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What OpenAI shakeup means for health,

November 28, 2023
Reporter, STAT Health Tech Writer

Good morning! Hoping you had a restful holiday. I'll catch you up on health tech's latest, from AI startups' brewing fears of overregulation to experts warning against concentrating AI talent at a handful of behemoths. Thoughts and news tips go to mohana.ravindranath@statnews.com.

artificial intelligence

Open AI shakeup triggers call for standards

Twists and turns at OpenAI last week — which culminated in executives Sam Altman and Greg Brockman agreeing to return to the nonprofit with a new board — have prompted a call for more robust standards for generative AI's use in health care, Casey Ross reports. 

During the days-long leadership shakeup at OpenAI, the organization that made ChatGPT, Microsoft had offered to employ Altman and Brockman — a scenario that triggered experts' fears that just a handful of tech companies could end up with too much control over generative AI's deployment in health care.

"There is a concern that we're entering a sort of Coke or Pepsi moment where there will be a few big players in the generative AI…market and their systems will form the backbone of a lot of what is to come," Glenn Cohen, director of Harvard Law School's Petrie-Flom Center for Health Law Policy, told STAT. Other experts warned that turmoil at OpenAI might force that team to become more profit-driven. Read more from Casey. 


FRom the bay  

Health startups fear overregulation under AI order

The White House's sweeping AI directive drew a largely positive response from health industry watchers who have long warned about the potential for algorithmic bias to exacerbate disparities or spew error-ridden diagnoses. But AI entrepreneurs and investors across the country — including from celebrated institutions like Y Combinator and Andreessen Horowitz — are also urging Washington to consider the risk of hampering innovation with overly complicated or potentially misguided rules. 

As the Health and Human Services Department stands up its AI task force over the next few weeks, startups are watching closely for hints as to new regulatory requirements. It's possible, for instance, that upcoming regulations focus on auditing training datasets to eradicate bias — but if reporting requirements don't vary by model type, they could prove difficult for startups, Curai's Neal Khosla told me. 

The chasm between the rapidly evolving AI industry and Washington regulators was laid bare earlier this month during Federal Trade Commission chair Lina Khan's visit to Y Combinator. FTC advised the White House on certain elements of the executive order, especially related to competition, she said then. 

"There has been some backlash from folks from our community, especially smaller AI startups," Garry Tan, head of Y Combinator, said during that conversation. In a LinkedIn post, Google Brain founder and AI investor Andrew Ng said that the order's attempt to establish a computational threshold for reporting requirements would block innovation. 

"Today's supercomputer is tomorrow's pocket watch. So as AI progresses, more players — including small companies without the compliance capabilities of big tech — will run into this threshold," he wrote. "Over time, governments' reporting requirements tend to become more burdensome." Read more.  


Washington

Telehealth advocate Rep. Anna Eshoo to retire

California Democrat Anna Eshoo, who's long called for expanding Medicare coverage for virtual care, plans to retire from the House after 32 years in Congress, my colleagues Rachel Cohrs and John Wilkerson report. While she's a stalwart ally to the pharma industry, she has also supported and introduced several measures related to telehealth — and it's no coincidence that her district includes Silicon Valley. Eshoo is currently the top Democrat on the House's influential Energy & Commerce Committee's health panel. 

Eshoo also drew support from the medical device industry when she wrote legislation increasing FDA funding for device reviews, Rachel and John write. Read more on her legacy here



Devices

FDA backs out of international standards group 

Also on medical devices, the FDA has officially withdrawn from the Global Harmonization Working Party, a group of medical device experts aiming to better align international regulations, per a letter to that group's chair from from Center for Devices and Radiological Health head Jeffrey Shuren. 

In his letter Monday to Jinghe Xu, Shuren said the agency didn't realize how big the gap was between GHWP and another organization, the  International Medical Device Regulators Forum. Leadership also wasn't diverse or globally representative, and regulators were underrepresented in working groups compared to industry leaders, he wrote. 

"FDA's goal in joining GHWP was to provide a bridge between the two organizations. Unfortunately, GHWP does not offer the opportunity for FDA and other regulatory bodies to have our voices heard and considered," he wrote. 


Research

NEJM's new AI journal takes shape

The New England Journal of Medicine's new journal focused on AI — called NEJM AI — is approaching its January 2024 debut with a handful of early -release articles on topics ranging from exploring GPT-4 for complex clinical diagnoses to measuring clinical adoption of medical AI devices by examining claims dataThe journal is a step toward rigorous evaluation of the technology's use in health care, the lack of which has been a key stumbling block for AI advocates urging hospitals to adopt it for diagnostic purposes. Among fascinating tidbits: in one limited analysis, the GPT-4 tool correctly diagnosed more than half of  complex clinical cases.


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What we're reading

  • Why Amazon has overpromised and underdelivered in health care, Bloomberg
  • Cyberattack on Ardent Health diverts ambulances in multiple states, CNN
  • Rural medics used telehealth to treat a man attacked by bison, CBS News

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.


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