security of my information… /s
(yes, it can be both, but this post doesn’t seem at all concerned with one, and entirely with the other)
