“Despite the convenience and value of telehealth, many states have rolled back COVID-19 pandemic–era flexibilities and reimposed strict licensure requirements for telemedicine. Thus, as it was prepandemic, so it is again that a physician, duly licensed in their home state, is prohibited from consulting or following up with an out-of-state patient via video or phone unless they are also licensed in the patient’s state. Penalties for doing so without that license can amount to tens of thousands of dollars in fines and potential imprisonment. Despite growing pressure to respond to patient preferences and widespread evidence of the benefits of interstate … Read More
All posts in Health Information Technology
“As artificial intelligence (AI) tools become more consistently used in health care, federal agencies, health care facilities, medical societies, and other stakeholders are grappling with how to ensure they do not introduce unintended patient harm. [..] Regardless of approach, a well-designed one could improve safety, promote patient and health care professional confidence in AI use, and incentivize developers and users to focus on these important issues. Developing a testing and certification approach that is effective, rigorous, and rapid and that is a shared responsibility of both developers and users is necessary to meet the needs of multiple stakeholders. The Office … Read More
“The idea of medical transparency undergirding provisions in the 2016 Cures Act is broadly supported. But implementation of the regulations expanding access to medical records, which took effect in 2021, has been more divisive. Congress has taken little interest in this issue, and federal health officials have stood by the rules, arguing that concerns will be resolved as technology improves and as medical practices adjust how they prepare patients for results. “There is just a moral imperative here, which is for patients, this is their information. They ought to be able to access it whenever they want,” said Micky Tripathi, … Read More
Excerpt – For a growing number of doctors, A.I. chatbots — which can draft letters to insurers in seconds — are opening up a new front in the battle to approve costly claims, accomplishing in minutes what years of advocacy and attempts at health care reform have not. [..] Doctors are turning to the technology even as some of the country’s largest insurance companies face class-action lawsuits alleging that they used their own technology to swiftly deny large batches of claims and cut off seriously ill patients from rehabilitation treatment. Some experts fear that the prior-authorization process will soon devolve … Read More
“In January 2024, the pharmaceutical company Eli Lilly launched LillyDirect, a service that includes a direct-to-consumer pharmacy and a referral network of in-person and telehealth clinicians. These tools are intended to add new options for patients to access the company’s drugs, including its newly approved antiobesity drug tirzepatide (Zepbound). [..] LillyDirect is similar to several pharmacies that cut out insurers and PBMs [pharmacy benefit managers] and allow patients to purchase drugs at discounted cash prices. These include pharmacies introduced by major retail companies like Walmart, Costco, and Amazon, and independent pharmacies like the one named for its billionaire cofounder Mark … Read More
“Already, we are being told that A.I. is making coders and customer service representatives and writers more productive. At least one chief executive plans to add ChatGPT use in employee performance evaluations. But I’m skeptical of this early hype. It is measuring A.I.’s potential benefits without considering its likely costs — the same mistake we made with the internet. I worry we’re headed in the wrong direction in at least three ways. One is that these systems will do more to distract and entertain than to focus. Right now, the large language models tend to hallucinate information: Ask them to … Read More
“Data and Methods Data We used data from the American Hospital Association (AHA) IT [information technology] Supplement Survey fielded between April and September 2021, an annual survey of hospitals on their IT capabilities and experiences. The AHA IT supplement is sent to Chief Information Officers and completed by those individuals or their delegates. [..] We combined this data with information on hospital characteristics from the 2020 AHA Annual Survey, the most recent year available. [..] Perceived information blocking [..] For health IT developers, hospitals were asked if they had experienced information blocking via price; contractual language; artificial technical, process or resource … Read More
“At the South by Southwest conference in March, where health startups displayed their products, there was a near-religious conviction that AI could rebuild health care, offering apps and machines that could diagnose and treat all kinds of illnesses, replacing doctors and nurses. Unfortunately, in the mental health space, evidence of effectiveness is lacking. Few of the many apps on the market have independent outcomes research showing they help; most haven’t been scrutinized at all by the FDA. Though marketed to treat conditions such as anxiety, attention-deficit/hyperactivity disorder, and depression, or to predict suicidal tendencies, many warn users (in small print) that they … Read More
Why predictions of an imminent economic revolution are overstated Excerpt – [..] in the 1960s Robert Fogel published work about America’s railways that would later win him a Nobel Prize in economics. Many thought that rail transformed America’s prospects, turning an agricultural society into an industrial powerhouse. In fact, it had a very modest impact, Fogel found, because it replaced technology—such as canals—that would have done just about as good a job. The level of per-person income that America achieved by January 1st 1890 would have been reached by March 31st 1890 if railways had never been invented. Of course, … Read More
“the American Medical Informatics Association, with seed funding from the National Library of Medicine, formed a group under the moniker of 25 × 5 to reduce clinician documentation burden by three-quarters during the next 5 years. A workshop in 2022 allied with the 25 × 5 initiative identified 6 major EHR issues: Based on those discussions and our professional observations, 4 issues emerged as most salient and 3 as most actionable. The continued lack of nationally used unique personal safety identifiers for health as originally mandated in the HIPAA (Health Insurance Portability and Accountability Act) in the mid-1990s presents a continuing threat to privacy, … Read More