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Where Generative AI falls short in batch of new studies

April 25, 2024
Health Tech Correspondent

Good morning health tech readers!

This week I remembered one of my all-time favorite  headlines, from an amazing 2015 blog post by tech historian and writer Matt Novak, which argued that promises to deliver flying cars by so-and-so date are always too optimistic. Why was I thinking about this? Because of the amusing New Yorker article that claims that flying cars kind of are a thing now. Did the future that was never going to happen quietly materialize while we were all in lockdown?

Reach me: mario.aguilar@statnews.com

Artificial intelligence

Generative AI doesn't always save time and money

Readers, you are not going to believe it, but many generative AI tools being rapidly developed for health care are still pretty rough and not quite ready for patients.

A series of recent research papers by academic hospitals has revealed significant limitations of large language models (LLMs) in medical settings, undercutting common industry talking points that they will save time and money, and soon liberate clinicians from the drudgery of documentation, STAT's Casey Ross reports

"Doing this research we start to understand the failure modes," said Danielle Bitterman, a radiation oncologist at Mass General Brigham who co-authored one paper told Casey. "If we roll this out too soon, we will see early errors and people will get scared of it."

Read more here


Hospitals

HCA doubles down on AI for clinician notes

HCA Healthcare, the largest for-profit hospital chain in the United States, is planning to expand the use of an artificial intelligence tool to document doctor-patient interactions in its emergency rooms, STAT's Brittany Trang reports.

The plans for a broader roll out of the AI tool across its network comes nearly a year after the 184-hospital health system started working with medical documentation company Augmedix to pilot its ambient scribe technology at a handful of ER departments within the HCA network.

HCA's plans are part of growing efforts by health care providers across the country to lean on AI to reduce clinician burnout by shifting the burden of repetitive administrative tasks like medical note-taking to technology. The move comes at a time when federal agencies are still writing rules to make sure that the use of AI-based tools in clinical settings do not harm patients.

Read more here


Research

Telehealth experiment for PTSD gets funding boost

Here's an update that answers the question: How do we scale promising digital health research? 

A few years ago, I wrote about a remarkable study in which researchers at the University of Washington used telemedicine to beam specialized mental health treatment to people with bipolar disorder and post-traumatic stress disorder who lived in communities with limited access to mental health care. The comparative effectiveness study funded by the Patient-Centered Outcomes Research Institute randomized patients to either a referral group or a collaborative care group. The referral group was connected over video to a psychiatrist and psychologist for a standard course of treatment. Meanwhile in the collaborative care model, a remote psychiatrist evaluated a patient and then supported treatment delivered by care managers in the local primary care setting. Collaborative care has been around for decades, but it's mostly used in the context of anxiety and depression.

The results were positive and significant in both treatment groups, but the collaborative care group used less of the costly and hard to come by psychiatric care. In my story at the time, I pondered how this innovative, but somewhat complex, care model might be scaled so more people could benefit.

Well, PCORI just announced a $2.5 million grant to the University of Washington's AIMS Center and collaborative care company Concert Health to fund implementation of the research at 150 primary care practices in medically underserved areas. The funding will support training staff on how to adapt collaborative care to the more serious mental health conditions, as well as to help Concert develop its technology for the new model. 



Telehealth

Teladoc earnings on deck and other virtual care notes

  • This afternoon Teladoc will report its first quarter earnings, and we're watching to see if there are any hints about what may have prompted the abrupt departure of long-time CEO Jason Gorevic — or if there are any signs of the company changing course. Can Teladoc keep its promise to continue to improve adjusted earnings as revenue growth slows down? In particular, revenue for BetterHelp, the company's virtual mental health subsidiary, is projected to decrease, and it will be interesting to see just how much it drops.
  • Speaking of Teladoc, earlier this week I enjoyed the Wall Street Journal's dive on the cratering value of Cathie Wood's Ark Investment Management funds, which are heavily invested in tech companies. Wood has been a long-time Teladoc booster, and Ark currently holds just under 10% of Teladoc's stock.
  • Earlier this week, digital mental health company Headspace announced it would offer text-based mental health coaching currently available to enterprise customers to individual consumers who use its wellness app, with plans to introduce therapy to consumers later this year. It's an interesting move, given that direct-to-consumer digital mental health is a very competitive market with high user-acquisition costs. (See BetterHelp's declining revenues above). 
  • We flagged the new Health Affairs paper looking at telehealth utilization on Tuesday, but it's worth highlighting a key finding: Medicare patients in health systems that used the most telemedicine saw health benefits, like fewer emergency department visits, but also saw a 1.6% increase in health care spending. While that might seem like a modest increase, it turns into a very big number when you're talking about millions of Medicare patients. Cost is likely to be a key determinant for what — if any — expiring Covid-19 telehealth flexibilities are extended beyond this year. Congress is currently weighing about a dozen bills proposing to do that. When someone sees the CBO estimates, please send them to me!
  • Endpoints reported that Optum is shutting down Everycare, the virtual care platform the UnitedHealth subsidiary launched during the pandemic that was marketed to consumers as well as to employers. Though Optum coyly did not confirm the closure, it offered a statement saying that it would continue to offer virtual care. Incredibly vague? Optum is a huge player, so the move might be read as an indicator of low demand for virtual care post-pandemic. 

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What we're reading

  • UnitedHealth Group cuts jobs in Optum's naviHealth division, Modern Healthcare
  • Measuring algorithmic bias to analyze the reliability of AI tools that predict depression risk using smartphone sensed-behavioral data, npj Digital Medicine
  • Genetic analysis reveals H5N1 flu virus outbreak in cows likely started earlier than thought, STAT

Thanks for reading! More on Tuesday - Mario

Mario Aguilar covers how technology is transforming health care. He is based in New York.


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