June 27, 2023

chatbots

The cost of being replaced by a chatbot

The National Eating Disorders Association's plan to replace its volunteer staff with an AI-driven chatbot called Tessa drew censure last month, touching off a nationwide discussion on the blurry boundary between responsibly using automation to augment human work versus replacing it outright. The potential harm to people with eating disorders became clear when Tessa began dispensing diet tips.

I spoke to former NEDA hotline volunteers who said the switch robbed them of a meaningful personal and professional connection to people taking the first step toward recovery.

"This is a job I undertook not only as somebody who is recovered from an eating disorder, but also because I'm looking to get involved professionally," said one volunteer and recent college graduate. With Tessa, she said, "I had this opportunity taken away."

The helpline isn't supposed to offer crisis support, but volunteers told me callers did often reach out when they were in crisis. And bots likely wouldn't be able to deescalate as well as humans, nor make certain judgement calls. Still, bots could eventually be helpful in helping volunteers quickly mine resources, one told me. Here's the full story.

medical devices

Device makers race to keep up in obesity treatment

The makers of minimally invasive surgical devices to help people lose weight seemed poised to capture a wide swath of the obesity treatment market. Then, a new class of weight loss medications called GLP-1s hit the market — and the entire treatment landscape changed.

For the companies developing surgical tools and gastric balloons to treat obesity, such as Apollo Endosurgery and Allurion, the drugs present both a rich opportunity to capitalize on new interest in the condition and an existential threat to their market share.

"A device that may give you 15% weight loss, and looked like it was blowing away the competition, is now going to look weak in comparison to drugs," Lee Kaplan, director of Massachusetts General's obesity institute, told my colleague Lizzy Lawrence. Read her full story.

Diabetes

Does DIY still have a place in diabetes care?

Dana Lewis — who built her own artificial pancreas in 2014, and is now a prominent name in the device-hacking DIY diabetes care community — sparred with pediatric endocrinologist Greg Forlenza about the future of that movement last week at the American Diabetes Association's scientific sessions, Katie Palmer writes. Forlenza said the number of approved systems on the market makes hacking together devices for type-1 diabetes an unnecessary risk.

But for Lewis and many DIYers, the ability to custom-tune their insulin delivery algorithms — to reduce the number of times they have to touch their device, or respond to an alarm — can significantly improve their quality of life. "That's something that we don't quantify right now" in research, said Lewis, who has shared the code for her artificial pancreas so others can use it. Read the full story here.

millionWashington

CMS proposes new pathway for reimbursing breakthrough devices

A long-awaited CMS effort could make the path to reimbursement easier for medical device makers, Lizzy writes. A new proposal outlines the Transitional Coverage for Emerging Technologies program, which would apply to FDA-designated "breakthrough devices." The goal is to streamline the process for securing Medicare coverage, potentially overcoming the "valley of death" device makers face between scoring approval and actually getting covered.

Under the voluntary pathway, device makers could access CMS officials before FDA market authorization. Officials would review early evidence, help manufacturers design studies and guide them on existing coverage areas. The goal is to finalize coverage within six months of FDA clearance, according to CMS. Read more from Lizzy, and to keep up on the space, check out our Breakthrough Device Tracker.

neurotech

Muscle sensor company sees early promise in a pig

Phantom Neuro, a small startup working on a muscle sensor to allow better control of prosthetic limbs, has tested its device on a pig and found that could decode the pig's movements in real time, Lizzy tells us.

Lizzy spoke with founder Connor Glass about the company's proof of concept in the pig (also named Lizzy!), and his eventual goal of implanting the device under the skin at the site where a patient's body connected to the robotic prosthetic. The device would communicate the amputated limb's movements to the person's phone, and after that, to the prosthetic.

"We put it on top of the muscle in the shoulder of this pig, and in real-time recorded the muscle activity from the pig as it walked on a treadmill," Glass said. "Then we used that to drive control of a virtual robot pig leg." The company team will continue working on making the sensor communication more seamless, and eventually testing it on sophisticated robotic limbs. In the meantime, Phantom Neuro has built out its board with Thomas Oxley, CEO of brain-computer interface company Synchron, and Joshua Duyan, former Chief Strategy Officer of CTRL labs. The company has raised around $9 million, according to AlphaSense.

Hospitals

Babyscripts expands maternal health tech in South

A few months ago I wrote about the potential for maternal health tech — digital scales, connected blood pressure cuffs, and remote monitoring apps — to meaningfully address major health inequities across marginalized, medically underserved populations. But the technology's not always within reach for the cash-strapped health systems that want to help.

Babyscripts, a maternal health tech company with an app that health systems can customize for their patients, recently announced a partnership with Memorial Hermann in Southeast Texas. Memorial Hermann patients using the app will get educational content, appointment reminders, and suggestions for behavioral changes.

The health system wouldn't share how much the technology cost, nor how many patients it aims to sign up. But Victoria Regan, VP of women's and children's services at the health system, said its goals were to improve in-network utilization and patient experience scores.

Providers already like that they're able to customize the educational content for individual patients — including maps and lists of pediatricians — and also prepare them for appointments, she said.

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What we're reading

The race to prevent machine learning's worst case scenario, New York Times
How health tech is targeting Tampa Bay nurse shortages, Tampa Bay Times
Health misinformation is rampant in youth baseball, STAT

Thanks for reading! More on Thursday - Mohana

Mohana Ravindranath is a Bay Area correspondent covering health tech at STAT and has made it her mission to separate out hype from reality in health care.