An AI incrementalist has his say

Presented by Better Medicare Alliance: The ideas and innovators shaping health care

Dec 20, 2023 View in browser   By Daniel Payne, Erin Schumaker and Ruth Reader Presented by TECH MAZE Robert Havasy. | Courtesy of Robert Havasy Robert Havasy thinks a lot about how AI is used in health care and where policymakers should step in over the coming months and years. As senior director of informatics strategy at the Healthcare Information and Management Systems Society, also known as HIMSS, a nonprofit that helps bring tech to care, he hears from a broad swath of the industry as well as from the government. He recently spoke with Daniel about how he sees AI changing the business. This interview has been edited for length and clarity. Will AI blow up the health care system as we know it? A lot of things are going to be different — if that counts as blowing it up. Different could be better, different could be worse. You have the people who believe firmly that certain doom is around the corner. But then you have people on the other end of the spectrum that say machines can always do everything better and more reliably than humans. I don't know that I can say it’s going to blow things up, but it’s going to change a lot — and health care does not react well to change. Is Washington ready for this? This is one of the few topics where everybody wants to jump immediately. There are a number of bills floating around Congress. Especially since we're coming to an election year, everybody wants to act — but it feels more like governments are trying to react without really having the time to think it through. Do you think governments should be taking small steps, then? I think so. Does that make me an incrementalist? At the very least, a helpful framework has been: Is this going to create an inconvenience — the kind of problem that politicians often like to solve — or is this going to cause catastrophic harm to individuals or to society? And they probably require different levels of intervention and different speeds of intervention. What I’m not sure we’re good at is discriminating between the two. A message from Better Medicare Alliance: We support policy solutions to strengthen Medicare Advantage and improve the beneficiary experience. Our policy priorities include modernizing prior authorization, establishing marketing guidance clarity, and improving provider directories. Learn more about Better Medicare Alliance's recommendations for Medicare Advantage priorities.   WELCOME TO FUTURE PULSE Denver Center for the Performing Arts. | Shawn Zeller/POLITICO This is where we explore the ideas and innovators shaping health care. Greetings, blog readers! Dr. Monica Bertagnolli took the reins of the NIH director's blog this week, where she'll post about discoveries and research at the National Institutes of Health. Share any thoughts, news, tips and feedback with Carmen Paun at cpaun@politico.com, Daniel Payne at dpayne@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 Lauren Gardner talks with POLITICO health care reporter Alice Miranda Ollstein, who reviews significant developments surrounding abortion over the past year and breaks down what to expect in 2024. Listen to today’s Pulse Check podcast   A message from Better Medicare Alliance:   IDEAS LAB Dr. Shreya Shah studies AI-created patient communications at Stanford. | Daniel Payne/POLITICO Stanford Health Care put AI to work in patient communications in a recent pilot that offers clues to how the tech could affect one of its most likely use cases in health care. What happened? In a pilot with more than 200 providers — from doctors to nurses to pharmacists — an AI system generated suggested messages to send to patients. The medical professionals could ignore it, change it or send it, said Dr. Shreya Shah, medical informatics director for primary care and population health at Stanford Health Care. The results: While many clinicians said the software exceeded their expectations, it didn’t affect the amount of time they spent on messages. How often the providers used the tool varied widely. Some never used it. Others ignored the message if they didn’t like it. And others put it to heavy use. What’s next? Shah said that training the AI on more data could fine-tune it so the doctors wouldn’t need to edit the messages as often. A message from Better Medicare Alliance: More and more seniors are choosing Medicare Advantage than ever before, including in rural communities. In 2023, 40% of all eligible Medicare beneficiaries in rural counties were enrolled in an MA plan—nearly four times the share in 2010. As rural Medicare Advantage enrollment grows, the program is making care more affordable for rural communities because Americans in rural areas are more likely to face financial challenges than those in urban areas. Medicare Advantage covers all of the same services as Fee-For-Service (FFS) Medicare, but offers additional cost protections, including an annual cap on out-of-pocket expenses and additional benefits that support beneficiaries' overall health, like dental and vision. Ultimately, beneficiaries save $2,400/year on average compared to FFS Medicare beneficiaries. Read about our proposed solutions for improving and maintaining care for seniors.   WORLD VIEW The EMA, like the FDA, is trying to figure out how to regulate the use of AI in drug development. | Peter Dejong/AP Drug regulators in both the U.S. and Europe are racing to develop new protocols for evaluating advanced AI. Here, the Food and Drug Administration regulates drugs. Across the pond, it’s the European Medicines Agency. The Europeans issued their work plan this week, POLITICO’s team there reports. What’s in it? As with the FDA, the Europeans are still gathering data to inform future decisions. The EMA plans to stand up an “AI Observatory” by the end of the year to monitor the technology and move toward setting principles for responsible use. Staff will upskill through events such as hackathons and master classes. Why it matters: AI is already embedded in the drug development process, and regulators want to keep tabs on the potential risks without harming innovation by setting too many rules.   Follow us on Twitter Carmen Paun @carmenpaun Daniel Payne @_daniel_payne Ruth Reader @RuthReader Erin Schumaker @erinlschumaker   Follow us

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