Literature Review

AI-generated draft replies integrated into health records and physicians’ electronic communication JAMA Network; by Ming Tai-Seale, PhD, MPH; Sally L. Baxter, MD, MSc; Florin Vaida, PhD; et al; 4/15/24Objective: To investigate the association between GenAI-drafted replies for patient messages and physician time spent on answering messages and the length of replies.Conclusions and Relevance: In this QI study, GenAI-drafted replies were associated with significantly increased read time, no change in reply time, significantly increased reply length, and some perceived benefits. 

The Promise and Pitfalls of AI in Medicine: Guest Bob WachterGeriPal Podcast, by Eric Widera and Alex Smith, with Bob Wachter; 4/18/24Our guest today is Bob Wachter, Chair of Medicine at UCSF and author of the Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age.  Bob recently wrote an essay in JAMA on AI and delivered a UCSF Grand Rounds on the same topic.Publisher's note: An interesting exchange. With apologies for the lenght, this portion of the transcript caught my eye:

Remote SNF monitoring partnership promises 25 percent rehospitalization reduction McKnights Senior Living, by Josh Henreckson; 4/15/24 A new partnership between technology company Circadia Health and 81 skilled nursing facilities operated by Ciena Healthcare aims to significantly improve preventive care and reduce preventable rehospitalizations. Circadia’s C100 remote monitoring devices ... will be installed in residents’ rooms. They are capable of continuously monitoring key vital signs like residents’ breathing rate, heart rate and unusual motions and compare them with personalized profiles. 

AI in palliative and end-of-life care: "How new technology makes us feel is important" Marie Curie, by Dr. Ami Nwosu, Research Lead at the Marie Curie Hospice, Liverpool, UK; 4/11/24... People who require palliative and end of life care require specific physical, emotional, psychological and social needs, which requires holistic assessment and support. Although there are more opportunities to use AI technologies in palliative care, there may be concern from family caregivers that technology may be unable to provide the person-centered, human connection which may be desired when people are at their most vulnerable.

Ethical issues abound in adoption of Artificial Intelligence in cancer care Oncology Nurse Advisor; 4/4/24There may be ethical barriers to the adoption of artificial intelligence (AI) into cancer care, according to a study published online March 28 in JAMA Network Open. Andrew Hantel, M.D., from the Dana-Farber Cancer Institute in Boston, and colleagues evaluated oncologists’ views on the ethical domains of the use of AI in clinical care. The analysis included 204 survey responses from 37 states. ... “These findings suggest that the implementation of AI in oncology must include rigorous assessments of its effect on care decisions as well as decisional responsibility when problems related to AI use arise,” the authors write.

FDA approves AI Tool that can detect sepsis Forbes, by Cailey Gleeson; 4/3/24 The U.S. Food and Drug Administration approved an AI tool that can diagnose sepsis, Prenosis, the company behind the software, announced Wednesday, the latest in a series of agency approvals for AI diagnostic tools. ... At least 350,000. That’s how many adults who develop sepsis die from the condition or are discharged to hospice annually, according to the U.S. Centers for Disease Control and Prevention. 

Northwell backs 'emotionally intelligent' AI voice startupBecker's Health IT, by Gile Bruce; 3/28/24The venture capital arm of New Hyde Park, N.Y.-based Northwell Health is backing a startup that is developing a conversational artificial intelligence platform that mimics human speech. Northwell Holdings participated in a $50 million series B funding round March 27 for Hume AI, which was founded by a former Google researcher to provide "near-human-level conversation" with AI. Northwell has already invested several million dollars in the "emotionally intelligent" voice interface.Editor's Note: Is this an April's Fools Day joke? No. Will these replacements of human conversation improve or potentially harm the patient/caregiver experience? What outcomes could be generated if $50 million was invested in making human professionals more emotionally intelligent? For this high-tech oriented hospice and palliative editor/leader, this direction raises patient/caregiver/professional concerns and cautions. 

How healthcare AI is regulated by the FDA, HHS, state laws Modern Healthcare, by Gabriel Perna; 3/26/24 Widespread oversight of artificial intelligence in healthcare is still a work in progress but that doesn’t mean the technology is completely unregulated. ... There are areas where developers, providers and insurers are regulated in how they use AI. Federal agencies like the Food and Drug Administration and Health and Human Services Department have some oversight authority. Also, a few states have enacted laws governing use of AI within clinical care.

Digital avatars and personalized voices—How AI is helping to restore speech to patients JAMA Network, by Samantha Anderer and Yulin Hswen, ScD, MHP; 3/22/24 This conversation is part of a series of interviews in which JAMA Editor in Chief Kirsten Bibbins-Domingo, PhD, MD, MAS, and expert guests explore issues surrounding the rapidly evolving intersection of artificial intelligence (AI) and medicine.  As a specialist in advanced brain mapping methods, Edward Chang, MD, set out to understand the mechanisms that turn our thoughts into words. Now, with the help of AI, his team at the University of California, San Francisco (UCSF) Weill Institute for Neurosciences has demonstrated that the brain signals associated with speech-related sensory and motor processes could grant a new voice to patients who have lost the ability to speak.

HHS Secretary Becerra: We’re with you on telehealth flexibilities Hospice News, by Jim Parker; 3/21/24 Telehealth flexibilities must become permanent U.S. Health and Human Services (HHS) Secretary Xavier Becerra indicated in a congressional hearing [Wed]. At the end of this year, telehealth flexibilities implemented during the pandemic are slated to expire. In a hearing before the U.S. House Ways and Means Committee Becerra said that HHS was willing to make them permanent. However, he said this would require closer collaboration with state governments. “We’re with you. We can’t allow those flexibilities to expire, and we need to work closer with our state partners, because much of the flexibility that comes from telehealth means being able to go over state lines,” Becerra said.

Are the robots coming for my nursing job? Minority Nurse; 3/20/24 While medication-dispensing robots, telemetry, electronic fetal monitoring, artificial intelligence, and other technological advances have altered our work as nurses, fears that robots will replace us and send nurses into the historical career dustbin are likely unfounded. ... The human side of nursing is the art that maintains the sacredness of the nurse-patient bond. Nursing may be partially driven by plans of care developed within the parameters of the nursing process, but where the rubber hits the road is where person-to-person interaction informs the patient experience and the nurse’s calling.

Give generative AI another decade to revolutionize healthcare Modern Healthcare - Opinion, by Keith Figoli; 3/15/24... Generative artificial intelligence is poised to transform healthcare by enabling solutions to effectively address [common patient care] challenges. This cutting-edge technology opens new avenues for innovation in diagnosis, treatment planning, operations efficiency and overall healthcare delivery–and industry leaders are taking notice. A recent survey revealed that 25% of healthcare organizations implemented a generative AI solution in 2023, while 58% plan to adopt one this year. However, the generative AI-driven transformation won’t – and shouldn’t – happen overnight.

Use of machine learning to optimize referral for early palliative care: Are prognostic predictions enough  Journal of Clinical Oncology - Editorials; by Gary E. Weissman, MD, MSHP; Joseph A. Greer, PhD; and Jennifer S. Temel, MD; 3/15/24  The Takeaway In the article that accompanies this editorial, [Weissman] et al used a machine learning (ML) algorithm to identify patients with advanced cancer who were receiving non–curative-intent treatment and at risk of death within 1 year to allocate early palliative care services at least 6 months before death as a means to increase use of early palliative care in the context of limited resources. While ML prognostic models are one promising strategy for triaging palliative care services, initiation of palliative care based exclusively on estimated survival and in the months before death likely excludes patients who would benefit from early palliative care initiated at the time of diagnosis, regardless of their estimated survival.