AI’s fearsome potential spurs new rules

The ideas and innovators shaping health care

Apr 12, 2023 View in browser   By Ben Leonard, Erin Schumaker and Ruth Reader TECH MAZE HHS' Micky Tripathi wants to keep AI in health care on the up and up. | Office of the National Coordinator for Health IT Artificial intelligence has great potential for improving health care, but people should have “tremendous fear” about possible problems that could arise when software makes critical decisions, Micky Tripathi, the national coordinator for health information technology, has said. Tripathi’s office at the Department of Health and Human Services is trying to head off those problems. On Tuesday, the agency announced a new proposal that aims to open up AI code to scrutiny. If the agency finalizes the proposal, technology developers who want HHS certification — required by many government and nongovernment health care programs — must open up those algorithms to show customers what’s in them. HHS also wants feedback on whether the agency should require broader disclosure to patients and the public. And the proposed rule would require the technology developers to adopt and document risk-management practices and offer real-world testing plans. Why it matters: Health care providers use AI to assist with diagnoses and treatment decisions, but AI hasn’t yet transformed care amid bureaucratic hurdles and a lack of trust in the technology. That distrust is partly driven by known problems with bias, the result of algorithms influenced by historical inequities in care among different racial groups, insufficient testing and flawed design decisions. HHS warns in the proposed rule that bias in models could exacerbate health disparities and artificial intelligence could be used improperly or inappropriately. HHS said that more transparency will improve the chances that the technology evolves in the most effective ways. What’s next: The proposed rule will open for 60 days of public comment starting April 18. Tripathi emphasized in a press briefing that the regulations don’t aim to evaluate algorithms’ quality or effectiveness, but he didn’t close the door to that possibility in the future, saying his office would seek input from other agencies if it were to pursue such rules.   STEP INSIDE THE WEST WING: What's really happening in West Wing offices? Find out who's up, who's down, and who really has the president’s ear in our West Wing Playbook newsletter, the insider's guide to the Biden White House and Cabinet. For buzzy nuggets and details that you won't find anywhere else, subscribe today.     WELCOME TO FUTURE PULSE Lady Bird Johnson Park, Washington, D.C. | Ben Leonard This is where we explore the ideas and innovators shaping health care. Double take: A million smokers across England are eligible for a free vape kit from a surprising source — the Department of Health and Social Care. It's part of England's new "swap to stop" program, in which the government will offer 1 in 5 smokers vape starter kits in conjunction with behavioral support to help them quit smoking. The goal is reducing England's smoking rate to 5 percent or less by 2030 by helping adults quit and by keeping children and non-smokers from starting. 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 Daniel Payne about his report on lawmakers' proposals to ease the clinician shortage by expanding the roles of health care workers, allowing them to care for more patients than they currently do — even though some doctors say the proposed changes would put patient safety at risk. Listen to today’s Pulse Check podcast THE NEXT CURES Deer blood seems to be a cure-all for Lyme disease, a finding driving new research. | Getty Images Deer blood kills the bacterium responsible for Lyme disease, a promising finding that could one day help treat the disease in humans. Researchers at the University of Massachusetts Amherst knew that deer are hosts for Lyme-carrying ticks but don’t carry Lyme disease themselves. They also noticed something intriguing: The disease-carrying ticks that fed on deer were cleared of Lyme. Inside the lab: The researchers filled test tubes with the Lyme-causing bacterium and added serum from the blood of white-tailed deer. It killed the bacterium. The finding opens up a new area of focus for the team, Stephen Rich, a professor of microbiology and an author of the study in Vector-Borne and Zoonotic Diseases, told Erin: “Can we co-opt that into a future tool to prevent people and pets from getting Lyme?" Lyme disease parasites can neutralize human, dog and mouse — but not deer — immune systems. If Rich and his team can pinpoint the mechanism in the deer immune system that controls Lyme disease susceptibility, they’ll try to match it to an existing drug to induce a similar protective response in humans. Why it matters: Lyme disease is the most common insect-borne disease in the U.S., with 476,000 people diagnosed each year, according to the Centers for Disease Control and Prevention. Symptoms include skin rash, fever, headache and fatigue. The CDC says an infection, if left untreated, can spread to the joints, heart and nervous system. What’s next: Rich’s research is housed at the New England Center of Excellence in Vector-Borne Diseases, which last year received a $10 million grant from the CDC for its project, Is Tick Control Helping. The project brings together New England-based university research teams and state and local health departments to study backyard practices for keeping disease-carrying ticks and mosquitos at bay. The Phase 1 Project ITCH study, which is open to participants, kicks off this spring.   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.     CHECKUP Doctors were happy with virtual visits during the pandemic, but are now ready to meet you in person. | AP Photo/Alan Diaz Patients and doctors alike thought that telemedicine visits during the pandemic went smoothly, but a much smaller segment of both groups wants to continue care mainly in the virtual realm. A new study published in Health Affairs by researchers at Harvard University, the CDC and the Association of State and Territorial Health Officials, among others, found that 90 percent of both patients and doctors said video visits went “very” or “somewhat” well. But the researchers also found that: — 80 percent of doctors preferred “all or most” visits to be in-person going forward versus 19 percent “all or most” via telemedicine. — 36 percent of patients wanted “all or most” care to be delivered virtually in the future. — Doctors were more concerned than patients about the quality of virtual care. The findings add to previous research showing that while the expansion of telemedicine access has proven popular, most people see its utility as limited so far. A recent survey from Rock Health and Stanford University’s Center for Digital Health, for example, found that most patients prefer to get prescription refills and care for minor issues via telemedicine, but most also want to go to their doctors’ offices for annual physicals, treatment for chronic conditions and emergency care. Still, substantial minorities preferred telemedicine in those cases — more than a third for chronic care, for example.   Follow us on Twitter Ben Leonard @_BenLeonard_ Ruth Reader @RuthReader Carmen Paun @carmenpaun Erin Schumaker @erinlschumaker   Follow us

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