WellAI Founder Sergei Polevikov

Artificial Intelligence

GenAI Still Working Toward Prime Time With Patients

When it rains it pours for AI research, and a trio of studies published just last week suggest that many new generative AI tools might not be ready for prime time with patients.

The research that grabbed the most headlines came out of UCSD, finding that GenAI-drafted replies to patient messages led to more compassionate responses, but didn’t cut down on overall messaging time.

• Although GenAI reduced the time physicians spent writing replies by 6%, that was more than offset by a 22% increase in read time, while also increasing average reply lengths by 18%.

• Some of the physicians were also put off by the “overly nice” tone of the GenAI message drafts, and recommended that future research look into “how much empathy is too much empathy” from the patient perspective.

Another study in Lancet Digital Health showed that GPT-4 can effectively generate replies to health questions from cancer patients… as well as replies that might kill them.

• Mass General Brigham researchers had six radiation oncologists review GPT-4’s responses to simulated questions from cancer patients for 100 scenarios, finding that 58% of its replies were acceptable to send to patients without any editing, 7% could lead to severe harm, and one was potentially lethal.

• The verdict? Generative AI has the potential to reduce workloads, but it’s still essential to “keep doctors in the loop.”

A team at Mount Sinai took a different path to a similar conclusion, finding that four popular GenAI models have a long way to go until they’re better than humans at matching medical issues to the correct diagnostic codes.

• After having GPT-3.5, GPT-4, Gemini Pro, and Llama2-70b analyze and code 27,000 unique diagnoses, GPT-4 came out on top in terms of exact matches, achieving an uninspiring accuracy of 49.8%.

The Takeaway

While it isn’t exactly earth-shattering news that GenAI still has room to improve, the underlying theme with each of these studies is more that its impact is far from black and white. GenAI is rarely completely right or completely wrong, and although there’s no doubt we’ll get to the point where it’s working its magic without as many tradeoffs, this research confirms that we’re definitely not there yet.

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The Wire

• Augmedix Go Launch: Following a successful pilot at HCA Healthcare, Augmedix announced the general availability of Augmedix Go, which it’s calling the “first fully-automated GenAI-powered medical documentation product for EDs.” Incubating the product at HCA reportedly allowed Augmedix to fine-tune its AI to the unique challenges of clinical documentation in the ED, such as capturing multiple non-sequential interactions with a single patient in a noisy environment.

• Optum Telehealth Shutdown Redux: Out of all the great analyses that came out this week on the demise of Optum’s telehealth business, Sergei Polevikov’s breakdown of why this move could just be the tip of the iceberg was definitely one of the more thought-provoking. The article covers the blocking and tackling of why telehealth vendors are having a tough time, but is also packed with hot takes on everything from cybersecurity to insider trading. The message gets across loud and clear: telehealth emperors have no clothes.

• Nearly All Hospitals Share Web Data: New research in JAMA Network Open shows that nearly all non-federal acute care hospitals – 96% – share website user data with third-parties. Only 71% of those hospitals have a privacy policy in place, and just 56% shared which outside companies have access to user data. For some unfortunately well-timed related reading, TechCrunch broke the news that Kaiser Foundation Health Plan is notifying 13.4 million patients that they were affected by a data breach stemming from information it shared with third party advertisers.

• Midi Series B: Midi Health landed $60M in Series B funding to support women going through menopause by partnering with more payors and hiring 150 new clinicians before the end of the year. Since launching in 2022, Midi has grown a nationwide network of nurse practitioners and physicians that provide interventions spanning lifestyle coaching to prescriptions. Midi also recently made its virtual care clinic available to employers in all 50 states, and notched a major partnership with Memorial Hermann Health System.

• AI Improves Physician-Nurse Collaboration: The use of an AI-powered deterioration model significantly reduced the risk of escalations in care for inpatients at Stanford Health Care, according to a recent study in JAMA Internal Medicine. Overall, deterioration events – ICU transfers, rapid response team incidents, and codes – declined 10.4% among 963 patients who were on the verge of being considered high-risk. The AI model scanned vital signs, EHR, and lab data every 15 minutes to alert medical teams of any red flags.

• Community + Biofourmis: Indiana-Based Community Health Network is deploying Biofourmis’ care-at-home platform to help scale remote services to more patients. Community plans to leverage Biofourmis to minimize the time patients spend in a medical facility by enabling a comparable level of care at home through telehealth and RPM, specifically touting the benefits of patient-reported outcomes in the patient app, clinician app, and bi-directional messaging.

• Wegovy’s Medicare Accessibility: KFF estimates that recent moves from the FDA and CMS to support semaglutide (Novo Nordisk’s Wegovy) for cardiovascular event risk reduction will expand coverage to 3.6M more Medicare beneficiaries (7% of all beneficiaries). Because Medicare doesn’t support weight loss-only medications, this expansion will have a major impact on beneficiaries’ GLP-1 accessibility… and costs. If 10% of that population uses Wegovy for a full year, it would add up to $2.8B in new Medicare Part D spending.

• Hospitals v. Payors: The California Hospital Association filed a lawsuit against Anthem Blue Cross alleging that the payor is taking too long to approve post-acute care for long-term care, physical therapy, and several other services. CHA alleges that discharge delays caused by Anthem Blue Cross are forcing patients to wait longer before changing facilities, causing hospitals to keep providing high-cost care while tying up limited capacity. Although the suit only names Anthem, a recent CHA survey foreshadowed a larger problem after finding that 4,500 California patients are awaiting payor approval to be discharged on a daily basis.

• 20M Disenrolled From Medicaid: Over 20 million Medicaid beneficiaries were disenrolled during the past year after states resumed eligibility checks following a pandemic-era hiatus. That represents a significant 31% of all beneficiaries with a completed redetermination, and KFF reports that nearly a quarter of that group still lacks health coverage. Among all adults who had Medicaid prior to the start of the unwinding, only two-thirds took action to renew it, and 58% of those that tried to re-enroll experienced at least one major problem during the process.

• symplr Teams Up With Branch: symplr is teaming up with Branch to integrate a new same-day payroll solution within the symplr Contingent Talent Management platform for healthcare staffing firms. Features like these are increasingly make-or-break for staffing firms competing for talent in a tight labor market, and symplr helps make them possible by giving its users the ability to combine timecard data with other HR workflows.

• Hello Heart’s Senior Impact: A new JACC study suggests that Hello Heart’s mobile self-management program is particularly effective among older users. Among 8,148 people aged 65+ using the Hello Heart app, 84% reduced systolic BP within 26 weeks (mean drop of 18.1 mmHg), 80% reduced LDL-C by 3.9 months (-76.6 mg/dL), and 70.4% lost weight by three months (-8.8 pounds). The 65+ study participants also had 45% higher app engagement than younger users.

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