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In a healthcare industry still burdened with 1960s technology, generative AI may offer a little relief — but companies are still working to overhaul a broken system that’s keeping doctors and nurses more focused on paperwork than patients.

By Katie Jennings and Rashi Shrivastava, Forbes Staff


Every week, Eli Gelfand, chief of general cardiology at Beth Israel Deaconess Medical Center in Boston, wastes a lot of time on letters he doesn’t want to write — all of them to insurers disputing his recommendations. A new drug for a heart failure patient. A CAT scan for a patient with chest pain. A new drug for a patient with stiff heart syndrome. “We’re talking about appeal letters for things that are life-saving,” says Gelfand, who is also an assistant professor at Harvard Medical School.

So when OpenAI’s ChatGPT began making headlines for generally coherent artificial intelligence-generated text, Gelfand saw an opportunity to save some time. He fed the bot some basic information about a diagnosis and the medications he’d prescribed (leaving out the patient’s name) and asked it to write an appeal letter with references to scientific papers.

ChatGPT gave him a viable letter — the first of many. And while the references may sometimes be wrong, Gelfand told Forbes the letters require “minimal editing.” Crucially, they have cut the time he spends writing them down to a minute on average. And they work.

Gelfand has used ChatGPT for some 30 appeal letters, most of which have been approved by insurers, he says. But he’s under no illusion that ChatGPT or the AI that powers it is going to save the U.S. healthcare system anytime soon. “It’s basically making my life a little easier and hopefully getting the patients the medications they need at a higher rate,” Gelfand says. “This is a workaround solution for a problem that shouldn’t really exist.”

That problem: The U.S. spends more money on healthcare administration than any other country. In 2019, around a quarter of the $3.8 trillion spent on healthcare went to administrative issues like the ones bemoaned by Gelfand. It’s estimated around $265 billion of that was “wasteful” — unnecessary expenditures necessitated by the antiquated technology that undergirds the U.S. healthcare system. Gelfand can use a chatbot to electronically generate an appeal letter. But he has to fax it to the insurer. And that encapsulates the challenge facing companies hoping to build time-saving AI back-office tools for a healthcare system stuck in the 1960s.


Cut The “Scut”

The fax machine isn’t going away anytime soon, says Nate Gross, cofounder and chief strategy officer of Doximity, a San Francisco-based social networking platform used by two million doctors and other healthcare professionals in the U.S. That’s why Doximity’s new workflow tool, DocsGPT, a chatbot that helps doctors write a wide range of letters and certificates, is connected to its online faxing tool.

“Our design thesis is to make it as easy as possible for doctors to interface with

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