The US federal government shutdown continues, and with it, the loss of payment for telehealth visits for Medicare beneficiaries.
I reached out to a few of my CMIO friends to understand how their systems are addressing the issue. The first health system moved telehealth visits onto the regular schedule by just updating the resource and place of service. It doesn’t sound like it went well. Administrators made the decision without assessing staffing, and although they had enough exam rooms, they didn’t have staff to complete registration or intake functions.
The second organization is honoring scheduled telehealth visits, but is not scheduling new ones. It will absorb any losses that are generated by lack of payment.
The third site is offering patients an in-person visit that is near their scheduled telehealth day at one of its convenient care locations, or a later in-person visit with the original provider. This may work for primary care, but not for subspecialists, although the institution reports that few subspecialists use telehealth.
From a patient perspective, honoring existing visits but not scheduling new ones is the least interruptive. I’m curious how many other organizations have taken that approach. If you’re knee-deep in managing Medicare telehealth limitations, feel free to weigh in.
Mr. H mentioned this article about the administration’s opposition to private-sector vetting of healthcare AI tools. I see the risk of big vendors sidelining startups, but these organizations are competitive and independent enough that “cartel” overstates it. The Coalition for Health AI lists 3,000 industry partners from big tech, health systems, medical specialty groups, standards organizations, and even startups.
No federal organization is resourced to monitor healthcare AI, which leaves it largely unregulated. Waiting for our elected leaders and their appointees to get something in place creates a lot of patient-facing risk in the interim. Given current priorities, lawmakers are unlikely to address this soon.
Also in the AI realm, a reader shared this piece about how the use of AI tools is impacting energy and infrastructure. For those not familiar with the organization, IEEE is the Institute of Electrical and Electronics Engineers and has its roots in professional organizations of electrical engineers and radio engineers. Its goal is to advance technology “for the benefit of humanity,” and members hail from 190 countries.
The infographics estimate that one day’s per-user consumption of AI resources by ChatGPT, based in 25 queries, is enough to run a 10-watt LED bulb for an hour. Globally, that year of use requires the annual electrical output of two nuclear reactors. The page notes that it’s difficult to calculate these needs because high-intensity queries can consume far more resources. At scale, the numbers become immense. I’ve made a conscious effort recently to only use AI resources when they’re likely to be of more benefit than traditional ones, but it’s hard to avoid the convenience and easy access to AI.
AI research article of the week: JAMA Network Open published an article looking at whether a hybrid chatbot using both AI and rule-based elements can help encourage patients to receive pneumococcal vaccinations. The study was small (under 400 individuals) and focused (Hong Kong residents over 65 years of age), but the authors found that subjects who interacted with the hybrid chatbot, which included real-time answers to patient questions, were more likely to receive the vaccine than those who received a standard chatbot intervention. It will be interesting to see this work replicated in different locales and age groups, although I suspect the results will be similar.
Most consumers don’t read the Terms and Conditions thoroughly each time they sign up for a new online profile or service. We have seen a gradual but persistent devaluing of individuals’ privacy as their data is bought and sold almost constantly. In discussing apps and solutions, I will often ask, “What is your privacy worth?”
A recent class action settlement that involves Facebook sharing user data with third parties puts a number on it of just $34 per claimant. That, my friends, is how much your privacy is worth.
I had a chance this week to visit a former colleague who retired from the healthcare software industry. It was great to hear what life is like on the other side. She and her husband have been traveling the world in a low-key way and sharing most of their adventures with friends and family via social media. They’ve done some cool things, although she mentioned that she didn’t completely leave her life as a road warrior behind because she’s had plenty of arguments with rental car agencies and challenges with airlines.
They say that they would have retired earlier if they had found a better way to buy health insurance before Medicare eligibility. Unless you are a multi-millionaire, that sentiment is shared by millions of workers in the US. The fact that people feel forced to stay in unfulfilling jobs or in bad relationships because of access to healthcare is something to think about.
I didn’t attend last week’s Becker’s Health IT + Digital Health + RCM Meeting, but happened to be in town for a bit of baseball. I was able to swing by a couple of conference-adjacent events. A special shoutout to Ambience Healthcare for putting on an elegant rooftop event complete with ice artists carving the Chicago skyline.
I’ve been to many vendor events, but this one felt different. It had plenty of tables and seating, which encouraged deep and meaningful conversations among people who are working to solve the same problems. There was no loud music to shout over, although there was some occasional chainsaw noise from the artists.
I had a great conversation with someone who is deep into the implementation of ambient documentation solutions at their organization. They invited me to come see it in action, which I might do. Extra points to the company’s marketing team, to Charlotte who kept the event running smoothly, and to whichever marketer decided to use Phineas Gage as a patient name on the company website.
What’s the most creative event or marketing effort you’ve seen recently? Leave a comment or email me.
Email Dr. Jayne.
