UpToDate's AI push and the nagging questions about chatbots in medicine

UpToDate, a revered physician's reference boasting thousands of expert-written articles, will this month roll out a search interface that will work much like ChatGPT, allowing doctors to punch in medical questions and get generated answers. With well-funded, AI-native competitors like OpenEvidence boasting hundreds of thousands of registered doctors, it was only a matter of time.

For busy clinicians, and especially for trainees, the services can be a boon. But they are based on unpredictable large language models, and there's no guarantee the generated responses to queries are always accurate. There's no easy way to benchmark their performance, and the effects of bots on medicine haven't been studied. As Katie Palmer reports, clinicians have observed unusual performance. UpToDate and others use techniques to rein in the technology, but as with anything in medicine, it's best to proceed with caution. Or is it too late for caution?

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How the shutdown hurts overcrowded hospitals

Over the last week, I've spoken to a half-dozen hospitals that rely on hospital at home programs to take the burden off their overcrowded emergency departments. Or I should say they did. Beginning last week, many started pausing admissions to their home hospitals as leaders anticipatied that lawmakers in Washington would fail to reauthorize the Medicare waiver that allows them to deliver this care. A temporary extension is linked to budget legislation that Congress has not passed. While hospital at home programs are nascent, the health systems that have adopted them really need help with capacity.

Read my whole story here

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The telehealth situation

Expanded telehealth coverage that allows Medicare enrollees to receive telehealth care in their homes also lapsed, though, unlike hospital at home, the services don't have to immediately stop.

CMS directed regional contractors to temporarily hold claims in the event that the shutdown is quickly resolved. This may help with reimbursement for services provided during the lapse if Congress authorizes retroactive payment. It still puts patients and providers in a tough spot: Do you continue with your telehealth appointment in hopes that the government will eventually pay?

Health tech news roundup

The Food and Drug Administration wants to h ear from the public on "best practices, methodologies, and approaches for measuring and evaluating real-world performance of AI-enabled medical devices." The deadline is December 1st.
The Cancer AI Alliance, including centers like Dana-Farber and Memorial Sloan Kettering, announced a new federated data research platform.
In other AI cancer news: HHS announced it's doubling funding to the Childhood Cancer Data Initiative at the National Cancer Institute from $50 million to $100 million. According to the release, the initiative "will also bring in private-sector partners to apply advanced artificial intelligence to speed up cures for pediatric cancer."
Fresh off announcing a $625 million capital commitment, Sanofi Ventures announced it's invested in QuantHealth, which helps drug companies simulate clinical trial outcomes.
Assort Health, a voice AI agent-maker that helps providers field patient phone calls, announced it raised a $76 million Series B round led by Lightspeed Venture Partners. Yes, more voice agents.
Smart ring maker Oura is now facilitating blood testing for "cardiometabolic biomarkers" though Quest Diagnostics. Users will be able to see the results in the Oura app, along with some context. Wearable maker Whoop announced a very similar offering around Quest lab testing a few weeks ago. Whoop's Advanced Labs offers a few subscription tiers for periodic blood testing, beginning at $199 for one yearly test; Oura will charge $99 per panel. Do we get it? Consumer blood testing is now a race to the bottom.
Omada Health, maker of digital chronic disease management programs, announced a new Meal Map feature "designed to help members make informed food choices." It joins a growing number of services available to provide people with nutrition advice.