Consulo Indicium - 6/12/23
Information for your Consideration…
A Rising Tide Lifts All AI/ML Boats – Sam Altman was recently interviewed on The New Yorker Radio Hour related to his efforts at ChatGPT to deploy a new language model AI/ML system, and Yoshua Bengio, an early pioneer of AI/ML by David Remnick. They discussed the growing concerns surrounding the potential unfettered use of nonhuman intelligence and its impact on society. The interview is a follow-up to a piece I wrote last month on the use of AI/ML in medicine and its growing impact on how, where, who and why we will deliver care in the future. And, if you really want to go DEEP into an assessment by Altman, check out this segment which lasts 2 hours and 23 minutes. You’ll have a headache at the end of it – if you listen carefully…
More On AI/ML – In the last edition of the FickFiles, I had a long piece on the evolving presence of AI/ML in our lives and, especially, the impact on health care. Now, come the warnings of Geoffry Hinton who recently discussed the impact of AI/ML on radiology and observed that “we have enough trained radiologists” and that they will be replaced as a specialty by AI/ML programs within the next five year…”ten years at the outside”. It’s a prediction he made at a hospital presentation where it “…did not go down so well.”
Layoffs Are up, Up, UP! – A new report was just released by Challenger, Gray & Christmas, a leadership support and workforce analysis firm, revealing that job cuts or layoffs of workers across all USA markets were up 287% since May 2022. In particular, it was noted that the healthcare community is not immune with over 33,000 layoffs in the industry from January through the present period. That’s up from just over 18,000 cuts for a similar period in 2022 or, an 81% increase. It appears that most of the worker layoffs are in the support industries surrounding healthcare (e.g. pharmaceutical, supplies, etc.) rather than in front line workers although declines were noted there. These are areas that tend to follow other mainstream business areas such as automotive, technology and the like. Regardless, the reductions in health care staffing come in the midst of a major worker shortage across the board on the care delivery side.
Solving The Workforce Shortage – Hippocratic AI recently announced the launch of a $50 million seed fund to further develop their nascent “…artificial Health General Intelligence (HGI)” service. The goal is to fill the healthcare workforce shortage gap and lower costs of care delivery through the effective use of an adjunct service. Their perspective is that by integrating these tools with the existing practices of all types of care delivery personnel, costs will be lowered, and staffing problems will ease. To date, the model has passed 114 different certification exams including nursing, pharmacy, dentistry, and several medical specialties. It’s an interesting approach and fits with my argument that we need to be pursuing AI/ML that provides “clinically augmented intelligence” for clinicians in practice.
Speaking Of Workforce Shortages – In the April 2023 issue of Health Affairs, researchers Kreider and Werner report on home care workforce shortages which are hampering the ability to delivery in-home and community-based care services. They used data from the American Community Survey and the Henry J. Kaiser Family Foundation to review workforce trends and Medicaid care delivery. Their study revealed an 11.6% decline in staffing for Medicaid home and community-based services (HCBS) for 2013 to 2019 with further declines suggested for 2020. The issue speaks to the need for a comprehensive workforce strategy rather than a type-by-provider type approach.
More On The Technology Front – Scientists from BioNTech who were the first to make a new mRNA vaccine against Covid recently announced that have created vaccines for 16 pancreatic cancer patients. The basic notion is to use the mRNA to create specialized T cells that specifically target genomic properties of the individual’s personal pancreatic tumor cells. Not only is the vaccine customized to the individual, the production of the vaccine can occur rather quickly allowing for much more rapid turnaround in the treatment of the cancer. Not only is this a game changer for pancreatic cancer – it is more likely a game changer for virtually all types of cancer. Stay tuned…
The Best Approach For Managing Medicare Patient Interaction – A recent article in JAMA Open Network (2023 Mar 29; 6:e235242) provides some interesting findings on the preference of the elders on the use of telehealth versus phone visits for aftercare. The results were derived from 4700 US Medicare patient beneficiaries residing in community-based settings. There were four major findings: 1) the practices were composed of those offering both video and phone visits (70%), phone visits only (23%) and video only (6%) visits; 2) the practices offering phone only visits were skewed toward lower socio-economic groups, older patients and those with Hispanic ethnicity; 3) when offered a choice of modality, 43% of patients selected phone visits and with those who had previously had a video visit, 28% selected phone visits as well; and, 4) the factors associated with selecting phone visits were older age, lower technology access and lower educational level. Hmmm. Something to think about as we begin to offer these services on a more regular basis across practices.
One-A-Day Works!! – For those age 60 and over (= that’s me!), a new study in the American Journal of Clinical Nutrition reports that: “A daily multivitamin may help slow memory loss in people age 60 and older” and, it’s not something expensive but rather the inexpensive, over-the-counter type you simply buy at the drug store. Specifically, those taking a multivitamin exhibited 3.1 fewer years of memory loss compared to the control group in a study that tracked more than 3,500 people for up to three years. I sure hope it helps 😊.
Our Dysfunctional Health Care System – Yet another study points to the dysfunction of the American health care system or, lack thereof. The Federal Reserved recently released a report that outlines the devastating impact of health care costs on patient care access. The report notes that “in 2022, 28% of adults went without some kind of medical care because of the high cost.” Furthermore, 23% of USA adults in 2022 had a major, unexpected medical expenditure with the “the median amount for those major bills…between $1,000 and $1,999.” Long story short? The “system is broken” and, you can quote me on that...
Social Media And The Well-Being Of Our Youth – In an unprecedented report, USA Surgeon General Vivek Murthy, MD issued a 19-page public health advisory calling attention to the potential risks of social media on young people. The report urged for a push to more carefully consider the potential adverse effects of social media by fostering depression, anxiety and other mental health problems among children and adolescents. For example, a study in 2019 found that adolescents between the ages of 12 – 15 who devoted more than 3 hours a day on social media were at double the risk of developing symptoms of depression and anxiety. It was a call to action by Murthy on the need to consider the risks related to mental health for children and adolescents and requires the attention of the entire medical community.
