#Advantage of AI

[blogshog1]

How ChatGPT will impact Digital Marketing in 2024-25?

As a large language model trained by OpenAI, ChatGPT has the potential to revolutionize the way we approach digital marketing. With its advanced natural language processing capabilities, ChatGPT can be used to create personalized marketing experiences for customers, automate customer service, and analyze customer data in real-time.Read More: https://www.blogshog.com/how-chatgpt-will-impact-digital-marketing/

[mostlysignssomeportents]

Epic Systems, a lethal health record monopolist

Epic Systems makes the dominant electronic health record (EHR) system in America; if you're a doctor, chances are you are required to use it, and for every hour a doctor spends with a patient, they have to spend two hours doing clinically useless bureaucratic data-entry on an Epic EHR.

How could a product so manifestly unfit for purpose be the absolute market leader? Simple: as Robert Kuttner describes in an excellent feature in The American Prospect, Epic may be a clinical disaster, but it's a profit-generating miracle:

https://prospect.org/health/2024-10-01-epic-dystopia/

At the core of Epic's value proposition is "upcoding," a form of billing fraud that is beloved of hospital administrators, including the "nonprofit" hospitals that generate vast fortunes that are somehow not characterized as profits. Here's a particularly egregious form of upcoding: back in 2020, the Poudre Valley Hospital in Ft Collins, CO locked all its doors except the ER entrance. Every patient entering the hospital, including those receiving absolutely routine care, was therefore processed as an "emergency."

In April 2020, Caitlin Wells Salerno – a pregnant biologist – drove to Poudre Valley with normal labor pains. She walked herself up to obstetrics, declining the offer of a wheelchair, stopping only to snap a cheeky selfie. Nevertheless, the hospital recorded her normal, uncomplicated birth as a Level 5 emergency – comparable to a major heart-attack – and whacked her with a $2755 bill for emergency care:

https://pluralistic.net/2021/10/27/crossing-a-line/#zero-fucks-given

Upcoding has its origins in the Reagan revolution, when the market-worshipping cultists he'd put in charge of health care created the "Prospective Payment System," which paid a lump sum for care. The idea was to incentivize hospitals to provide efficient care, since they could keep the difference between whatever they spent getting you better and the set PPS amount that Medicare would reimburse them. Hospitals responded by inventing upcoding: a patient with controlled, long-term coronary disease who showed up with a broken leg would get coded for the coronary condition and the cast, and the hospital would pocket both lump sums:

https://pluralistic.net/2024/06/13/a-punch-in-the-guts/#hayek-pilled

The reason hospital administrators love Epic, and pay gigantic sums for systemwide software licenses, is directly connected to the two hours that doctors spent filling in Epic forms for every hour they spend treating patients. Epic collects all that extra information in order to identify potential sources of plausible upcodes, which allows hospitals to bill patients, insurers, and Medicare through the nose for routine care. Epic can automatically recode "diabetes with no complications" from a Hierarchical Condition Category code 19 (worth $894.40) as "diabetes with kidney failure," code 18 and 136, which gooses the reimbursement to $1273.60.

Epic snitches on doctors to their bosses, giving them a dashboard to track doctors' compliance with upcoding suggestions. One of Kuttner's doctor sources says her supervisor contacts her with questions like, "That appointment was a 2. Don’t you think it might be a 3?"

Robert Kuttner is the perfect journalist to unravel the Epic scam. As a journalist who wrote for The New England Journal of Medicine, he's got an insider's knowledge of the health industry, and plenty of sources among health professionals. As he tells it, Epic is a cultlike, insular company that employs 12.500 people in its hometown of Verona, WI.

The EHR industry's origins start with a GW Bush-era law called the HITECH Act, which was later folded into Obama's Recovery Act in 2009. Obama provided $27b to hospitals that installed EHR systems. These systems had to more than track patient outcomes – they also provided the data for pay-for-performance incentives. EHRs were already trying to do something very complicated – track health outcomes – but now they were also meant to underpin a cockamamie "incentives" program that was supposed to provide a carrot to the health industry so it would stop killing people and ripping off Medicare. EHRs devolved into obscenely complex spaghetti systems that doctors and nurses loathed on sight.

But there was one group that loved EHRs: hospital administrators and the private companies offering Medicare Advantage plans (which also benefited from upcoding patients in order to soak Uncle Sucker):

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8649706/

The spread of EHRs neatly tracks with a spike in upcharging: "from 2014 through 2019, the number of hospital stays billed at the highest severity level increased almost 20 percent…the number of stays billed at each of the other severity levels decreased":

https://oig.hhs.gov/oei/reports/OEI-02-18-00380.pdf

The purpose of a system is what it does. Epic's industry-dominating EHR is great at price-gouging, but it sucks as a clinical tool – it takes 18 keystrokes just to enter a prescription:

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2729481

Doctors need to see patients, but their bosses demand that they satisfy Epic's endless red tape. Doctors now routinely stay late after work and show up hours early, just to do paperwork. It's not enough. According to another one of Kuttner's sources, doctors routinely copy-and-paste earlier entries into the current one, a practice that generates rampant errors. Some just make up random numbers to fulfill Epic's nonsensical requirements: the same source told Kuttner that when prompted to enter a pain score for his TB patients, he just enters "zero."

Don't worry, Epic has a solution: AI. They've rolled out an "ambient listening" tool that attempts to transcribe everything the doctor and patient say during an exam and then bash it into a visit report. Not only is this prone to the customary mistakes that make AI unsuited to high-stakes, error-sensitive applications, it also represents a profound misunderstanding of the purpose of clinical notes.

The very exercise of organizing your thoughts and reflections about an event – such as a medical exam – into a coherent report makes you apply rigor and perspective to events that otherwise arrive as a series of fleeting impressions and reactions. That's why blogging is such an effective practice:

https://pluralistic.net/2021/05/09/the-memex-method/

The answer to doctors not having time to reflect and organize good notes is to give them more time – not more AI. As another doctor told Kuttner: "Ambient listening is a solution to a self-created problem of requiring too much data entry by clinicians."

EHRs are one of those especially hellish public-private partnerships. Health care doctrine from Reagan to Obama insisted that the system just needed to be exposed to market forces and incentives. EHRs are designed to allow hospitals to win as many of these incentives as possible. Epic's clinical care modules do this by bombarding doctors with low-quality diagnostic suggestions with "little to do with a patient’s actual condition and risks," leading to "alert fatigue," so doctors miss the important alerts in the storm of nonsense elbow-jostling:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5058605/

Clinicians who actually want to improve the quality of care in their facilities end up recording data manually and keying it into spreadsheets, because they can't get Epic to give them the data they need. Meanwhile, an army of high-priced consultants stand ready to give clinicians advise on getting Epic to do what they need, but can't seem to deliver.

Ironically, one of the benefits that Epic touts is its interoperability: hospitals that buy Epic systems can interconnect those with other Epic systems, and there's a large ecosystem of aftermarket add-ons that work with Epic. But Epic is a product, not a protocol, so its much-touted interop exists entirely on its terms, and at its sufferance. If Epic chooses, a doctor using its products can send files to a doctor using a rival product. But Epic can also veto that activity – and its veto extends to deciding whether a hospital can export their patient records to a competing service and get off Epic altogether.

One major selling point for Epic is its capacity to export "anonymized" data for medical research. Very large patient data-sets like Epic's are reasonably believed to contain many potential medical insights, so medical researchers are very excited at the prospect of interrogating that data.

But Epic's approach – anonymizing files containing the most sensitive information imaginable, about millions of people, and then releasing them to third parties – is a nightmare. "De-identified" data-sets are notoriously vulnerable to "re-identification" and the threat of re-identification only increases every time there's another release or breach, which can used to reveal the identities of people in anonymized records. For example, if you have a database of all the prescribing at a given hospital – a numeric identifier representing the patient, and the time and date when they saw a doctor and got a scrip. At any time in the future, a big location-data breach – say, from Uber or a transit system – can show you which people went back and forth to the hospital at the times that line up with those doctor's appointments, unmasking the person who got abortion meds, cancer meds, psychiatric meds or other sensitive prescriptions.

The fact that anonymized data can – will! – be re-identified doesn't mean we have to give up on the prospect of gleaning insight from medical records. In the UK, the eminent doctor Ben Goldacre and colleagues built an incredible effective, privacy-preserving "trusted research environment" (TRE) to operate on millions of NHS records across a decentralized system of hospitals and trusts without ever moving the data off their own servers:

https://pluralistic.net/2024/03/08/the-fire-of-orodruin/#are-we-the-baddies

The TRE is an open source, transparent server that accepts complex research questions in the form of database queries. These queries are posted to a public server for peer-review and revision, and when they're ready, the TRE sends them to each of the databases where the records are held. Those databases transmit responses to the TRE, which then publishes them. This has been unimaginably successful: the prototype of the TRE launched during the lockdown generated sixty papers in Nature in a matter of months.

Monopolies are inefficient, and Epic's outmoded and dangerous approach to research, along with the roadblocks it puts in the way of clinical excellence, epitomizes the problems with monopoly. America's health care industry is a dumpster fire from top to bottom – from Medicare Advantage to hospital cartels – and allowing Epic to dominate the EHR market has somehow, incredibly, made that system even worse.

Naturally, Kuttner finishes out his article with some antitrust analysis, sketching out how the Sherman Act could be brought to bear on Epic. Something has to be done. Epic's software is one of the many reasons that MDs are leaving the medical profession in droves.

Epic epitomizes the long-standing class war between doctors who want to take care of their patients and hospital executives who want to make a buck off of those patients.

Tor Books as just published two new, free LITTLE BROTHER stories: VIGILANT, about creepy surveillance in distance education; and SPILL, about oil pipelines and indigenous landback.

If you'd like an essay-formatted version of this post to read or share, here's a link to it on pluralistic.net, my surveillance-free, ad-free, tracker-free blog:

https://pluralistic.net/2024/10/02/upcoded-to-death/#thanks-obama

Image: Flying Logos (modified) https://commons.wikimedia.org/wiki/File:Over_$1,000,000_dollars_in_USD_$100_bill_stacks.png

CC BY-SA 4.0 https://creativecommons.org/licenses/by-sa/4.0/deed.en

[vamptarot]

When you start enjoying a PAC but notice that the reader used AI and didn’t actually channel sh#t.

[crouton-moons]

Zionist.

saying don't fall for scams does not make someone a zionist. tumblr asks are NOT actual calls for aid!

i was just going to delete this ask like i do all scam asks, but i figured id post it just in case other people are getting similar things for... not being gullible? for trying to stop other people from being scammed and sending their money to scammers instead of actual palestinians?

many people in palestine obviously need aid. an obvious bot sending thousands of messages to thousands of people asking for "aid" will not help those people. they aren't from actual victims. they're from random people who are weaponizing the kindness of strangers to make a buck. falling for it helps absolutely no one. critical thinking is even MORE important in a time like this, stop falling for this obvious shit! they're just like the ai porn bots. they're used by the same exact people for the same exact reasons, getting money off those who are gullible. they're scumbags who are weaponizing peoples empathy to make a buck off a genocide. stop. falling. for. it.

they're trying to take advantage of you. they're assuming you're too stupid to think critically about who you think you're helping. stop proving them right.

there are thousands of actual ways to donate to those in need that aren't tumblr ask scams!

[gojoest]

FINALLY I TOUCHED THE BUTT OF SYLUS and his response is so hjahsjs

[starlit-eudemonia]

Me cracking open my old physiology textbook in the summer to see if it’s plausible for Ais to feel through his horns (he probably can b/c they’re probably attached to his skull with living tissue connected there and it probably can’t regrow). Or if they could break off with minimal consequence (they can’t b/c they aren’t structured like antlers).

[fortunaegloria]

Scans of the Brazilian magazine "Set" from March 2006. Despite the cover and main article of the mag being the TV shows that were revolutionizing the way of watching and making television at the time, like 24, Lost, CSI and The Simpsons, the focus here is on Harrison Ford and the movie Firewall.

There's an interview that addresses the issue of Ford's age and how he continues to make action movies. He mentions that he receives many scripts with characters that he believes are too old to play. There is a discussion about the accuracy of the technology shown in Firewall and how the filmmakers worked hard to ensure authenticity.

Ford talks about the physical work involved in the action scenes and how they are choreographed like a dance. He also mentions the technology on the set, with director Richard Loncraine being an enthusiast of wireless technology. The interview also highlights that the script for Firewall went through many changes, especially to validate the use of technology in the movie.

Harrison explains that he chose to act in Firewall because he thought the character was interesting and that the movie could be entertaining for audiences. He also talks about the changing audience, which is getting younger and younger.

And finally, Ford expresses his enthusiasm for reprising the role of Indiana Jones in a fourth movie, even though he acknowledges that the character has also aged. He highlights his privileged position of being able to choose his projects and make mistakes, mentioning that he tries to show his versatility in different genres, but recognizes that he is also a "product" and has a degree of independence in this process.

More mags here.

[carlyraejepsans]

look i understand that ai generated content is a controversial topic, and ultimately protecting artists' intellectual property should take moral priority, but i feel like when people say "you don't want character.ai you want to rp with someone" they're kinda missing the point because unlike a chatbot, you can't exactly look your rp partner in the eye and say "that sucked ass. do that again"

[vehemourn]

im considering starting to keep like. a List of accounts that post art & photography Without GenAI & a list of accounts that DO. I am SERIOUSLY sick of these accounts taking advantage of ppls trust AND Consistently Deleting replies that point out it's AI

[danekez]

Oh... Hmmm.

Okay so Generative AI cannot think. If you ask it a question, the answer will differ based on what information it has been fed. But the program itself is not taking information from multiple accounts, considering it's truthfulness and impact, and then making informed opinionated decisions. It is, to be reductionist, taking information and spitting it back out based on the likelihood that words do or do not go together.

To make a fair comparison, that's how I did a lot of my book reports and homework- I didn't always think critically because I was on a deadline and I didn't care. I just re-said what the book said and I changed the words enough to make it "my own".

That's not thinking. That's not thinking. I am capable of generating slough for the sake of getting through the day, but I have the ability to choose to slow down and contemplate my own opinions and come to my own conclusions- to create new ideas and new concepts and apply those to pre existing theories. Generative AI cannot do that.

So why do people regard AI as thinking, qualifid, and insightful? Maybe it's my tinfoil hat here but... I think it's related to the reduction of media literacy and critical thinking skills. It feels connected. Like people are being taught that thinking is the same as reciting, and that reciting is the only valuable action worth rewarding. That's how conservative policies thrive, after all- to do as you're told and the repeat that on your own. So... When a machine is doing that exact same thing, it feels natural. But to anyone with a developed skill in critical thinking and media literacy, it rings very hollow like a form of uncanny valley.

I dunno. I think AI is succeeding in trapping people because it matches the current narrative of how we are meant to communicate and succeed socially. Teach your kids how to sound out words and think about why something happens, not just that it does.

[lemmaeof]

getting really fucking tired of people who don't know how generative AI works comparing AI "training" to how people learn as an artist because they're jus not even remotely the same thing on any level

artists take inspiration and learn by seeing something, going "I want to do something like that", and practicing that specific thing until they're satisfied with it, while AI are "trained" by force-feeding them five billion images (including literal child pornography, it turns out) to build a statistical model of what certain things "look like"

there's no intentionality to AI - even if you're feeding stable diffusion source pics to tune it, it was already pre-trained on the laion data set - at most you're amplifying noise

just get the concept of people's problem with AI being copyright out of your head, the problem is that it's an inauditable black box that's designed from the ground up to destroy the concept of intentionality in art in order to generate infinite """content""" sludge for capitalists

[mistygreenwoods]

you know, it would be lovely if a nightshade esq program or thing worked for writing on ao3 to poison the batch of anyone scraping the site and ruin their samples. Like scrambling their writing or some shit.

I don't know anything about coding, or know it it would even be possible (or if it exists), but, like, I think this would be lovely tbh

[eternaljunkyard]

sucks that that guy scraped ao3 but idk. people like him are always gonna exist. there will always be stuff to scrape off the internet but idk. i can't consciously archive lock my works. partially because its so difficult to get an account now but also because I don't think I should have to lock my works. i don't think other people should have to suffer because of a couple scalpers trying to make a quick buck. and ofc I understand people who do archive lock their works, plagiarism isn't fun or good and you can take the time to get a free account and it's hunky dory, but open and accessible fanfic and fandom have done so so much for me I can't justify locking mine. idk. also this is just gonna keep happening and at some point the scalpers are gonna make accounts and then there you go anyway. so.

[boardboxes]

why is my university professor encouraging the use of AI to help us with our projects .. maam this is higher education if we cant figure out how to cite or start a paper on our own idk what to tell you

[sunandmoonseisai]

"ai generated content have a lot of advantages! You're just scared of progress!"

Downside of ai generated imagery:

Abundance of misinformation

It is now increasingly easy to create fake proofs against someone

Lack of regulation. You can generate pornography out of anyone's image without their consent.

Photo realistic child pornography

Frauds on all sides are selling Ai image as their own creation

Human creativity is increasingly devalued

Bright side of ai generated imagery

It's a fun toy to create pretty pictures and funny memes

[danielnelsen]

continuing my dai solo nightmare run

i did wicked eyes and wicked hearts around a week ago and it was fine because there's very little combat, but ive been really putting off here lies the abyss for that reason. it scales up to level 15 and im at level 17, which is still scary because magic hits through armor, but i also realised that if i wait any longer im not gonna get any xp from it

but i do get two npcs fighting with me in the fade i guess. they're usually inconsequential when i have a whole party, but they might be getting me through this