AI has yet to revolutionize health care – POLITICO

By BEN LEONARD and RUTH READER

08/17/2022 10:00 AM EDT

Updated 08/17/2022 03:43 PM EDT

Investors have honed in on artificial intelligence as the next big thing in health care, with billions flowing into AI-enabled digital health startups in recent years.

But the technology has yet to transform medicine in the way many predicted, Ben and Ruth report.

Companies come in promising the world and often dont deliver, Bob Wachter, head of the department of medicine at the University of California, San Francisco, told Future Pulse. When I look for examples of true AI and machine learning thats really making a difference, theyre pretty few and far between. Its pretty underwhelming.

Administrators say that algorithms from third-party firms often dont work seamlessly because every health system has its own tech system, so hospitals are developing their own in-house AI. But its moving slowly research on job postings shows health care lagging every industry but construction.

The FDA is working on a model to regulate AI, but its still nascent.

Theres an inherent mismatch between the pace of software development and government regulation of medical devices, said Kristin Zielinski Duggan, a partner at Hogan Lovells.

Questions remain about how regulators can rein in AIs shortcomings, including bias that threatens to exacerbate health inequities. For example, a 2019 study found a common algorithm in hospitals more frequently directed white patients to programs providing more personalized care than Black patients.

And when providers build their own AI systems, they typically arent vetted the way commercial software is, potentially allowing flaws to go unfixed for longer than they would otherwise. Furthermore, with data often siloed between health systems, a lack of quality data to power algorithms is another barrier.

But AI has shown promise in a number of medical specialties, particularly radiology. NYU Langone Health has worked with Facebooks AI Research group (FAIR) to develop AI that allows an MRI to take 15 minutes instead of an hour.

Weve taken 80 percent of the human effort out of it, said John D. Halamka, president of Mayo Clinic Platform, which has an algorithm in a clinical trial that seeks to reduce the lengthy process of mapping out a surgery plan for removing complex tumors.

And in another success story, Louisianas Ochsner Health developed AI that detects early signs of sepsis, a life-threatening infection.

Micky Tripathi, HHS national coordinator of health information technology, says AI could resemble sports broadcast systems that spit out a teams chance of winning at any given point in the game. In health care, an electronic health records system could give doctors a patients risk profile and the steps they might need to take.

This will be deemed as one of the most important if not the most important transformative phases of medicine, said Eric Topol, founder of the Scripps Research Translational Institute. A lot of heavy lifting is left to be done.

Welcome back to Future Pulse, where we explore the convergence of health care and technology. Tiny blood draws from infants, used to screen for disease, are now also being used in criminal investigations to indict their parents! What a world.

Share your news, tips and feedback with Ben at [emailprotected] or Ruth at [emailprotected] and follow us on Twitter for the latest @_BenLeonard_ and @RuthReader. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp here.

ABORTION RULING FALLOUT More Democrats are backing companion legislation by Rep. Sara Jacobs (D-Calif.) and Sen. Mazie Hirono (D-Hawaii) that would make it harder for online firms to share personal data.

Jacobs is touting her bill, the My Body My Data Act, in response to Nebraska polices seizure of Facebook messages between a woman and her daughter that allegedly revealed a plan to induce an illegal abortion outside the states 20-week limit.

The similar bills from Jacobs and Hirono would limit the data that firms can collect, protect personal health information not currently covered by the health privacy law HIPAA and give the FTC power to enforce the act alongside a private right of action.

Ninety-three representatives have signed on, along with 13 senators. Without GOP support, the bill cannot pass the Senate, but Jacobs encourages state lawmakers to follow her lead in their capitals.

BIDEN SIGNS HEALTH CARE, CLIMATE BILL President Joe Biden signed legislation Tuesday that will allow Medicare to negotiate drug prices in an attempt to cut costs.

Beginning in 2026, the legislation enables Medicare to negotiate with manufacturers on 10 pricey drugs, expanding as the decade goes on. Cancer, HIV and diabetes drug costs could be considered during negotiations, according to SVB Securities.

Bidens signature caps the largest victory for Democrats since taking control of both chambers of Congress and the White House in January 2021, POLITICOs Sarah Ferris and Jordain Carney report.

Beginning in 2026, the legislation enables Medicare to negotiate with manufacturers on 10 pricey drugs, expanding as the decade goes on. | Drew Angerer/Getty Images

The drug negotiation portions came despite fierce opposition from the pharmaceutical industry, which argued the legislation would curb innovation.

Something to watch: Steve Ubl, the president of PhRMA, the drug industry lobbying group, said that members supporting the bill wont get a free pass and that one of PhRMAs member companies would nix 15 drugs if the bill became law.

BRUTAL CYBERSECURITY NUMBERS Close to 6 in 10 hospital and health system leaders said their organizations had at least one cyberattack in the past two years, according to new data from the cybersecurity company Cynerio and the cybersecurity research center Ponemon Institute.

The report also notes that the attacks which cost an average of nearly $10 million often recur: Among the victims, 82 percent had been hit by four or more attacks during the timeframe.

And the damage isnt just financial about 1 in 4 cyberattacks resulted in increased mortality by leading to delayed care, according to the report.

UNITEDHEALTHCARE TELEHEALTH SURGE The nations largest health insurer has seen patients gravitate toward telemedicine in a plan called Surest, which gives enrollees prices upfront.

Presented with the costs, enrollees choose telemedicine visits 10 times more often than people in typical plans and go to the emergency room or undergo surgery less frequently.

When a consumer goes out there and looks for [care] ..., were able to say, Hey, did you know that virtual visit offering is a zero co-pay? Alison Richards, CEO of Surest, told Future Pulse. Thats where were seeing that increase in virtual care.

Many other major insurers offer virtual-first plans that push patients toward telemedicine before in-person care.

RACIAL DISPARITIES IN HOSPITAL PROFITS Revenue and profit per patient are lower at hospitals serving the highest percentage of Black Medicare patients.

U.S. hospital financing effectively assigns a lower dollar value to the care of Black patients, a study published in the Journal of General Internal Medicine found.

Researchers from UCLA, Johns Hopkins and Harvard Medical School examined profits at 574 hospitals serving high rates of Black patients. Profits were on average $111 lower per patient day at the hospitals, and revenues were $283 lower.

Equalizing reimbursement levels would have required $14 billion in additional payments to Black-serving hospitals in 2018, a mean of approximately $26 million per Black-serving hospital, the researchers found. Health financing reforms should eliminate the underpayment of hospitals serving a large share of Black patients.

TELEREHABILITATION CAN IMPROVE BACK PAIN Good news for the quarter of Americans who suffer from acute lower back pain: It can be treated remotely.

A recent study found that a 12-week telehealth program from a New York company called Sword Health significantly reduced pain, depression, anxiety and productivity among those who completed it.

The program, overseen by a physical therapist, involves a combination of exercise, education and psychotherapy.

Of the roughly 338 people who completed the study, more than half reported a significant reduction in their disability and 61 percent experienced decreased pain.

The rub is that there is no rub: The program doesnt work for everyone. Some patients with acute lower back pain need more hands-on help, like massage or spinal manipulation, and digital rehab cant do that.

OTC HEARING AIDS GET FDA NOD The FDA has created regulatory guidance for hearing aids that manufacturers can sell over the counter, reports POLITICOs David Lim. Until now, patients have needed a prescription.

The change could bring new competition to the hearing aid market. On average, one prescription hearing aid costs approximately $2,300, though some run as much as $6,000, according to Consumer Affairs.

The rule will go into effect in 60 days. Manufacturers that want to sell existing products over the counter will have 240 days to comply with technical requirements and rules that aim to ensure the OTC hearing aids are easy to use without a doctors help.

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CORRECTION: An earlier version of Future Pulse misstated where Sword Health is based. The company is based in New York.

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AI has yet to revolutionize health care - POLITICO