AI and EMS: Tool or Gimmick?

OpenAI, a nonprofit artificial intelligence lab located in the Mission District of San Francisco, launched ChatGPT on November 30, 2022. ChatGPT (short for Chat Generative Pre-trained Transformer) is a currently free “bot” that uses computer machine, reinforcement, supervised, and transfer learning to provide detailed responses to queries generated by users.

The core function of the bot is to appear as if you are talking to a human in a conversation. Users who have signed up for the service have asked ChatGPT millions of queries, from “tell me a joke” to “write song lyrics.” Students using the bot input essay prompts from their teachers to have AI write them an essay.

While the technology is both exciting and frightening at the same time, is there a use for AI and ChatGPT in EMS?

What It Can and Can’t Do

The biggest limitation of ChatGPT is that it isn’t human—its responses attempt to mimic a human and learn from prior replies how to be more “human.”

Much like humans, it isn’t perfect. For starters, the point of reference for ChatGPT is prior to 2021. As a result, if you attempt to get queries answered regarding events of the last two years, such as “Create a disaster response plan from Hurricane Ian,” it would be at a loss. It also cannot express opinions on politics or activism. Many users have found that its responses range from slightly inaccurate to completely wrong, but at other times its responses are spot-on.

To prevent harmful, racist, sexist, or false information, ChatGPT responses are filtered through a company-wide moderation protocol. Still, ChatGPT churns out information that is questionable, or sometimes downright false.

In a December 2022 article in the New York Times, writer Kevin Rose commented that “ChatGPT is, quite simply, the best artificial intelligence chatbot ever released to the general public….ChatGPT feels different. Smarter. Weirder. More flexible. It can write jokes (some of which are actually funny), working computer code and college-level essays. It can also guess at medical diagnoses, create text-based Harry Potter games and explain scientific concepts at multiple levels of difficulty.”

What Does This Have to Do With EMS?

EMS is a human-based profession grounded in science. We use computers all the time, from dispatch information to GPS, note taking and chart writing, cardiac rhythm acquisition and interpretation, and research on medications, to name a few.

I’m sure all of us use our phones for some reason on nearly every call. How could AI like ChatGPT be used to help EMS?

It does have the potential to be a good teacher. I asked ChatGPT to “Write a model EMS chart narrative for a 63-year-old male with chest pain.” It produced this in three seconds:

Narrative:

Patient called 9-1-1 reporting chest pain. Upon arrival, patient was found sitting in a chair in his living room, clutching his chest. Patient stated that the pain started suddenly while he was watching TV and described the pain as a sharp, crushing sensation in the center of his chest. Patient also reported shortness of breath and sweating.

Vital signs upon arrival: Blood pressure: 140/90 mmHg, Heart rate: 110 beats per minute, Oxygen saturation: 89% on room air.

Patient was placed on a cardiac monitor and found to have ST elevation in leads II, III, and aVF, consistent with an acute anterior myocardial infarction. Patient was given aspirin and a sublingual nitroglycerin. An IV was established and patient was given morphine sulfate for pain control.

Patient was transported to the nearest hospital with a cardiac catheterization lab. En route, patient's blood pressure dropped to 90/60 mmHg and another dose of nitroglycerin was administered. Patient arrived at the hospital and was taken directly to the cath lab for emergent angioplasty.

Patient's condition was stable throughout transport, and he was alert and oriented. Patient's family was notified and met him at the hospital.

Patient's cardiac enzyme levels were elevated, consistent with an acute myocardial infarction. Patient underwent successful angioplasty and was admitted to the cardiac care unit in stable condition.

Please note that this is a sample narrative, and the patient's symptoms, treatment, and outcome may vary depending on the specific circumstances of the case. This is just an example, and the patient's condition should be evaluated by a medical professional.

While this narrative is not perfect and obviously speculative, it could possibly be used as a teaching tool for student EMTs or paramedics.

Other ideas:

• Take research papers on EMS and medical topics, paste it in, and ask ChatGPT to summarize for you in a given number of sentences.

• Give it questions from quizzes and it will give you the correct answers, at least most of the time. It could be a study guide for your EMT or paramedic exam.

• Ask it to write a model letter to an insurance company requesting a review of an insurance claim for an ambulance run.

• Ask it to generate questions you could ask in a paramedic interview to get some practice prompts.

David Canes, MD, of Lahey Hospital & Medical Center in Burlington, MA, remarked on social media about how he's used ChatGPT: "Young health care professionals need to keep a close eye on this," Canes said. "The technology is likely to improve by leaps and bounds. Doctors [and other medical professionals] need to have a seat at the table when it comes to any workflow improvements, so this is no different."

Future Directions

Currently, several investors are setting up ChatGPT to be a for-profit company. How this may work is still unknown, but a subscription model or app purchase are certainly possibilities. For now, it presents as an interesting glimpse into the future of machine learning and computer-assisted health care.

Perhaps in the future we may see an AI paramedic partner on our ambulances. Until then, EMS is a human endeavor with humans taking care of other humans, albeit with computers helping along the way.

References

Bowman, Emma (December 19, 2022). "A new AI chatbot might do your homework for you. But it's still not an A+ student". NPR. Retrieved January 19, 2023.

Piper, Kelsey (December 15, 2022). "ChatGPT has given everyone a glimpse at AI's astounding progress". Vox. Retrieved January 20, 2023.

Roose, Kevin (December 5, 2022). "The Brilliance and Weirdness of ChatGPT". The New York Times. Retrieved January 20, 2023.

DePeau-Wilson, Wilson (December 29, 2022) What Can ChatGPT Do For Your Practice? MedpageToday. Retrieved January 20, 2023.

Barry Bachenheimer, EdD, NREMT/FF is an educator, an active FF/EMT, and a frequent contributor to EMS World.