Literature Review

Virtual reality videos for symptom management in hospice and palliative careMayo Clinic Proceedings - Digital Health; by James R Deming, Kassie J Dunbar, Joshua F Lueck, Yoonsin Oh; 8/24Nature scenes significantly improved total symptom scores, as well as scores for drowsiness, tiredness, depression, anxiety, well-being, and dyspnea. The improved scores were not sustained 2 days later. Overall, bucket-list videos did not significantly improve symptoms. Neither previous experience with an activity nor a strong connection correlated with significant improvement; however, when patients rated video quality as outstanding, scores improved. Patients with lower functional status tended to have more symptoms beforehand and improve the most.

Southern Tier Health helps HomeCare & Hospice, Total Senior Care on USDA grant Olean Times Herald, Olean, NY; by Kellen M. Quigley; 10/22/24 A collaboration between three local agencies looking out for the health and well-being of their clients is getting a modern technological boost thanks to a federal grant. The Southern Tier Health Care System, Inc. (STHCS) was recently awarded nearly $140,000 through the U.S. Department of Agriculture’s Rural Development Rural Utilities Service Distance Learning and Telemedicine Grant Program. This funding is meant to empower rural communities by leveraging advanced technology to connect residents and healthcare providers, overcoming the challenges of distance and low population density. Of the total grant, $114,606.80 was allocated to HomeCare & Hospice and Total Senior Care for state-of-the-art digital communication and remote learning tools, including high-definition displays, advanced cameras and integrated audio systems.

The Tesla Bot is the future of at-home care, but not the way Elon wants you to think AndroidCentral; by Nicholas Sutrich; 10/17/24 Imagine waking up on your 91st birthday to a friendly robot companion that brings your morning coffee and a nice warm robe to start the day in. After making you breakfast, it bids you good day and heads back into the closet for a quick charge-up. At around 11 a.m., you realize there's a new pain in your leg that you haven't experienced before, so you make a quick phone call to the doctor, and, in a minute, your robot companion emerges from the closet, entirely remote-controlled by your doctor. They can run scans, have a full conversation, and even perform exams, all without you having to leave your home and go through the irritating task of trying to find transportation across town. ... Nothing replaces full face-to-face human interaction, but the ability for a fully remote-controlled robot that can be embodied by anyone with a VR headset like the Meta Quest 3 is a future I want to fully embrace.

Ethical considerations in the design and conduct of clinical trials of artificial intelligenceJAMA Network Open; Alaa Youssef, PhD; Ariadne A. Nichol, BA; Nicole Martinez-Martin, JD, PhD; David B. Larson, MD, MBA; Michael Abramoff, MD, PhD; Risa M. Wolf, MD; Danton Char, MD, MS; 9/24In this qualitative study, interviews with 11 investigators involved in clinical trials of AI [artificial intelligence] for diabetic retinopathy screening confirmed the applicability of current ethical principles but also identified unique challenges, including assessing social value, ensuring scientific validity, fair participant selection, evaluation of risk-to-benefit ratio in underrepresented groups, and navigating complex consent processes. These results suggest ethical challenges unique to clinical trials of AI, which may provide important guidance for empirical and normative ethical efforts to enhance the conduct of AI clinical trials. These considerations call for further guidance on where to focus empirical and normative ethical efforts to best support conduct clinical trials of AI and minimize unintended harm to trial participants.

Mass General Brigham tests drones for 'hospital at home': 6 things to know Becker's Health IT; by Giles Bruce; 10/15/24 Somerville, Mass.-based Mass General Brigham has tested out drone delivery for its hospital-at-home program. Here are six things to know:

Why recent outages are a wake-up call for healthcare and regulators Forbes; by Chris Bowen; 10/11/24 When the CrowdStrike outage first started to show itself in the early hours of that hazy July morning, it was hard to believe that this wasn’t a hack or cyberattack. I was driving in my car that morning and looked up to see a digital billboard glitch into the "blue screen of death" before my eyes. Flights were grounded, travel was delayed, and nearly every Windows machine in the world was unusable. It was total mayhem. Clearly, this was an outage of major proportions, as millions of Windows systems worldwide essentially cratered. Caused by a faulty misconfiguration, we saw firsthand how the very digital advancements that have helped transform and modernize our world also expose us to more vulnerabilities than ever. ... In healthcare, this event laid bare the vulnerabilities we cannot overlook—the gaps that directly threaten patient care and safety. It’s a clear reminder of our industry’s utmost responsibility to patient privacy and well-being. ...

Harnessing natural language processing to assess quality of end-of-life care for children with cancerJCO Clinical Cancer Informatics; Meghan E Lindsay, Sophia de Oliveira, Kate Sciacca, Charlotta Lindvall, Prasanna J Ananth; 9/24Data on end-of-life care (EOLC) quality, assessed through evidence-based quality measures (QMs), are difficult to obtain. Natural language processing (NLP) enables efficient quality measurement and is not yet used for children with serious illness. Conclusion: A high proportion of decedents attained specified EOLC-QMs more than 30 days before death. Our findings indicate that NLP is a feasible approach to measuring quality of care for children with cancer at the end of life and is ripe for multi-center research and quality improvement.

Research suggests AI could enhance patient safety, but raises questions The American Journal of Managed Care (AJMC); by Hayden E. Klein; 9/26/24 A new study from Boston University highlighted the potential of generative artificial intelligence (AI) to improve patient safety in health care. Published in The Joint Commission Journal on Quality and Patient Safety, the study tested the widely used AI model GPT-4 on the Certified Professional in Patient Safety (CPPS) exam, where it answered 88% of questions correctly. Researchers believe AI could help reduce medical errors, estimated to cause 400,000 deaths annually, by assisting clinicians in identifying and addressing safety risks in hospitals and clinics. ... The study authors suggested that AI has promise in helping doctors better recognize, address, and prevent mistakes or accidental harm in hospitals and clinics. ... However, the study also highlighted critical limitations of current AI technologies, including the risk of bias, fabricated data, and false confidence in responses. 

77% of health system IT employees eyeing new jobs Becker's Health IT; Naomi Diaz; 9/25/24 Health system IT employees are keeping their options open, with 77% actively seeking new jobs or planning to do so within the next year, according to Bloomforce's "2024 EHR Salary Insights Report." The report, based on an online survey conducted between November and December 2023, gathered responses from 284 healthcare professionals across various roles, including application analysts, team leads, project managers and people managers. It explored areas such as salary, job satisfaction, work-life balance, talent retention and attitudes toward remote work. Here are some key findings from the report: [Click on the title's link to read more.]

That message from your doctor? It may have been drafted by A.I. DNYUZ; 9/24/24 Every day, patients send hundreds of thousands of messages to their doctors through MyChart, a communications platform that is nearly ubiquitous in U.S. hospitals. They describe their pain and divulge their symptoms — the texture of their rashes, the color of their stool — trusting the doctor on the other end to advise them. But increasingly, the responses to those messages are not written by the doctor — at least, not entirely. About 15,000 doctors and assistants at more than 150 health systems are using a new artificial intelligence feature in MyChart to draft replies to such messages. Many patients receiving those replies have no idea that they were written with the help of artificial intelligence. In interviews, officials at several health systems using MyChart’s tool acknowledged that they do not disclose that the messages contain A.I.-generated content. The trend troubles some experts who worry that doctors may not be vigilant enough to catch potentially dangerous errors in medically significant messages drafted by A.I. 

AI shouldn't decide who dies. It's neither human nor humane Fox News; by John Paul Kolcun and Anthony Digiorgio; 9/20/24 [Opinion] As we write this, PubMed ... indexes 4,018 publications with the keyword "ChatGPT." Indeed, researchers have been using AI and large-language models (LLMs) for everything from reading pathology slides to answering patient messages. However, a recent paper in the Journal of the American Medical Association suggests that AI can act as a surrogate in end-of-life discussions. This goes too far. The authors of the paper propose creating an AI "chatbot" to speak for an otherwise incapacitated patient. To quote, "Combining individual-level behavioral data—inputs such as social media posts, church attendance, donations, travel records, and historical health care decisions—AI could learn what is important to patients and predict what they might choose in a specific circumstance." Then, the AI could express in conversant language what that patient "would have wanted," to inform end-of-life decisions. We are both neurosurgeons who routinely have these end-of-life conversations with patients’ families, as we care for those with traumatic brain injuries, strokes and brain tumors. These gut-wrenching experiences are a common, challenging and rewarding part of our job. Our experience teaches us how to connect and bond with families as we guide them through a life-changing ordeal. In some cases, we shed tears together as they navigate their emotional journey and determine what their loved one would tell us to do if they could speak. 

Using AI and social media to understand health disparities for transgender cancer careJAMA Network Open; Augustine Annan, PhD; Yeran Li, PhD; Jingcheng Du, PhD; Yezhou Sun, MS; A. I. Asante-Facey, MD; Xiaoyan Wang, PhD; Matthew Monberg, PhD; 8/24Transgender individuals experience lower health care use and higher health care discrimination rates. This qualitative study revealed 3 barriers in transgender cancer care: lack of awareness, access issues, and clinical challenges. The consistent reporting of clinical challenges indicates the need for tailored medical guidelines and gender-affirming support systems. Addressing these disparities requires enhanced clinician education, evidence-based guidelines, policy reforms, and inclusive health coverage. Despite potential biases and limitations in the representativeness of social media data, this study may offer valuable insights to guide future initiatives toward achieving equitable health care for transgender individuals.

Breaking the barriers in information sharing: Changing the discussion from legal risk to C-suite opportunity N2K; by Rick Howard; 9/16/24 In the evolving landscape of cybersecurity, sharing information among institutions is critical to bolster defenses against increasingly sophisticated threats. Cooperation between organizations can strengthen everyone’s defenses, but such an approach requires openness and transparency, something that many organizations have been reluctant to do. ... The C-suite – comprising top executives such as the CEO, CFO, CIO, CISO, and others – plays a critical role in shaping an organization's approach to cybersecurity. In the context of information sharing, the C-suite's role is pivotal in driving the cultural and operational changes necessary to transition from a risk-averse stance to one that recognizes the strategic value of collaboration and information exchange. One of the most successful initiatives that C-suite leaders can champion is participation in industry-specific Information Sharing and Analysis Centers (ISACs). ... [Following discussions include:] The business case for information sharing ... Enhanced risk management ... Cost savings and resource efficiency ... Compliance and legal benefits ... Innovation ... Professional Development ... Challenges to information sharing ... Legal and regulatory complexities ... Risk of exposure and misuse ... Trust issues among organizations ... Technical barriers ... Cultural and organizational obstacles ... Sharing information ... Categorize information by sensitivity ... Assess recipients ... Vet the data ... Monitoring and oversight ... Engaging in industry-wide collaboration ... Real world examples - Health-ISAC and the faulty CrowdStrike update ... The path forward ... [Click on the title's link for the full article and a whitepaper.]