AI in Healthcare (Part Two)

AI Tools for Speech Pathologists and other Allied Health Professionals: What We Are Currently Using and How

After surfacing from my deep dive into AI, I started to ask how our administrative team and clinicians use AI. I also implemented some trials within the team and we came back to review and discuss our findings. Yes, we have officially jumped on the AI bandwagon. We continue our investigations and trials of new AI tools aiming to adopt new technology in paediatric therapy. Here are some of the best AI tools we have found for our team.

Non-allied health specific tools:

ChatGPT: Provides immediate responses to common queries, enhances communication and reduces time for administrative tasks such as writing professional and concise emails.

We use ChatGPT to translate (overseen by native speakers), create resources, realistic scripts, scenarios, therapy ideas, and goal ideas, quickly locate research papers and generate summaries of their content; write emails, phone scripts, problem-solving suggestions, create policy and guidelines, produce education and marketing material, and of course, social media posts. However, generated content can sound quite ‘AI’ and lose personality.

CoPilot: An AI assistant that helps generate content, automate tasks, and enhance productivity in various applications such as Microsoft Office. It can also be used to create templates and draft reports.

We use CoPilot incidentally on our PCs when it offers suggestions for more concise language for written communication. We use it to create PowerPoint presentations and generate therapy ideas and strategies (like ChatGPT), but have found that it still requires a lot of editing for our needs. It does help with providing structure and ideas for presentations. Due to the nature and complexity of our reports, we have yet to try utilising AI to assist with this process.

Grammarly: Grammarly provides suggestions to improve sentence grammar and structure, ensuring they convey a more precise and compelling message.

We use it for all written work as it sits in the background and provides prompts for case notes, report writing and all kinds of communications (e.g. email and blogs). Paid subscription was found to be significantly better with the ability to better express tone, professionalism and emotions.

Siri/Alexa/Google: An AI-powered voice assistant designed to respond to spoken commands and help with daily tasks. It can set reminders, answer questions, control smart home devices, send messages, and provide real-time information like weather updates or directions.

This is how we play background music everyday at reception! Some of us use these tools to ask simple questions, set reminders, make suggestions, set timers, manage our task lists, find locations, and direct clinicians on the road. We have our own at each clinic, the devices synched to our computers and clinic phones. Outside the clinic, I also use it to control smart home devices, send messages, record information, and check the weather.

Zoom Assistant: An AI-powered tool that helps streamline meeting management by offering features like automated scheduling, real-time transcription and captions, meeting summaries, and follow-up reminders. These functions improve the efficiency and accessibility during Zoom calls.

We use it for real-time transcription during our weekly team meetings. It also allows us to generate meeting summaries, and categorise and reorganise information in order to be clear and concise. I have found it to be better than other voice-transcription tools.

Otter: An AI-powered transcription and note-taking tool that converts spoken content from meetings, lectures, interviews, and conversations into written text in real time. It provides features like automated transcriptions, speaker identification, and searchable notes, making reviewing, sharing, and organising information from audio or video recordings easier.

We have found that Otter has been somewhat helpful in meetings and discussions, as it effectively identifies speakers. The transcription is mediocre; however, you can easily discern errors with context. The searchable notes are a great feature, especially for longer meetings, for identifying and locating specific details discussed. It also categorises and summarises information, although the summaries do not provide sufficient detail. I have yet to find the ‘perfect’ transcription and note-taking tool.

Allied Health Specific tools:

Heidi Health (HH): HH uses AI to analyse patient data and can generate assessments and clinical notes. It is HIPPA Australia compliant. HH also has clinical decision support, which can help clinicians make informed decisions. The insights provided are reportedly based on evidence-based guidelines, thus resulting in better clinical outcomes.

We use HH’s transcribing features to document case history interviews and assessment sessions, so that we can cross-check information recorded manually and via HH. The SOAP note is a practical feature; however, the SOAP templates do not meet our clinical documentation needs so we rarely use it during intervention. Clinicians would also need to record observations manually. At our clinic, we occasionally use parts of what HH has generated. HH generated texts are always reviewed before inputting them into our template. There are, however, customisation features with the paid subscription (which we do not have). In saying this, we do not feel comfortable storing patient data on HH at this stage.

Realize Language: Realize language analyses an individual’s output and vocabulary use (e.g., nouns/verbs/adjectives) and tracks time usage. It syncs to the AAC device, churning out data, which can be used for assessment, therapy planning and reports.

We use this for our AAC assessment, therapy planning, and assistive technology applications for NDIS. The data it yields includes visuals, which provide clear and concise information about AAC device usage. This helps us set and track goals. This AI tool does a great job of enhancing all aspects of clinical work with AAC users.

At our clinic, we ALWAYS use AI tools with human oversight and de-identify individuals. Data is not stored and is deleted after the completion of case notes. There are many AI options out there, so it is our ongoing goal to continue to explore and screen for risk and safety.

If you are interested in exploring AI options, here are some popular ones out there:

• https://www.heidihealth.com/au 

• https://scribe.commure.com/

• https://www.clinicalnotes.ai/

• https://www.patientnotes.app/

• https://www.cliniscribe.com.au/

• https://www.lyrebirdhealth.com/

• https://www.everbility.com/

In the blog, did you know which parts was AI generated?

*Hint: AI description*

AI in Healthcare (Part One)

Where do you start with AI?

“I have no idea!” was my initial thought when someone asked me about AI use. Without realising, AI has been rapidly growing and becoming part of our norm from ChatGPT to tailored social media advertisements. Without realising it, I too was using it or being influenced by it. My next question was “Do AI and health care mix?”. I initially hesitated about starting the AI journey at our clinic, but I knew it was inevitable. People were already beginning to use it, and I felt like I needed to be one step ahead. I wanted to create safe use policies to mitigate and manage risks and have control of this rapidly evolving AI world.

There have been giant leaps with AI in healthcare. AI supports diagnostics, intervention, automation, and optimisation, creating quicker, more efficient, and more accurate outcomes. It sounded promising!  After doing hours of research, I also discovered the advantageous side of AI that could be harnessed at our clinic and the infinite opportunities. This opened another meaning to modern therapy solutions for children, which raised many questions. “How could we use AI in therapy?” and “How could we do innovative speech therapy?”. I must admit that this is an exciting space, but do we have too much ‘positive propaganda’ being preached to us? We can easily be swept away with all the flashy ‘new intelligence’ without considering the risks and the laws around AI use. In this blog series, I will summarise my findings and reflections on my recent discoveries.

The Role of AI in Healthcare 

After ‘jumping down the rabbit hole’ with the initial ‘AI Healthcare’ Google search, I found that the consensus is that AI has shown its potential to support patient engagement, diagnosis and analysis, reduce human error, and reduce administrative burdens (e.g., voice-transcription apps that transcribe and summarise interviews between clinicians and patients). “How does this translate?” It can offer faster, more accurate and personalised intervention plans, thus improving quality outcomes and productivity. “Sounds amazing right?” However, it comes with a big BUT, which we will discuss later.

In terms of managing administrative burdens, I have been looking at transcription apps and have not been 100% satisfied with them. Even though it is not perfect, the apps can reduce time spent on note-taking, requiring edits here and there. It also aids in categorising sections more efficiently and instantly, making case notes and meetings more precise and concise.

In terms of assessment analytics, AI can help with assessment analysis by pairing the results with observations to create goals, strategies and examples to some degree. I have found it to be mediocre for more complex cases and even in simple cases, require editing. However, some of the generated ideas could be useful to prompt the clinician in the right direction or probe for further investigation.

Although AI has shown incredible potential, our clinic’s Team Leader and I have agreed that early career staff should minimise their use of AI. This is to prevent reliance on AI and instead develop their analytical skills, clinical judgment, and reasoning skills. Our senior staff are also reluctant to use parts of AI due to its inability to generate clinically accurate results and recommendations. Although AI has shown that it is beneficial in generating ideas, suggestions, and strategies, clinicians are strongly advised to apply their clinical judgement and reasoning to thoroughly analyse the information before implementing it.

Despite its advantages, implementing AI in healthcare comes with challenges, including data privacy concerns, integration with existing systems, and the need for training healthcare professionals to use these tools effectively and safely, which will be explored in the next part of the series.

I have created a post to summarise the pros and cons of AI:

AI Pros & Cons

AI Pros

AI Cons

Understanding Literacy Approaches in Our Education System: A Guide (Part 1)

What is literacy and why is it important? 

Literacy encompasses more than just reading and writing; it extends to understanding and interpreting language. It’s a foundational skill that empowers individuals to communicate, comprehend, and engage in society effectively. This includes access to knowledge, economic prospects, social connections, and participation in democratic processes. It is beyond being able to decode written words; it involves critical thinking, interpretation and the ability to analyse and evaluate information.

Navigating the complexities of the education system can be a daunting task, especially when it comes to identifying the most effective approach to literacy. Fortunately, ongoing research in the field of literacy provides us with valuable insights, significantly enhancing our understanding of how best to teach reading and writing. Then why are there so many inconsistencies?

What are the main approaches to teaching literacy in Australia?

Within the realm of literacy education, several approaches have gained prominence, including the Whole Language Approach (WLA), Systematic Synthetic Phonics (SSP), and Balanced Literacy (BL), each with its nuances and derived methodologies. There has been a shift in the recent years from a Whole Language Approach (WLA) approach to a Systematic Synthetic Phonics (SSP) and Balanced Literacy (BL) approach. In this article we will be discussing these main approaches for teaching literacy specifically rather than language learning.

1. Whole Language Approach ( WLA )

The Whole Language Approach (WLA) promotes the concept that language should be viewed as a complete system. It emphasises teaching children to recognise whole words by sight and using context rather than relying on phonics for decoding.

Emerging in the 1800s and coming into prominence in the 1980s, largely due to the efforts of politician Horace Mann, Whole Language Approach (WLA) advocates for learning language in context. It encourages students to understand texts by applying their existing knowledge and using cues from their surroundings, instead of focusing on phonics or breaking down learning into smaller segments.

The approach prioritizes practical applications and immerses students in environments rich in literature. Mann also cautioned against the practice of teaching children to phonetically sound out words, arguing that it could divert their attention away from understanding the meaning of the words.

2. Systematic Synthetic Phonics (SSP)

Systematic Synthetic Phonics (SSP), on the other hand, offers a structured literacy teaching approach that teaches children to break down words into smaller phonetic components. It emphasises the explicit instruction of the relationship between letters (graphemes) and sounds (phonemes) whilst incorporating phonological awareness activities like blending and segmenting sounds in a systematic format. Recognised for its evidence-based foundation, Systematic Synthetic Phonics (SSP) addresses the cognitive processes essential for reading. You may have heard of programs like MultiLit, Minilit, Sounds Write, and Little Learners Love Literacy that are based off an Systematic Synthetic Phonics (SSP) approach.

3. Balanced Literacy (BL) 

Balanced Literacy (BL) attempts to merge the philosophies of Whole Language Approach (WLA) and Systematic Synthetic Phonics (SSP), aiming for a middle ground. This means using Whole Language Approach (WLA) approaches and embedding phonics into their teaching. However, defining this ‘balance’ can be challenging, and critics argue that, in practice, it often leans more towards ‘whole language’ principles. The concern lies in whether children’s foundational literacy skills are sufficiently developed; without a solid base, students may struggle to advance.

4. Reading Recovery (RR)

Reading Recovery (RR) is a literacy intervention approach that was developed to aid struggling readers in their early schooling years. It employs individualised instruction, with each student receiving personalised 1:1 lessons from a trained Reading Recovery (RR) teacher, lasting 30 minutes per day for 12-20 weeks. During these sessions, students engage in reading familiar books with the slow introduction of new books, as well as writing tasks such as assisted story construction.

They also listen to new books and attempt to read them. There is some emphasis on letter identification, sound segmentation (breaking the sounds up in words), and phonemic awareness (identifying individual sounds in words) tasks. However, there is limited targeted intervention on phonological awareness skills, which are fundamental pre-literacy skills.

Other shortcomings noted include the use of repetitive and familiar books, leading to children memorising specific words instead of employing their phonological awareness skills. Additionally, selected books offer visual cues, allowing children to guess the correct word rather than utilising their phonological awareness abilities. Furthermore, there is insufficient evidence supporting the long-term effectiveness of Reading Recovery (RR), thus has become less and less popular.

5. Other literacy approaches 

Other approaches include:

• Multimodal literacy, which utilises digital technologies and multimedia platforms to improve literacy skills, such as websites, videos, social media posts, advertisements, and interactive digital media.

• Literacy across the curriculum, where literacy skills and strategies are integrated into all subject areas, not solely English classes. This method entails embedding explicit instruction in literacy skills and strategies within subject-specific lessons.

Additionally, it’s crucial to acknowledge that schools might incorporate multiple approaches to literacy. For instance, a school could offer instruction in ‘sight words’ while primarily adopting a Systematic Synthetic Phonics (SSP) approach for teaching literacy. The rationale behind integrating ‘sight words’ could be to enhance orthographic abilities (identifying patterns of specific letters as words such as diagraphs ‘sh’) and overall reading fluency.

Understanding literacy Approaches in our Education System: A guide (Part 2)

Does the literacy approach matter?

The choice of literacy approaches holds significance as they impact students’ reading and writing skills differently. A typical developing student can still master literacy using a Whole Language Approach (WLA), however evidence-based methods, backed by research, are more likely to foster positive literacy development outcomes. Since students’ needs vary, effective literacy approaches should be tailored to address these individual needs rather than expecting uniform progress with the curriculum.

For instance, if a student struggles with blending sounds to form words, they require additional practice in that specific area. The importance of literacy approaches extends to ensuring students establish strong foundational skills; otherwise, they risk falling behind, which can adversely affect both their learning progress and attitudes towards learning. While there may be slight variations between programs, as long as there is adherence to a Systematic Synthetic Phonics (SSP) approach, the differences are unlikely to be significant.

Providing evidence-based literacy approaches is crucial for children with specific learning impairments (e.g. dyslexia), intellectual disabilities, and other neurodivergent conditions. These children often face unique challenges that can impact their ability to acquire literacy skills. By implementing evidence-based approaches, educators and specialists can tailor instruction to meet the individual needs of these children and maximise their potential for success.

When does it stop mattering which approach is used?

Once your child has developed the ability to read and write proficiently and actively participate in the learning curriculum, they have achieved the goals of literacy acquisition. At this point, they will transition from the stage of ‘learning to read and write’ to ‘reading and writing to learn.’ While this transition typically occurs around grade 4, it begins earlier and extends beyond this grade level.

How does this relate to the Victorian State curriculum?

Schools are mandated to follow the Victorian State Curriculum, yet the implementation of this curriculum can vary significantly. The Department of Education provides a list of recommendations on initiatives and programs. Among the recommended approaches and gaining increasing popularity is the ‘Science of Reading’ approach, which incorporates Systematic Synthetic Phonics (SSP) teachings. The approach encompasses five critical sub-skills: phonemic awareness, phonics, fluency, vocabulary, and comprehension.

Another factor to take into account when discussing literacy skills is the shift from the phase of “learning to read” to that of “reading to learn.”

“In grades K–3, children are in the process of learning to read, while in grades 4–12, they transition to reading to learn” (Chall, Jacobs, & Baldwin, 1990; Chall and Jacobs, 2003). However, it’s crucial to recognise that this transition isn’t strictly delineated. Children continue to develop their reading skills beyond Grade 4, and they also utilise reading as a means of learning before reaching this grade level. This research underscores the importance of establishing a strong literacy foundation to empower children as independent learners amidst this evolving learning process. 

What to ask your primary school about literacy approaches 

If you’re unsure about the literacy approach used at your school, it’s advisable to ask your teacher. If they cannot provide a clear answer, consider reaching out to the learning coordinator or the school’s leadership team for clarification. If terms like “synthetic phonics” or “phonological awareness” are mentioned in the response, your school is likely following a more evidence-based approach.

The role of Speech Pathology in literacy

Speech Pathologists (SP) are adept at assessing and addressing literacy concerns focusing on phonological and phonemic awareness skills essential for literacy. Speech Pathologists offer targeted interventions that prioritise these foundational elements. Their scope also extends to reading fluency, vocabulary, language, reading comprehension, meta-cognitive strategies and written language skills such as grammar, sentence structure, and organisation.

By addressing these areas comprehensively, Speech Pathologists help individuals develop well-rounded literacy skills that are crucial for academic success and lifelong learning. 

Speech Pathologists base their interventions on a foundation of research, ensuring that their approaches are evidence-based and effective. Speech Pathologists have also played a significant role in literacy research, contributing to the body of knowledge on effective literacy interventions and advocating for evidence-based practices. In particular, Speech Pathologists have advocated for the Systematic Synthetic Phonics (SSP) approaches to be taught in schools, which emphasises systematic instruction in letter-sound correspondences and phonics rules. Speech Pathologists caution against the inefficacies of programs like Reading Recovery (RR) and Whole Language Approach (WLA).

By staying informed about the latest research and best practices in literacy instruction, Speech Pathologists ensure that they can provide high-quality, evidence-based interventions that meet the needs of their clients and promote literacy success.

Conclusion

The journey through literacy education is multifaceted, with various approaches offering different paths to the same goal: proficient reading and writing skills.

As we continue to rely on robust research and evidence-based practices, it becomes clear that a deep understanding of phonological awareness skills and structured instruction plays a vital role in developing strong literacy foundations. For parents and educators alike, staying informed about these methodologies and their implementation within curricula like Victoria’s is crucial for supporting our children’s literacy development.

This blog was initially written for Melbourne Schools: https://melbourneschools.com.au/blog/