OMERS Ventures Principal Investor Christina Farr

Artificial Intelligence

Study: AI is in the Eye of the Beholder

At a time when new healthcare AI solutions are getting unveiled every week, a study in Nature Machine Intelligence found that the way people are introduced to these models can have a major effect on their perceived effectiveness.

Researchers from MIT and ASU had 310 participants interact with a conversational AI mental health companion for 30 minutes before reviewing their experience and determining whether they would recommend it to a friend.

Participants were divided into three groups, which were each given a different priming statement about the AI’s motives:

• No motives: A neutral view of the AI as a tool
• Caring motives: A positive view where the AI cares about the user’s well-being
• Manipulative motives: A negative view where the AI has malicious intentions

The results revealed that priming statements certainly influence user perceptions, and the majority of participants in all three groups reported experiences in line with expectations.

• 88% of the “caring” group and 79% of the “no motive” group believed the AI was empathetic or neutral – despite the fact that they were engaging with identical agents.

• Only 44% of the “manipulative” group agreed with the primer. As the authors put it, “If you tell someone to be suspicious of something, then they might just be more suspicious in general.”

• As might be expected, participants who believed the model was caring also gave it higher effectiveness scores and were more likely to recommend it to a friend. That’s obviously relevant for those developing similar mental health chatbots, but a key insight for presenting any AI agent to new users.

An interesting feedback loop was also found between the priming and the conversation’s tone. People who believed the AI was caring tended to interact with it in a more positive way, making the agent’s responses drift positively over time. The opposite was true for those who believed it was manipulative. 

The Takeaway

The placebo effect is a well documented cornerstone of medical literature, but this might be the first study to bridge the phenomenon from sugar pill to AI chatbot. Although AI is often thought of as primarily an engineering problem, this research does a great job highlighting how human factors and the power of belief play a huge role in the perceived effectiveness of the technology.

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The Wire

• Henry Ford + Ascension + Genesys: Henry Ford Health is combining with Ascension Michigan and Genesys in the latest same-market consolidation blockbuster, creating a joint venture with over $10.5B in revenue across 13 hospitals and 550+ care sites in the Detroit area. The combined entity will take on Henry Ford Health’s branding while making it very clear that this “is neither a merger nor an acquisition,” but a joint venture designed to improve community care and create “expanded career pathways.”

• KFF Benefits Survey: KFF’s 2023 Employer Health Benefits Survey has the answers to most questions about the largest source of health coverage in the country, starting with the fact that the average annual premium rose 7% in 2023 for both single- ($8,3435) and family-coverage ($23,968). Workers shouldered an average of 17% of that cost for single coverage (29% for family), and this chart paints an interesting picture of the growing share of worker salaries that’s getting eaten by healthcare and inflation. 

• Waystar Kicks Off IPO: Where there’s smoke, there’s usually fire, and that was definitely the case with Waystar’s public IPO filing. Waystar was formed in 2017 through the merger of Navicure and ZirMed, and has since acquired eight other companies to help build out its revenue cycle management platform. The inorganic growth has propelled Waystar’s business to over 30k clients and $704M in 2022 revenue, although the flip side of that coin is a $2.3B debt load. However the IPO shakes out, it’ll be an important bellwether for other healthcare companies eyeing a public debut.

• Resetting VC Expectations: Chrissy Farr’s excellent Second Opinion laid out why not every healthcare company needs to be backed by venture capital, and why the industry’s obsession with $1B+ unicorn exits might be preventing it from celebrating more modest outcomes ($100M-$500M). “Many of the most successful healthcare companies stay in their lane and don’t ever become the kind of ‘mega platforms’ that venture investors love. They’re a niche business, but they’re killing it in their niche.”

• Flexibility Key to Physician Retention: Leaving a healthcare practice is a complex choice “with multiple interdependent factors,” according to a JABFM study that looked at why physicians left a large multispecialty practice between 2021 and 2022. The study found that burnout and EHR burden weren’t the primary motivators for physicians leaving, but rather the pursuit of more time off, work flexibility, and better compensation. To reduce turnover, the authors stressed maintaining adequate staffing levels and an appropriate distribution of work across all team members.

• Innovaccer Expands Curana Partnership: Innovaccer is expanding its partnership with Curana Health to scale value-based care to senior living facilities across the country. Curana originally began leveraging Innovaccer last year to create a unified view of patient data and help perform risk stratifications / identify proactive interventions. Through the expanded partnership, the duo will be working to create a new platform purpose-built for senior communities, including automated care pathways, virtual care management with RPM, and several other patient- / provider-facing solutions.

• Amwell DoD Contract: Amwell and defense IT firm Leidos landed a massive $180M contract with the Department of Defense to power the “Digital First” transformation of the Military Health System (MHS). That will involve replacing the MHS’ current telehealth solution for 9.6M service members with Amwell’s Converge platform, as well as a series of automated care programs to guide patients through their treatments. Amwell has been steadily migrating clients to its new Converge platform, and expects to have most of its providers onboarded before year-end.

• Pair Team Secures $9M: Medicaid startups are having a moment, with Pair Team securing a $9M Series A round to support community-based organizations just a week after provider enablement company Waymark also grabbed funding. Pair Team connects Medicaid’s highest-risk patients to its network of safety net organizations (shelters, food pantries, rehab facilities, etc.) and provides staffing support to fill care gaps, with plans to use the recent financing to expand throughout California.

• Telemedicine Effective for OUD: A new analysis of 91k Medicaid patients in 2020 found that “enrollees who initiated buprenorphine treatment via telemedicine had higher odds of retention in treatment but no change in the odds of opioid-related nonfatal overdose.” The findings arrive just as the DEA extended telehealth flexibilities through 2024, and the growing body of evidence supporting prescribing of controlled substances for certain use cases makes it more likely that we’ll see some longer-term changes. 

• FDA 2024 Medtech Priorities: The FDA is ramping up medtech guidance in 2024, adding 21 documents to its A-List of priorities. The upcoming guidance includes topics du jour like AI and cybersecurity, as well as revised direction on pulse oximeters and the “use of real-world evidence to support regulatory decision-making for medical devices.” FDA A-Lists included just 10 documents in 2023 and four in 2022, so next year’s heavy docket and the agency’s new Digital Health Advisory Committee appear to be the start of a true tempo shift.

• First Dog Open-Heart Surgery: The University of Florida’s College of Veterinary Medicine performed the first open-heart surgery on a dog in the US, successfully performing a 7-hour surgical mitral valve repair procedure on George, a 12-year-old miniature poodle. After a week in the ICU and nearly two months of recovery, the good boy is now taking two 45-minute walks a day and is expected to make a full recovery within three months.

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