“It’s about focus. The brain is slow and it can’t multitask.” This may be what close observers are saying about why the federal government was shut down for so long. It is tough to focus on the little things like keeping the government open to feed the most vulnerable Americans or making sure that sick, elderly patients are getting the virtual and at-home health care services they need when you are busy concentrating on foreign policy and trade issues. Walking and chewing gum at the same time is tough for mere mortals, which is why this line about the limitations of the human brain came from Will Smith’s con man character in the movie Focus. How con men operate is strangely aligned with our current challenges in training AI models for health care applications — today’s topic in the One Thoughtful Paragraph below.
Other news that makes it clear that our brains are slow and need time to figure out what all of this means:
- Brown University’s Center for Advancing Health Policy Research estimated the initial impacts of Medicare telehealth flexibilities expiring: in the first 17 days of October, the proportion of office encounters via telehealth declined by 24% and 13% for Medicare FFS and Medicare Advantage beneficiaries, respectively. This decline was more pronounced in some states than others. Telehealth services were reduced by 40% or more in Florida, Louisiana, Washington, Tennessee, Maryland, Oklahoma, and New York.
- UnitedHealthcare will no longer cover remote patient monitoring (RPM) for most conditions, including Type 2 diabetes and hypertension, concluding that RPM is medically necessary only to treat chronic heart failure and hypertension during pregnancy.
- The Digital Medicine Society (DiMe) launched an initiative to create a blueprint for integrated, at-home, and tech-enabled care for older seniors. Through its Connected Health Collaborative (CHcc), DiMe will work with partners like the Consumer Technology Association, the FDA, and UMass Chan Medical School’s Program in Digital Medicine to create a pathway for building reliable, affordable infrastructure that enables aging in place. CHcc’s inaugural project was a blueprint for hospital-at-home programs.
“I can convince anyone of anything. I once convinced a man that an empty warehouse was the Federal Reserve, so I’m good.” This line, and other great dialogue from the movie Focus, kept coming to mind as I read an op-ed this week about how we are training health AI tools. The 2015 film features two of the most attractive and compelling people in Hollywood, Margot Robbie and Will Smith, who deliver witty, fast-paced banter that help you understand how people become convinced of things that aren’t true. Which leads me to the op-ed I read this week by Dr. Peter Bonis, who is the Chief Medical Officer of Wolters Kluwer Health and an adjunct professor of medicine at Tufts University School of Medicine, and also the guy who helped develop UpToDate® — one of the go-to resources clinicians use to try to keep up with the latest medication and treatment information. Dr. Bonis wrote that a core challenge in making AI tools work for health care purposes is the need for access to highly-curated and up-to-date data. If you’re asking AI models to help with cancer research or treatment, for instance, you need data from hospitals that treat cancer patients. Otherwise, you won’t know much. Dr. Bonis argues that without access to this type of “proprietary, curated data” our computer-generated health care information will start to resemble the con men in the movie Focus — it might sound right, but it’s utter poppycock. (This is my language, of course, not Dr. Bonis’). My takeaway: we need to train AI models the way con men are trained in Focus — as one of the old-timers in the movie explains, that process can be disappointing when you don’t get it right: I took you off the street. Taught you my trade. I taught you my passion. Three generations of skills. And in spite of all my earnest efforts, in spite of all my hard work, you turned into a good person.
