For effective AI, keep it simple

The ideas and innovators shaping health care

Mar 28, 2023 View in browser   By Ben Leonard, Erin Schumaker and Ruth Reader INNOVATORS Simple algorithms were found to be nearly as good as the more complex ones at predicting suicidal risk. | Getty Images Simple algorithms aimed at reducing suicide risk work comparably to more complex ones, researchers from Kaiser Permanente, the FDA and other institutions found. The researchers examined data from nearly 26 million mental health visits made by more than 3 million people in seven health systems. They put the data through both more simple and more complex algorithms, incorporating varying numbers of “predictors,” such as demographic information, diagnoses, patient questionnaire responses and prescriptions. Bigger, not better: They found that simple algorithms were nearly as good as the more complex ones at predicting suicidal risk. The findings should help providers looking at using AI to improve mental health care as the sector undergoes a digital transformation. Artificial intelligence has received significant investment and figures to play an important role in the industry’s future. “In addition to transparency, trust, and explainability, transportability and technical ease of use can be practical barriers to implementing risk models in clinical care,” the researchers wrote. “As the number of predictors increases, so does the amount of information a health system must routinely access to employ a risk model in clinical care.” The bottom line: It’s easier to implement simpler models because it’s easier to write the algorithm, and simpler models require less computer memory and are less likely to bog down digital systems. WELCOME TO FUTURE PULSE Chappaquiddick, Mass/ Erin Schumaker This is where we explore the ideas and innovators shaping health care. Did you develop a devotion to hand sanitizer during the pandemic? It turns out, there is no added benefit to hand sanitizers and there might even be downsides. Alcohol-based sanitizers don’t only get rid of germs, they strip your hands of good microbes, leaving you prone to infection. You may want to stick to good-old handwashing going forward. Share any thoughts, news, tips and feedback with Ben Leonard at bleonard@politico.com, Ruth Reader at rreader@politico.com, Carmen Paun at cpaun@politico.com or Erin Schumaker at eschumaker@politico.com. Send tips securely through SecureDrop, Signal, Telegram or WhatsApp. Today on our Pulse Check podcast, host Megan Messerly talks with POLITICO’s Natalie Fertig, who recently sat down with Dr. Wilson Compton, the deputy director of the National Institute on Drug Abuse, to chat about the known health effects of cannabis and how scientists' limited access to cannabis products sold in state-legal dispensaries is thwarting effective research. Listen to today’s Pulse Check podcast   JOIN POLITICO ON 4/5 FOR THE 2023 RECAST POWER LIST: America’s demographics and power dynamics are changing — and POLITICO is recasting how it covers the intersection of race, identity, politics and policy. Join us for a conversation on the themes of the 2023 Recast Power List that will examine America’s decision-making tables, who gets to sit at them, and the challenges that still need to be addressed. REGISTER HERE.     FOLLOW THE MONEY Ophthalmology is one of the key investment areas for private equity. | AP A recent report indicates that private equity’s ongoing foray into health care is driving overlapping trends: consolidation and increased for-profit health care ownership. Public Citizen, a nonprofit consumer rights group, laid out private equity’s health care playbook in the report, highlighting key investment areas: — Medical specialties like anesthesiology, dentistry, ophthalmology, reproductive health care, gastroenterology and dermatology. Fast facts: A study published this year in the journal Health Affairs found that workforce turnover is likely higher at private equity-backed specialty practices than at similar practices owned by doctors. — Late-life and end-of-life care, such as home health care and nursing homes. Fast facts:Private equity hospice ownership rose from 3.4 percent of hospices in 2011 to 7.3 percent in 2019. Almost half of home health care deals in 2018 and 2019 involved private equity. — Billing and IT: Firms like Blackstone, Vista Equity Partners and Waud Capital Partners are invested in revenue cycle management (think billing, collections, data analytics). Fast facts: Companies are often paid a percentage of the debt they collect, which may encourage using aggressive tactics to obtain patient payments, according to the Private Equity Stakeholder Project, a nonprofit watchdog. — Behavioral and mental health services, including addiction and opioid treatment. Fact facts: Looser telehealth rules and increased demand for mental health services during the pandemic led to a spike in behavioral-health acquisitions. In 2021, most of those acquisitions involved private equity,according to The Wall Street Journal. Why it matters: Private equity-involved health care investments in 2022 reached the second-highest level on record, after 2021, according to the Private Equity Stakeholder Project. While the Federal Trade Commission monitors health care companies to keep the industry competitive, private equity deals are harder for regulators to track. Groups like Public Citizen call for more oversight. “Thanks to a lack of transparency, we don’t know everything about private equities’ incursion into health care,” Eagan Kemp, report author and health care policy advocate at Public Citizen, said in a statement. “But what we do know is shocking.”   LISTEN TO POLITICO'S ENERGY PODCAST: Check out our daily five-minute brief on the latest energy and environmental politics and policy news. Don't miss out on the must-know stories, candid insights, and analysis from POLITICO's energy team. Listen today.     WORKFORCE Half of patient-facing health workers’ time is spent with patients, while about a third is spent on administrative tasks, a survey by provider workflow company Holon found. | Getty Images The health care workforce has weathered a pandemic, but the stress on workers isn’t letting up. Even as Covid-19 has become less disruptive, more than half of the close to 700 health care workers surveyed by provider workflow company Holon said their jobs have become harder in the past year. Close to a fifth of respondents said they’d left their jobs in the prior year, with more than half citing dissatisfaction with management and nearly half pointing to a shortage of people to get the job done. What’s stressful? Half of patient-facing workers’ time is spent with patients, while about a third is spent on administrative tasks, the survey found. Nearly half of the health care workers said that administrative work has generally caused them the most stress in the past year. The bigger picture: The findings come as lawmakers on both sides of the aisle in Congress have prioritized workforce legislation. Sens. Bernie Sanders (I-Vt.), chair of the Health, Education, Labor and Pensions Committee, and Bill Cassidy (R-La.), the panel’s top Republican, have sought feedback on solutions for the health care workforce shortage with the goal of finding legislative remedies.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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