Direct-to-Consumer Drug Company Pharmacies

“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

Beyond the ‘Matrix’ Theory of the Human Mind

“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

Experiences with information blocking in the United States: a national survey of hospitals

“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

An AI Chatbot May Be Your Next Therapist. Will It Actually Help Your Mental Health?

“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

Your job is (probably) safe from artificial intelligence

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

Essential Electronic Health Record Reforms for This Decade

“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

Washington passes law requiring consent before companies collect health data

“A new Washington state law will require companies to receive a user’s explicit consent before they can collect, share, or sell their health data. Washington Governor Jay Inslee signed the My Health, My Data bill into law on Thursday, giving users the right to withdraw consent at any time and have their data deleted. The law should help shield users’ health data from the companies and organizations not included under the HIPAA Privacy Rule, which prevents certain medical providers from disclosing “individually identifiable” health information without consent. The HIPAA Privacy Rule doesn’t cover many of the health apps and sites that collect medical data, … Read More

Ethics of large language models in medicine and medical research

“Large language models (LLMs) are a type of deep learning model that are trained on vast amounts of text data with the goal of generating new text that closely resembles human responses. The release of ChatGPT (OpenAI, San Francisco, CA, USA), an LLM-based chatbot, on Nov 30, 2022, propelled LLMs to the forefront of public attention and made them accessible to millions of people to experiment with. Since then, medical practitioners and researchers have been exploring potential applications of LLMs, as much of medical practice and research revolve around large text-based tasks, such as presentations, publications, documentation, and reporting. [..] Ethical … Read More

Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Questions Posted to a Public Social Media Forum

“Some patient messages are unsolicited questions seeking medical advice, which also take more skill and time to answer than generic messages (eg, scheduling an appointment, accessing test results). Current approaches to decreasing these message burdens include limiting notifications, billing for responses, or delegating responses to less trained support staff. Unfortunately, these strategies can limit access to high-quality health care. For instance, when patients were told they might be billed for messaging, they sent fewer messages and had shorter back-and-forth exchanges with clinicians. Artificial intelligence (AI) assistants are an unexplored resource for addressing the burden of messages. While some proprietary AI assistants show … Read More

Once bullish on digital health, Orexo hits a wall on reimbursement

Excerpt – Orexo, which made almost all of its $60 million in 2022 revenues from U.S. sales of Zubsolv, a drug used to treat opioid use disorder, earned negligible income from its three software-based treatments in the first quarter of the year. On the company’s earnings call, CEO Nikolaj Sørensen attributed this to the company’s ongoing difficulty securing reimbursement for digital therapeutics. [..] Orexo’s new, careful approach is a stark contrast to the bullish tone the company took when it first dove into digital therapeutics in 2019 and 2020. At the time, Orexo was sitting on millions in Zubsolv profits … Read More