“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
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“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
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
“Chatbots like ChatGPT are used by hundreds of millions of people for an increasingly wide array of tasks, including email services, online tutors and search engines. And they could change the way people interact with information. But there is no way of ensuring that these systems produce information that is accurate. The technology, called generative A.I., relies on a complex algorithm that analyzes the way humans put words together on the internet. It does not decide what is true and what is not. That uncertainty has raised concerns about the reliability of this new kind of artificial intelligence and calls … Read More
“In recent months, executives have touted Teladoc as a source for “whole-person care” — a bid to distinguish it from smaller virtual companies addressing only one condition, or those who largely make money by facilitating prescriptions. The company offers primary care, urgent care, and virtual appointments, coaching, and disease management for chronic diseases such as diabetes and for mental health conditions. About a third of patients in Teladoc’s chronic care programs are using more than one — and that number has grown year-over-year and sequentially, executives said during a Wednesday earning call. Earlier this year, Teladoc unrolled its integrated care … Read More
“the new coaching service — codenamed Quartz — sounds like an expansion of the Apple Watch play from physical health to mental health, Bloomberg reported. It is “designed to keep users motivated to exercise, improve eating habits and help them sleep better” using “AI and data from an Apple Watch to make suggestions and create coaching programs tailored to specific users.” [..] About five years ago, I wrote about the various ways that the Apple Watch failed as a behavioral intervention. There’s some behavioral science, but also — because I was using it — I discovered that the constant nudging for achievement made me miserable. … Read More
Excerpt – The challenges uncovered by the project [reviews of AI compiled by researchers at Duke] point to a dawning realization about AI’s use in health care: building the algorithm is the easiest part of the work. The real difficulty lies in figuring out how to incorporate the technology into the daily routines of doctors and nurses, and the complicated care-delivery and technical systems that surround them. AI must be finely tuned to those environments and evaluated within them, so that its benefits and costs can be clearly understood and compared. As it stands, health systems are not set up … Read More
“ONC seeks to implement provisions of the 21st Century Cures Act and make updates to the ONC Health IT Certification Program (Certification Program) with new and updated standards, certification criteria, andimplementation specifications in 45 CFR Part 170. The proposed rule also includes multiple requests forinformation (RFI) to inform potential future rulemaking. RFI topic areas include electronic prior authorization, lab interoperability, predictive decision support interventions, and advanced Fast Healthcare Interoperability Resource (FHIR®) capabilities, among others across parts 170 and 171. We look forward to receiving public comment on these proposals and direct interested parties to the following link in order to … Read More
“While I’m often a patient who hates the experience of talking to my doctor through a laptop, I’m also a researcher who has devoted a large part of his career to better understanding what happens when new technologies are added to clinical spaces. From this perspective, I see three major challenges that have to be overcome before large language models can really serve as clinical scribes. The truth challenge. [..] There are two major chokepoints where hands-free AI could lead to inaccurate medical records. The first is in the speech-to-text technology. When the university where I teach pivoted online for … Read More
“Online prescribing rules for controlled drugs were relaxed three years ago under emergency waivers to ensure critical medications remained available during the COVID-19 pandemic. Now, the U.S. Drug Enforcement Agency has proposed a rule that would reinstate most previously longstanding requirements that doctors see patients in person before prescribing narcotic drugs such as Oxycontin, amphetamines such as Adderall, and a host of other potentially dangerous drugs. The aim is to reduce improper prescribing of these drugs by telehealth companies that boomed during the pandemic. Given the ongoing opioid epidemic, allowing continued broad use of telemedicine prescribing “would pose too great … Read More