Artificial Intelligence (AI) is already starting to touch the lives of Certified Legal Nurse Consultants. In this blog, we’ll address how the CLNC® Pros are using AI and recommend best practices for the use of AI in your CLNC business. While not every Certified Legal Nurse Consultant is proactively using AI to analyze medical records, most CLNC consultants have been using AI to search for information regarding a medication or disease process for several years now.
The significant game changer is the use of AI platforms to facilitate medical record analysis and production of chronological timelines and reports. Sophisticated CLNC consultants are getting involved at the early stages of using AI for these transformative purposes.
Suzanne E. Arragg, BSN, RN, CDONA/LTC, CLNC shares, “Using AI to summarize medical records provides a high-level context to help drive a deeper dive into the case issues. Chronologies can be drafted but do require significant editing and review for accuracy.”
Dale Barnes, RN, MSN, PHN, CLNC describes how she uses AI. She says, “For most cases, I load all of the records into the Al system. It will first put everything into a timeline (even if it’s 20,000 pages). I then decide what’s important and what’s not and set the system to provide only what I want. Since I do have cases that range from 3,000 pages to 20,000 pages, this initial organization makes my job easier. I have the ability to set parameters, so that I can include some things and have AI skip over others. I can also choose a format for the report or chronological timeline. After I get the work product, I add comments, opinions, footnotes, definitions or whatever is needed. That portion is time-consuming, but the first, most tedious part of the set-up is already done for me.”
Michelle Neal, RN, BSN, CLNC describes how she uses AI. She says, “I currently use AI intermittently as a tool to assist in my review of records. I like to think of it as a glorified OCR for many tasks. It’s very useful in locating keywords or facts of a case, identifying demographics, providing a generalized overview of the case, identifying past medical history, providing an overview of reason for admissions, identifying all potential dates of injuries, organizing medical records and creating graphs and tables. AI platforms offer features that provide citations and direct links to the relevant medical record and page number in response to specific questions. This capability significantly expedites the process of locating key facts within a case. The citation and linking functions make it easy to verify the accuracy of the answers provided by the AI platform. In my experience, AI is not yet consistent and accurate enough to create a chronological timeline or to define deviations from and adherences to the standards of care without a strict QA process on my part. While AI doesn’t replace clinical judgment or critical thinking skills required to analyze medical records, it does enhance the efficiency of my work.”
AI can probably never replace the requirement for testifying experts in medical-related cases. But even for consulting experts, AI is only a tool. AI is not a Certified Legal Nurse Consultant with the insider experience necessary to analyze complex medical-related cases. Dale Barnes, RN, MSN, PHN, CLNC agrees, “My attorney-clients have made it abundantly clear they do not expect or want AI to eliminate our jobs as Certified Legal Nurse Consultants. They want an easier, quicker system so we can spend more time locating experts, attending DMEs and consulting on more cases in a timely manner. In my experience, the attorneys do not want to draft chronological timelines themselves, even on Al. They seem to appreciate that a true expert in the field is essential.”
AI will only get better and smart CLNC consultants will embrace the efficiency and insights it offers for the development of your CLNC work product. As Shequita Moore, MSN, RN, LNFA, CLNC says, “AI will free up more time for you to consult on more medical-related cases.”
Certified Legal Nurse Consultants are also using AI to improve their marketing. Marcia Bell, RN, BSN, CAPA, CLNC shares, “I have used AI to convert my CV to a promotional profile for my CLNC business and it did a much better job than I could have.”
BEST PRACTICES FOR USING AI
- Have a healthy skepticism of the AI output.
AI is not perfect and can even be inaccurate. Approach it with a healthy skepticism. For example, Yolanda Anderson, RN, BSN, CEN, CLNC shares, “I do not rely solely on AI for answers. I generally use it to confirm a medication or disease process I already know about but want to validate that I have it right.”
If you choose to use AI for information you know little about, do not rely solely upon it. Validate the answers and responses provided by checking links provided and searching authoritative sources. Michelle Neal, RN, BSN, CLNC adds, “Always crosscheck the data generated from AI with the medical records. It’s important to remember that while AI can be a great tool to help facilitate case work, you’re still the consultant and responsible for verifying the accuracy of your work product.” Always review all relevant medical records before rendering an opinion. You are ultimately responsible for the work product you submit to the attorney.
- Verify that the AI tool is HIPAA-compliant.
Even if HIPAA-compliant, always communicate to attorney-clients that you are processing protected health information (PIH) through an AI platform. You need the attorney’s approval because even a HIPAA-compliant platform could in theory be hacked. Always use a secure VPN in your business practice.
- Prompt AI specifically and continue to refine prompts.
Suzanne E. Arragg, BSN, RN, CDONA/LTC, CLNC gives an example, “Asking AI to summarize all of the records is too broad. Instead, as an example, requesting a date-specific range and verbatim content from the physician’s progress notes will produce more specific results.”
Michelle Neal, RN, BSN, CLNC adds, “You must be clear and specific in prompts. Generalized questions often generate inaccurate results. For example, in a pressure injury case, I prompted the AI platform to identify whether the patient was frequently turned. The AI platform’s response indicated that the patient was frequently turned and repositioned. This was inconsistent with my review of the medical records. The AI platform provided me with every notation in which the word ‘turn’ was documented rather than when turning was actually implemented. AI failed to differentiate between a physician’s order versus actual treatment implemented. I quickly learned that prompting specifically will yield a more accurate result.”
AI is our future whether we like it or not. It has the potential to revolutionize both our lives and CLNC businesses. Michelle Neal, RN, BSN, CLNC adds, “While AI does not have human or clinical experience working directly with patients, I do recommend that Certified Legal Nurse Consultants proactively explore various AI platforms and take the time to learn their capabilities.”
Special thanks to the CLNC Pros: Yolanda Anderson, RN, BSN, CEN, CLNC, Suzanne E. Arragg, BSN, RN, CDONA/LTC, CLNC, Dale Barnes, RN, MSN, PHN, CLNC, Marcia Bell, RN, BSN, CAPA, CLNC, Carol Fridal, MS, RN, CEN, CLNC, Dorene Goldstein, RNC, BSN, CLNC, Shequita Moore, MSN, RN, LNFA, CLNC, Michelle Neal, RN, BSN, CLNC and Nicole Schuster, BSN, RN, ACM, CLNC for sharing best practices for the use of AI in your legal nurse consulting business.
Success Is Yours,
P.S. Comment and share how you’re using AI in your legal nurse consulting business.
