AI’s arrived in rural health

The ideas and innovators shaping health care

Dec 11, 2023 View in browser   By Daniel Payne, Ruth Reader, Carmen Paun, Erin Schumaker and Evan Peng INNOVATORS Bill Gassen. | Courtesy of Sanford Health Bill Gassen, president and CEO of Sanford Health, a South Dakota-based health system with hundreds of locations across the upper Midwest, isn’t waiting for the future of artificial intelligence. His health system is bringing the tech to every corner of its operations. That could mean significant changes for health providers of all sorts — not only in their clinical work but also in how they conduct business. Gassen talked to Daniel about how the system is using AI. This interview has been edited for length and clarity. How are you using AI now? First in clinical support and then for business improvement in the back office. If you look at the first one, we’ve got a team that’s developed algorithms that are helping us do a better job of predictive analytics for our patients so we can intervene earlier. On the back-office side, they’ve developed algorithms that help us do everything from nurse staffing to helping us schedule our infusion chairs. There has been some reporting about AI turning billing processes upside down — are you using it in that area? Those are opportunities for us to drive down costs that aren’t delivering a direct benefit to patients. If I’ve got a dollar, do I want to invest that in clinical advancement? Do I want to invest that in research? Do I want to invest in continuing to advance the workforce, to bring in more physicians and more nurses and more technicians? Or do I want to have to invest that in back-office support? If I can drive down some of those costs, it does free up more opportunity to invest. You’re also interested in what Congress does about pandemic-era telehealth policies, which are set to expire next year, right? Simply stated: We need those to be permanent. Everybody believes and knows that leveraging technology in a different way is a critical part of the pathway forward — I believe it’s probably our single most powerful weapon to allow us to address the issues of access and equity and to make sure that we’re doing better for all those patients. If those waivers go away, there’s not a sustainable business model around it. WELCOME TO FUTURE PULSE St. John, U.S. Virgin Islands. | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Here’s one job we didn’t expect AI to threaten: sommelier. But an artificial intelligence algorithm identified which estates 80 Bordeaux red wines came from with 100 percent accuracy, Science reports. It was so good it could distinguish wines made on one side of France’s Garonne River from those made on the other. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@politico.com, Evan Peng at epeng@politico.com, Ruth Reader at rreader@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 Kelly Hooper talks with Carmen, who explains why abortion has Congress deadlocked over the reauthorization of the President's Emergency Plan for AIDS Relief, or PEPFAR, a program credited with saving 25 million lives. Listen to today’s Pulse Check podcast WORKFORCE Doctors say patients do better when doctors are in charge, a new survey found. | John Moore/Getty Images | Getty Most physicians think patient care deteriorates when insurance companies, hospitals, private equity firms or staffing agencies take over doctor-owned medical practices, according to a new survey. NORC, based at the University of Chicago, polled 1,000 doctors who work at practices with non-physician owners and found nearly 60 percent thought it affected care quality either significantly or somewhat for the worse. The survey was commissioned by the Physicians Advocacy Institute. The top reason they believe care worsened: It reduced their autonomy to make decisions about patient care. Those who believed the change was bad for patients also noted an increased administrative burden, financial incentives playing a larger role in operations and less time to talk with the people they treat. Even so: Most — 63 percent — reported having high levels of independence. And, nearly 1 in 4 doctors didn’t see any effect on patient care under new ownership, while about 1 in 5 thought the ownership change benefited patients. Those who saw improvements cited technology and infrastructure updates and increased attention to patient outcomes. FOLLOW THE MONEY Pharma investment is down, but some areas remain strong. | Gerard Julien/AFP via Getty Images After a pandemic-era spending spree, investors are rethinking whether to sink money into biopharmaceuticals, according to a new report from industry analyst Pitchbook. The report estimates 84 deals worth $17.9 billion will be made in 2023 and said venture capitalists are making fewer deals with bigger price tags. The report outlines a few areas of interest: — Molecules discovered with artificial intelligence — Gene therapies like CRISPR — mRNA technology — Cell therapies like CAR-T — Emerging treatments that use nanotechnology for precision medicine and bacteriotherapy — Weight-loss drugs Even so: The report warns some of these investments could be overhyped: — Artificial intelligence-enhanced drug discovery has yet to prove that it’s better than traditional methods. — Gene therapy is highly regulated, and insurers won’t necessarily reimburse it. — Cell therapies are complicated to manufacture and can come with severe side effects. Emerging treatments, by virtue of their newness, will face unknown regulatory hurdles and technical challenges. The takeaway: Despite an overall decline in the amount of money going into biopharmaceuticals, investors are still finding areas of promise.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker Evan Peng @thepngfile   Follow us

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