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ARTIFICIAL INTELLIGENCE & HEALTHCARE
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Former Permanente Med Group CEO Says All Physicians Should Use ChatGPT |
Robert Pearl, MD, former CEO of Permanente Medical Group, said if he was still in charge, he'd have all physicians using ChatGPT in their practice, Wired reported April 24. "I think it will be more important to doctors than the stethoscope was in the past," Dr. Pearl said. "No physician who practices high-quality medicine will do so without accessing ChatGPT or other forms of generative AI." He said ChatGPT is already being used by physicians to summarize patient interactions, write letters and give a second opinion when it comes to diagnosing patients. He also believes physicians will continue to find other ways the technology can help improve patient care. For example: language models in healthcare will become similar to the iPhone, where the technology will incorporate various features that aim to help patients manage chronic disease. He even stated that technology like ChatGPT could help prevent some of the 250,000+ U.S. patient deaths that occur as a result of medical errors. And for now, ChatGPT could serve as a way to provide care for patients, as long as all of its decisions are reviewed by a physician. (https://www.beckershospitalreview.com/healthcare-information-technology/former-kaiser-ceo-says-all-physicians-should-use-chatgpt.html)
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ChatGPT Might Show More Empathy than Docs, Study Finds |
OpenAI's ChatGPT tool can answer patient questions with more empathy than human physicians can, according to a new study. In the study, recently published by JAMA Internal Medicine, researchers led by the University of California San Diego, La Jolla took a randomly drawn sample of about 200 patient questions from social media platform Reddit's AskDocs social media forum. Then both human doctors and ChatGPT answered the questions. They had a clinical team evaluate both of the answers to each of the questions, rating them on the quality of the answers and the empathy demonstrated. The chatbot won. It wasn't close. Evaluators preferred the response by the computer nearly 80% of the time over the human doctor's answer. (https://www.axios.com/2023/05/01/chatgpt-empathy-better-than-doctors)
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Microsoft & Epic to Roll Out New Generative AI Capabilities in EHRs |
Microsoft and Epic are teaming up to harness the power of Generative AI to improve the accuracy and efficiency of electronic health records. The partnership will integrate the Microsoft Azure OpenAI Service with Epic's EHR platform - for example, extending natural language queries and interactive data analysis to Epic's self-service reporting tool SlicerDicer. The announcement expands a partnership between the EHR provider and Microsoft through which Epic environments can be deployed on the Azure cloud platform. By leveraging AI algorithms to automatically fill in missing information, EHRs can become more complete, accurate and easier to use, freeing up clinicians to focus on patient care.
Generative AI uses machine learning to generate new content, such as text, images and even entire websites. In the context of EHRs, generative AI can be used to automatically fill in missing information, suggest diagnoses and even predict future health outcomes based on historical data. Among the health systems already deploying the integrated systems are UC San Diego Health; UW Health in Madison, Wisconsin; and Stanford Health Care, leveraging Epic's new capabilities to automatically draft message responses. (https://www.healthcareitnews.com/news/epic-microsoft-partner-use-generative-ai-better-ehrs)
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How AI & Facial Recognition Could Spot Stroke and Other Diseases |
Patients at Johns Hopkins Hospital who are suspected of having a stroke might get an unusual request from physicians: Can we film your face? The doctors' goal is to identify stroke patients by facial characteristics instead of waiting for brain scans or blood tests, helping speed both treatment and recovery. The Johns Hopkins team is training a computer algorithm to recognize changes in the patients' features, such as the paralysis of certain facial muscles or unusual eye movements, that might indicate damage to the brain from a stroke as opposed to seizures, severe migraines or anxiety disorders. Meanwhile, other researchers at MIT are looking at facial recognition to diagnose the progression of amyotrophic lateral sclerosis, or ALS, a degenerative nerve disease that affects the muscles. And a Florida-based startup has developed a tool to help pediatricians diagnose rare genetic conditions by analyzing images of children's facial features. Early research efforts point to a future in which facial scans, perhaps embedded in a smartphone camera or even a bathroom mirror, might monitor our general health while picking up signs of long-term neurological ailments such as dementia. Some researchers believe algorithms might even be used to track how well a treatment or drug is working by detecting changes in a person's face. (https://www.wsj.com/articles/ai-and-facial-recognition-may-be-able-to-spot-stroke-and-other-diseases-6ac5d965?mod=hp_lista_pos1)
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Uncle Sam Wants YOU to Comment on How AI Could Help Shape the Future of U.S. Policy |
Artificial intelligence policy has been a hot topic lately because of the massive popularity of AI tools such as ChatGPT, and the number of users they have acquired. To figure out the next policy steps in the U.S., the Biden Administration is seeking your opinion. The Department of Commerce's National Telecommunications and Information Administration (NTIA) recently launched a request for comment (RFC) regarding AI accountability. Through the RFC, the public is welcome to share any thoughts, concerns, or feedback they have about policies regarding AI. Specifically, the NTIA is seeking insight that can support the development of "AI audits, assessments, certifications and other mechanisms to create earned trust in AI systems," according to the site. The RFC will close on June 10, 2023, 60 days after the initial announcement. All of the insights collected will be delivered to the Biden Administration by the NTIA to aid in the administration's development of policy that ensures user safety regarding AI. The NTIA's statement says in the same way that food and cars are regulated for safety, AI models should be too. If you want to participate, visit the NTIA's site where you can find instructions on how to submit your written comments as well as more resources on the topic. (https://www.zdnet.com/article/the-white-house-seeks-your-opinion-on-chatgpt-and-ai-tools-for-safety-policy/)
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WORKFORCE NEWS
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Boomerang Nurses Come Back to Many Hospitals Amid Temp Job Slump |
Nursing shortages are easing for some hospitals after falling pay from temp agencies and new hospital perks drive more nurses back into permanent positions, The Wall Street Journal reported May 1. Department nurses left hospitals for more lucrative temp positions during the COVID-19 pandemic, but in the first few months of 2023, the pay and benefits between agencies and hospitals have begun to equalize. Hospitals across the country are increasing their nursing staff by hiring on temporary nurses or rehiring nurses who left for other positions. Better pay and perks like childcare and more flexible schedules are what many executives point to as an incentive to bring nurses back into permanent positions. (https://www.beckershospitalreview.com/nursing/nurses-stream-back-to-hospitals-amid-temp-job-slump.html)
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Nurse Shortage Pushes Hospitals into the Gig Economy |
Some of the nation's largest hospital systems including Providence and Advocate Health are using apps similar to ride-hailing technology to attract scarce nurses. An app from ShiftKey lets workers bid for shifts. Another, CareRev, helps hospitals adjust pay to match supply, lowering rates for popular shifts and raising them to entice nurses to work overnight or holidays. The embrace of gig work puts hospitals in more direct competition with the temporary-staffing agencies that siphoned away nurses during the pandemic. The apps help extend hospitals' labor pool beyond their employees to other local nurses who value the highly flexible schedules of gig work. The shift is among many ways hospitals are revamping hiring, schedules and pay to give nurses more control and to fill staffing gaps created by persistent labor shortages. (https://www.wsj.com/articles/nurse-shortage-hospitals-hiring-gig-economy-dc94bdb2?mod=hp_lista_pos1)
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That Said, 85% of Nurses Plan to Leave Hospital Roles 1 Year from Now: AMN Survey |
Only 15% of nurses currently working in hospital settings say they plan to stay in their current positions one year from now, according to a survey of 18,000+ nurses conducted by AMN Healthcare, one of the largest healthcare staffing companies in the country. The 85% who said they are making other career plans reported they are seeking travel nursing opportunities, considering going back to school, looking into part-time or per diem work, or departing the profession completely. Additionally, 55% of nurses across the profession reported feeling like they want to quit often. (https://www.beckershospitalreview.com/nursing/85-of-nurses-plan-to-leave-hospital-roles-1-year-from-now-survey.html)
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Cost of Benefits Strain Employers and Workers Alike |
The rising cost of benefits - and the insufficiency of their support in covering employee costs - are straining both employers and workers, a report from Aflac has shown. Three in 4 employers responding to a survey said their benefits costs went up in the last year, naming prescription drug costs and an increased need for mental healthcare and medical appointments as factors. Of all challenges when it comes to employee engagement and satisfaction, employers named "providing a competitive total compensation package" as their No. 1 struggle, with 47% picking this option - topping training and development (40%), implementing tech solutions (38%) and offering optimal flexible work arrangements (37%). (https://www.hrdive.com/news/cost-of-benefits-strain-employers-workers-alike/647578/)
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PHARMACY & PHARMACEUTICAL NEWS & TRENDS
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Mark Cuban Builds a Pharmacy Network |
Mark Cuban is creating an independent pharmacy network to "serve patients more widely" after pitching the idea to local pharmacy owners in February. Mark Cuban Cost Plus Drug Co. has operated as a mail-order, online pharmacy since January 2022, but with its latest endeavor, the business is looking to expand access to its portfolio of 1,000+ prescription drugs. The collaboration between independent pharmacies and Cost Plus Drugs includes a "Team Cuban Card," which acts like an insurance card at pharmacy checkouts. Independent pharmacists interested in partnering with Cost Plus Drugs were asked to complete an interest form with the company detailing the type of pharmacy they run and how patients access the services offered. So far, Cost Plus Drugs has 36 affiliate locations, with five in Florida, seven in Indiana, six in New Jersey, and 18 in Texas. The company said it will add new sites every month. (https://www.beckershospitalreview.com/pharmacy/mark-cuban-builds-a-pharmacy-network.html)
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Strong Sales of Obesity-Diabetes Drugs Could Affect Insurance Companies' Financial Results |
Not too much is standing in the way of a new class of obesity-diabetes drugs from becoming one of the biggest blockbusters the pharmaceutical industry has ever seen. Doctors are excited about the potential health benefits, the social-media hype just won't abate, and the weight loss can be dramatic. There is one major question still looming over this drug class, known as GLP-1s, though: What do insurers, who ultimately foot the bill, think about this new revolution in the treatment of obesity? If this class of drugs can truly surpass $100 billion in annual sales, as many analysts expect, insurers (and ultimately employers and the government) will have to foot the bill. UnitedHealth Group CEO Andrew Witty recently fired a first salvo, signaling there will be a tough approach both on pricing as well as on just who gets to take these drugs. (https://www.wsj.com/articles/demand-for-obesity-drugs-has-insurers-paying-close-attention-7330d093?mod=hp_minor_pos19)
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Moderna, Merck Show Progress Toward Cancer Vaccines |
Moderna Inc. and Merck & Co.'s cancer vaccine helped prevent relapse for melanoma patients, results from a mid-stage trial showed, demonstrating progress in the pursuit of shots to ward off cancer by jump-starting the immune system. About 79% of high-risk melanoma patients who got the personalized vaccine and Merck's immunotherapy Keytruda were alive and cancer-free at 18 months, compared with about 62% of patients who received immunotherapy alone, researchers said Sunday. The 157-person trial offers some of the strongest evidence yet that such vaccines could benefit cancer patients. Moderna and Merck said they would expand their research into other tumor types including non-small cell lung cancer. The companies have said they plan to run a larger study to confirm the vaccine's safety and efficacy in treating high-risk melanoma. (https://www.wsj.com/articles/moderna-shows-progress-toward-cancer-vaccines-27ff606?mod=hp_lead_pos3)
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Merck to Acquire Prometheus Biosciences |
Merck & Co. recently said it agreed to acquire Prometheus Biosciences Inc. for $10.8 billion, a push into the lucrative market for immune-disease treatments. Autoimmune drugs are some of the industry's biggest sellers and can command high prices, but companies are searching for next-generation products. Some top-sellers such as AbbVie Inc.'s arthritis treatment Humira recently began experiencing their first competition from cheaper versions. Other drugmakers have acquired autoimmune-treatment makers recently. Amgen's $27.8 billion agreement to purchase Horizon Therapeutics in December was the biggest healthcare merger of last year. The global immunology market is estimated to be worth more than $40 billion, according to analyst Michael Yee of Jefferies LLC. (https://www.wsj.com/articles/merck-in-late-stage-talks-to-acquire-prometheus-biosciences-eefe4909?mod=hp_lead_pos6)
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"These Drugs Are So Futuristic That Doctors Need New Training" |
A major obstacle looms for the drugs of the future: not enough doctors know how to administer them. For just one rare neurodevelopmental disorder, known as Angelman syndrome, clinical trials are testing four cutting-edge therapies. Twenty more research programs are under way and could yield treatments ready to move into human testing in the next several years, these promising therapies include antisense oligonucleotides (or ASOs) which affect how proteins inside cells are made; Crispr gene editors that can cut, rewrite, or replace faulty genes; and other novel approaches. But there's a hitch. Some of these drugs, as well as therapies in development for other conditions, are administered through lumbar punctures, which aren't a routine part of doctors' daily practices. They may involve infusions of a gene packaged inside the shell of a virus, which can lead to potential immune complications and can require close monitoring of patients. Some drugs need to be stored in special containers, which can take complicated planning and coordination that few doctors have experienced. "The bottleneck used to be the science and finding drugs," says Dr. Berent-Weisse. "The new bottleneck is having enough people trained to give them." That's bringing new efforts to address the problem. (https://www.wsj.com/articles/these-drugs-are-so-futuristic-that-doctors-need-new-training-d88c10dc?mod=hp_lista_pos1)
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HEALTHCARE & GOVERNMENT
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President Biden Signs Bill Ending COVID-19 National Emergency |
President Biden recently signed legislation formally ending the COVID-19 national emergency that was originally declared under the Trump administration in March 2020. The bill to end the national emergency, H. J. Res. 7, was advanced by House Republicans. It passed the House of Representatives in February by a vote of 229-197 and passed the Senate last month by a vote of 68-23. The national emergency that the bill ends is distinct from the public health emergency declared by HHS, which remains in effect, but is set to expire on May 11, 2023. (https://kslawemail.com/128/10147/pages/article2.asp?sid=2e426264-1697-4d83-9ab4-c1d33b2074d2)
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OCR Proposes Rule to Expand Reproductive Health Information Protections |
On April 17, 2023, the HHS Office for Civil Rights published a proposed rule that would expand protections for reproductive health information under HIPAA. The Proposed Rule would prohibit regulated entities from using or disclosing an individual's protected health information (PHI) for the purpose of conducting a criminal, civil, or administrative investigation into or proceedings against a person in connection with seeking, obtaining, providing, or facilitating reproductive health care where the health care provided was lawful under state or federal law. The Proposed Rule would also prohibit a regulated entity from disclosing PHI to identify an individual for purposes of initiating an investigation into a person who obtained, sought, provided or received lawful reproductive health care services. (https://kslawemail.com/128/10147/pages/article4.asp?sid=2e426264-1697-4d83-9ab4-c1d33b2074d2)
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CMS Proposes Policies to Improve Patient Safety and Promote Health Equity |
CMS recently issued a proposed rule for inpatient and long-term care hospitals that builds on the Biden-Harris Administration's key priorities to advance health equity and support underserved communities. If the proposal is finalized, acute-care hospitals would see a 2.8% pay increase in Medicare reimbursements, and long-term care hospitals would get a 2.9% bump. (https://www.cms.gov/newsroom/press-releases/cms-proposes-policies-improve-patient-safety-and-promote-health-equity)
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FTC Puts Health Companies on Watch for Misleading Ads |
Nearly 700 companies are receiving a warning from the Federal Trade Commission about the civil penalties they face for advertisements containing claims about products that cannot be backed up with reliable evidence. Pharmaceutical, retail, and health and wellness companies that market OTC drugs, dietary supplements, homeopathic products and health foods make up a large portion of the 670 companies receiving a notice of penalties from the FTC. With the notice issued, the agency can seek civil penalties - up to $50,120 per violation - against companies that knowingly engage in marketing conduct that has been found unlawful in previous FTC administrative orders. Among the recipients of the notice of penalties are AbbVie, Amazon, AstraZeneca, Costco, CVS Pharmacy, Johnson & Johnson, Pfizer, Rite Aid, Walgreens Boot Alliance and Walmart. The agency notes that recipients' inclusion on the list "does not in any way suggest that it has engaged in deceptive or unfair conduct." (https://www.beckershospitalreview.com/legal-regulatory-issues/ftc-puts-health-companies-on-watch-for-misleading-ads.html)
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CMS Releases Notice of Benefit and Payment Parameters for 2024 Final Rule |
On April 17, 2023, CMS released the U.S. Department of Health and Human Services Notice of Benefit and Payment Parameters for 2024 Final Rule that includes standards for issuers and Marketplaces, and requirements for agents, brokers, web-brokers and others. The Notice implements various changes previously proposed by CMS, including (i) requiring provider networks to comply with network adequacy standards and delaying the implementation of appointment wait time standards, (ii) standardizing plan options, (iii) adding special enrollment periods to increase ease of obtaining coverage, (iv) strengthening markets, and (v) bolstering program integrity. Read More: https://www.sheppardhealthlaw.com/2023/04/articles/centers-for-medicare-and-medicaid-services-cms/cms-releases-notice-of-benefit-and-payment-parameters-for-2024-final-rule/)
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HHS Encourages States to Apply for New Medicaid Reentry Demonstration Opportunity |
HHS, through CMS, is announcing a new opportunity for states to help increase care for individuals who are incarcerated in the period immediately prior to their release to help them succeed and thrive during reentry. The new Medicaid Reentry Section 1115 Demonstration Opportunity would allow state Medicaid programs to cover services that address various health concerns, including substance use disorders and other chronic health conditions. The goal of this demonstration opportunity is to help Medicaid enrollees establish connections to community providers to better ensure their health care needs are met during their reentry process. In January, California became the first state to cover certain health care services for individuals transitioning back to the community. (https://www.cms.gov/newsroom/press-releases/hhs-releases-new-guidance-encourage-states-apply-new-medicaid-reentry-section-1115-demonstration)
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Congress Alleges HHS Misallocated Hospitals' Pandemic Relief Funds |
The House Committee on Oversight and Accountability is investigating HHS's distribution of pandemic relief funds meant for struggling hospitals. In 2021, $178 billion was approved for the Provider Relief Fund to assist low-income hospitals struggling through the pandemic. A December article from The Wall Street Journal prompted Congress to look into where that money went, and why. "We are concerned about HHS's decisions to provide PRF funds to highly profitable hospitals in wealthy areas while rural hospitals risked going bankrupt as they tried to provide care to Americans in need," the committee wrote in an April 11 letter to Xavier Becerra, HHS' secretary. According to the letter, 1,257 hospitals that collectively reported $53.6 billion in profits received $16.7 billion from the PRF. Meanwhile, 1,644 hospitals that reported a collective $129.1 billion loss received $35 billion during the same time period. (https://www.beckershospitalreview.com/finance/hhs-misallocated-hospitals-pandemic-relief-funds-congress-alleges.html)
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HEALTHCARE BREAKTHROUGHS
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How 5G is Helping Surgeons Operate with Greater Precision |
Private 5G networks could transform the way doctors perform complex surgeries and coordinate with one another on operations. A glimpse of this future is visible in South Korea - at major hospitals across Seoul, private 5G has become the backbone technology for everything from speeding up on-site logistics systems to enabling the remote training of medical professionals. An early mover in this nascent space is Ewha Womans University Mokdong Hospital in Seoul. A private 5G network has been deployed at the hospital to support the vast data-transfer needs of a new technology that uses augmented reality to help guide surgeries. This so-called AR surgical guide, developed by South Korean medical-technology startup SKIA Co., is assisting breast-cancer surgeries at Ewha hospital. When a tablet PC is held above a patient's chest, CT images of the area the tablet is pointed at are displayed on the screen, showing the precise location of tumors and tissues. It's like looking into the body before any incisions have been made. The tablet can be moved around above the chest to see the CT images overlaid at varying angles. (https://www.wsj.com/articles/5g-internet-hospital-technology-surgery-91031b9)
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Another Medical Revolution Is Under Way: Cell-Therapy Applications Are a Reality Today |
In a recent opinion article in The Wall Street Journal, Michael Milken, chairman of the Milken Institute, writes that science now allows us to respond to health crises with antibiotics, polio vaccines, statins, genome sequencing, immunotherapies, monoclonal antibodies, anti-retroviral cocktails, robotic surgeries, advanced nutrition, powerful new diagnostic scans, focused ultrasound, artificial intelligence, Crispr gene editing and mRNA vaccines. The achievements of medicine over the past half century have been stunning: heart disease cut in half, AIDS increasingly controlled, cancer deaths heading down, several hereditary defects corrected, Covid vaccines delivered in record time. Twenty years ago, the idea of putting a live cell in a human, directing it to travel to a specific location, and having it do a specific task would have been considered impossible. Today it's reality, and hundreds of companies are working on cell-therapy applications. That's only the beginning. The driving force behind this progress is the astounding advance of our ability to produce, manipulate, store, retrieve and transmit data. Faster, cheaper, more communicable data have revolutionized medical research. (https://www.wsj.com/articles/another-medical-revolution-is-under-way-cancer-drugs-research-vaccines-technology-ai-data-prevention-be75114e?mod=opinion_lead_pos5O )
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AT&T Launches Medical Radar Device that Monitors Older Adults Through Walls |
AT&T has teamed up with medical sensor manufacturer Cherish Health to create a claimed "industry first: a radar device capable of detecting emergency conditions and monitoring people who are at risk of falling. It can do this across multiple rooms throughout the home, even through walls. Dubbed the Cherish Serenity, the device uses a combination of AT&T cellular connectivity and Cherish's radar and AI technology to detect body position, movement, and biometrics without requiring cameras or wearable trackers. The device is designed to help older generations live more independently while retaining some privacy. (https://www.theverge.com/2023/4/17/23686246/att-cherish-serenity-medical-radar-device-monitor-falls-privacy)
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COST OF HEALTHCARE
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How Much Does A Hospital-Day Cost? That Depends... |
Kaiser State Health Facts charted the adjusted expenses for nonprofit, for-profit and government hospitals per inpatient day in 2021 in every U.S. state, based on data from the 2021 American Hospital Association Annual Survey. The resulting estimate is for the expenses incurred in a day of inpatient care, which have been adjusted higher to reflect an estimate of outpatient service volumes, according to the Kaiser Family Foundation. The Foundation notes the figures are "only an estimate of expenses incurred by the hospital" for one day of inpatient care and do not substitute actual charges or reimbursement for care provided. (https://www.kff.org/health-costs/state-indicator/expenses-per-inpatient-day-by-ownership/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D)
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