Foundation model companies are doing the same. OpenAI launched a dedicated Healthcare & Life Sciences vertical, complete with industry-specific sales teams and solutions engineers.
令人惊讶的是：即使是基础模型公司如OpenAI也在转向专业化，成立了专门的医疗和生命科学垂直部门，配备行业特定的销售团队和解决方案工程师。这表明AI行业正在从通用模型向高度专业化的行业解决方案转变。
The updated Agents SDK made it production-viable for us to automate a critical clinical records workflow that previous approaches couldn't handle reliably enough.
令人惊讶的是：医疗健康公司Oscar Health已经使用更新的Agents SDK成功自动化了临床记录工作流程，这是以前的方法无法可靠处理的。这表明AI代理技术已经发展到足以处理复杂、高风险的医疗数据任务，这可能彻底改变医疗行业的记录管理方式。
The demand for these medications has been the most ferocious thing I have witnessed in my working life, and the hardest parts of running a telehealth company, like finding doctors and fulfilling prescriptions, can be entirely outsourced to platforms like CareValidate and OpenLoop.
大多数人认为医疗行业监管严格且难以突破，但作者指出GLP-1药物的需求如此之大以至于一个人可以在短短两个月内创建价值数十亿美元的公司，并将医疗服务的核心功能外包。这一观点挑战了传统医疗行业的复杂性认知，展示了AI如何颠覆传统受监管行业。
Where US healthcare fails, the amount of ChatGPT consultations grows. If anything expontentially is in play, it may well be exponentially worsening health outcomes for US population.
My tax status with the government is as an “auteur/artiste”—an author/artist. With this declaration, I have one very practical thing: health insurance.
Registering with l'Urssaf as an "artiste-auteur" (or micro-entrepreneur), which aligns one with a specific régime for the payment of social charges, automate registration with CPAM, the administrative arm of the French universal healthcare system.
When it comes to your healthcare, most people think that their only options are to pay for expensive Health Insurance or try out your luck being uninsured. The great news is that you have a third option; You can join a Health Share plan that is affordable and meets your needs! Health Sharing programs are one of the most effective and affordable alternatives to Health Insurance. If you don’t know what a Health Share is, you can start here to learn how it works and why it’s a great alternative to health insurance. If you are looking for affordable healthcare, I highly recommend checking out my article about the Best Health Share Plans.
Private Healthcare Systems (PHCS), and their associated MultiPlan networks, represent two key aspects that one must grasp in order to take full advantage of their health insurance benefits. But, what exactly are PHCS and MultiPlan networks, and how do they work? This guide aims to provide comprehensive insights into these healthcare structures. What is PHCS? Private Healthcare Systems, or PHCS, is one of the largest preferred provider organizations (PPOs) in the United States. A PPO is a type of health insurance arrangement where the insurance company has contracts with a network of “preferred” providers. In this context, PHCS forms contracts with doctors, hospitals, and other healthcare providers, who then agree to provide their services at reduced rates for patients covered by PHCS health insurance. Understanding MultiPlan Networks MultiPlan Network is a comprehensive group of healthcare providers that have agreed to offer discounted rates for services to insured individuals. It’s one of the oldest and most expansive independent PPO networks in the U.S., serving over 60 million people. PHCS became part of the MultiPlan network in 2006. This means that if your insurance uses the PHCS or MultiPlan network, you have access to these discounted rates when you use a provider within this network.
The assassination is a koan that brings to light the paradox at the heart of civilisation: what’s real is our experience of being alive, not how we can be quantified, but we pretend the opposite is true.
for - comparison - symbolosphere vs physiosphere - assassination of United Healthcare CEO Brian Thompson - Substack article - Best Served Cold: Luigi Mangione and The Age of Breach - Alexander Beiner
1:06:53 The true constraints are the resources that are available (and if those resources will co-create together for the good of the WHOLE).
Phone: (417) 269-2160
Often you'll be unable to get a situation resolved calling the Clinic. Instead call… CoxHealth Customer Experience (417) 269-6101
Often you'll be unable to get a situation resolved calling the Clinic. Instead call... CoxHealth Customer Experience (417) 269-6101
To build HIPAA compliant software, developers need to be aware of and comply with several key requirements outlined in the HIPAA Privacy Rule and Security Rule. These requirements are designed to ensure the confidentiality, integrity, and availability of protected health information (PHI) and to prevent unauthorized access, use, or disclosure of PHI.
Building software compliant with HIPAA standards necessitates a deep understanding of its Privacy and Security Rules to safeguard protected health information effectively.
This is the space where AI can thrive, tirelessly processing these countless features of every patient I’ve ever treated, and every other patient treated by every other physician, giving us deep, vast insights. AI can help do this eventually, but it will first need to ingest millions of patient data sets that include those many features, the things the patients did (like take a specific medication), and the outcome.
AI tools yes, not ChatGPT though. More contextualising and specialisation needed. And I'd add the notion that AI might be necessary as temporary fix, on our way to statistics. Its power is in weighing (literally) many more different factors then we could statistically figure out, also because of interdependencies between factors. Once that's done there may well be a path to less blackbox tooling like ML/DL towards logistic regression: https://pubmed.ncbi.nlm.nih.gov/33208887/ [[Machine learning niet beter dan Regressie 20201209145001]]
My fear is that countless people are already using ChatGPT to medically diagnose themselves rather than see a physician. If my patient in this case had done that, ChatGPT’s response could have killed her.
More ELIZA. The opposite of searching on the internet for your symptoms and ending up with selfdiagnosing yourself with 'everything' as all outliers are there too (availability bias), doing so through prompting generative AI will result in never suggesting outliers because it will stick to dominant scripted situations (see the vignettes quote earlier) and it won't deviate from your prompts.
If my patient notes don’t include a question I haven’t yet asked, ChatGPT’s output will encourage me to keep missing that question. Like with my young female patient who didn’t know she was pregnant. If a possible ectopic pregnancy had not immediately occurred to me, ChatGPT would have kept enforcing that omission, only reflecting back to me the things I thought were obvious — enthusiastically validating my bias like the world’s most dangerous yes-man.
Things missing in a prompt will not result from a prompt. This may reinforce one's own blind spots / omissions, lowering the probability of an intuitive leap to other possibilities. The machine helps you search under the light you switched on with your prompt. Regardless of whether you're searching in the right place.
My experiment illustrated how the vast majority of any medical encounter is figuring out the correct patient narrative. If someone comes into my ER saying their wrist hurts, but not due to any recent accident, it could be a psychosomatic reaction after the patient’s grandson fell down, or it could be due to a sexually transmitted disease, or something else entirely. The art of medicine is extracting all the necessary information required to create the right narrative.
This is where complexity comes in, teasing out narratives and recombine them into probes, probing actions that may changes the weights of narratives and mental models held about a situation. Not diagnostics, but building the path towards diagnostics. Vgl [[Probe proberend handelen 20201111162752]] [[Vertelpunt 20201111170556]]
This is likely why ChatGPT “passed” the case vignettes in the Medical Licensing Exam. Not because it’s “smart,” but because the classic cases in the exam have a deterministic answer that already exists in its database.
Machines will do well in scripted situations (in itself a form of automation / codification). This was a factor in Hzap 08 / 09 in Rotterdam, where in programming courses the problems were simplified and highly scripted to enable the teacher to be able to grade the results, but at the cost of removing students from actual real life programming challenges they might encounter. It's a form of greedy reductionism of complexity. Whereas the proof of the pudding is performing well within complexity.
Here’s what I found when I asked ChatGPT to diagnose my patients
A comparison of ChatGPT responses to actual ER case descriptions. Interesting experiment by the author, though there shouldn't be an expectation for better results than it gave.
Solving the gargantuan challenge posed by complex chronic diseases demands seismic shifts in research funding, medical training, and public attitudes.
Not to mention the myopic insurance- and profit-driven "healthcare" industry itself.
A study across the population of Scotland researched the affects of covid by comparing those with a positive PCR test with a control group that did not have covid. Vaccinations were shown to decrease symptoms. There are concerns about long-term effects as the virus becomes endemic.
Healthcare should be a human right.
Healthcare is a service provided by others.
When a person asserts that they have a right to the labor of others, this stakes a claim of ownership over that person and their labor.
"slavery, condition in which one human being was owned by another." https://www.britannica.com/topic/slavery-sociology
Everyone has a right to health, but they can make no such claim to the service of others to maintain it.
NDR. (2021, March 19). AstraZeneca: Greifswalder Forscher finden Thrombose-Ursache. /nachrichten/mecklenburg-vorpommern/AstraZeneca-Greifswalder-Forscher-finden-Thrombose-Ursache,coronavirus4660.html
Notion – The all-in-one workspace for your notes, tasks, wikis, and databases. (n.d.). Notion. Retrieved 14 February 2022, from https://www.notion.so
Beaumont, P. (2021, September 16). Which countries are enforcing mandatory Covid jabs – and how? The Guardian. https://www.theguardian.com/world/2021/sep/16/which-countries-enforcing-mandatory-covid-vaccination
Johnson, S. (2021, June 7). Spat at, abused, attacked: Healthcare staff face rising violence during Covid. The Guardian. http://www.theguardian.com/global-development/2021/jun/07/spat-at-abused-attacked-healthcare-staff-face-rising-violence-during-covid
Sgaier, S. K. (2021, May 18). Opinion | Meet the Four Kinds of People Holding Us Back From Full Vaccination. The New York Times. https://www.nytimes.com/interactive/2021/05/18/opinion/covid-19-vaccine-hesitancy.html
Adams, R., & editor, R. A. E. (2021, September 15). Covid teams can vaccinate pupils against parents’ wishes, schools told. The Guardian. https://www.theguardian.com/education/2021/sep/15/covid-teams-can-vaccinate-pupils-against-parents-wishes-schools-told
Ercolano, P. (2021, September 20). The legality of vaccine mandates. The Hub. https://hub.jhu.edu/2021/09/20/stacey-lee-employer-vaccine-mandate/
Regev-Yochay, G., Gonen, T., Gilboa, M., Mandelboim, M., Indenbaum, V., Amit, S., Meltzer, L., Asraf, K., Cohen, C., Fluss, R., Biber, A., Nemet, I., Kliker, L., Joseph, G., Doolman, R., Mendelson, E., Freedman, L. S., Harats, D., Kreiss, Y., & Lustig, Y. (2022). 4th Dose COVID mRNA Vaccines’ Immunogenicity & Efficacy Against Omicron VOC (p. 2022.02.15.22270948). medRxiv. https://doi.org/10.1101/2022.02.15.22270948
Huang, L., & Cao, B. (2021). Post-acute conditions of patients with COVID-19 not requiring hospital admission. The Lancet Infectious Diseases, 0(0). https://doi.org/10.1016/S1473-3099(21)00225-5
We don’t expect National Defence or health care to promote growth: we just accept that territorial integrity and a healthy populace are good things.
Been making that point about health (especially since, like education, it's a provincial jurisdiction). It's easy to think of perverse incentives if a profit motive dominates education and health. Physicians would want people to remain sick and teachers would prefer it if learners required more assistance.
Hadn't thought enough about the DND part. Sure gives me pause, given the amounts involved. Or the fact that there's a whole lot of profit made in that domain.
So, businesspeople are quick to talk about "cost centres". Some of them realize that those matter a whole lot.
Medical AI’s social impact is not merely a question of practice but also the insufficiency of its promise
Governor Kathy Hochul. (2022, January 27). #COVID Case and Hospitalization Update: -17,305 New Cases -8,741 Hospitalizations (-594) -134 New deaths reported by healthcare facilities through HERDS https://t.co/bIeDmJzJ2l [Tweet]. @GovKathyHochul. https://twitter.com/GovKathyHochul/status/1486794356421976069
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Eric Topol. (2021, April 23). Just published @TheLancet: Effect of vaccine in >23,000 health care workers https://t.co/ohy3VyHM3C Dose response: No vaccine 977 infections; 1 dose 71 infections; 2 doses 9 infections (14|8|4 per 10,000 person-days) "can prevent both symptomatic and asymptomatic infection " https://t.co/EybVBFmXrU [Tweet]. @EricTopol. https://twitter.com/EricTopol/status/1385729322472730626
ReconfigBehSci on Twitter: ‘RT @TheLancetInfDis: Newsdesk in March issue: #COVID19 among American Indians and Alaska Natives https://t.co/cJj2815IYw’ / Twitter. (n.d.). Retrieved 3 March 2021, from https://twitter.com/SciBeh/status/1367060643896053760
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Al Newman. (2022, March 8). @danaparish @jennybluebird2U To your point: Https://t.co/CsULpIACoI [Tweet]. @AlNewman_. https://twitter.com/AlNewman_/status/1501056062262333441
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Health sector facing ‘challenges not seen in a century’ as Victoria issues rare Code Brown. (2022, January 17). ABC News. https://www.abc.net.au/news/2022-01-18/victoria-records-more-covid-19-deaths-hospitalisations-and-cases/100762978
Jorge A. Caballero, MD (jorgecaballero.eth). (2022, January 10). 🧵/ I just spoke with two journalists about data that shows how the U.S. healthcare system is collapsing before our eyes. The million dollar question during both interviews was, “What else could we be doing right now?” The answer: Flatten the hospitalization curve. Now. [Tweet]. @DataDrivenMD. https://twitter.com/DataDrivenMD/status/1480607009867132928
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wparmet. (2022, January 5). Major Questions about Vaccine Mandates, the Supreme Court, and the Major Questions Doctrine. Bill of Health. http://blog.petrieflom.law.harvard.edu/2022/01/05/major-questions-vaccine-mandates-supreme-court/
Bower, Dr Marlee, Scarlett Smout, Amarina Donohoe-Bales, Lily Teesson, Eleisha Lauria, Julia Boyle, Philip Batterham, et al. ‘A Hidden Pandemic? An Umbrella Review of Global Evidence on Mental Health in the Time of COVID-19’. PsyArXiv, 14 January 2022. https://doi.org/10.31234/osf.io/bzpvw.
Berger, Eric. ‘As Omicron Peaks, the US Healthcare System Is Left “Broken beyond Repair”’. The Guardian, 4 February 2022, sec. Society. https://www.theguardian.com/society/2022/feb/03/us-coronavirus-healthcare-system-providers.
Nursing professionals are facing with severe sleep problems during the covid 19 pandemic time. Nurses were asked to work in an environment that had a more increased level of risk than ever before. Depression and anxiety from the workplace could affect the confidence of healthcare workers in themselves as well as general trust in the healthcare system. This will lead to their turnover intention which may undermine the efforts of the governments to control the COVID-19 pandemic. The rising concern may change the working schedules of healthcare workers, offering more occupational healthcare support.
Healthcare Mobile and Web App Development
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Halliday, J., & correspondent, J. H. N. of E. (2022, January 17). ‘Christmas was awful’: On the Omicron frontline at the Royal Preston hospital. The Guardian. https://www.theguardian.com/world/2022/jan/17/christmas-was-awful-on-the-omicron-frontline-at-the-royal-preston-hospital
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Up the line to death: Covid-19 has revealed a mortal betrayal of the world’s healthcare workers. (2021, January 29). The BMJ. https://blogs.bmj.com/bmj/2021/01/29/up-the-line-to-death-covid-19-has-revealed-a-mortal-betrayal-of-the-worlds-healthcare-workers/
Pathology insider describes unworkable conditions in SydPath PCR labs. (2022, January 10). ABC News. https://www.abc.net.au/news/2022-01-10/pathology-insider-describes-unworkable-conditions/100744536
Barry McAree 💙. (2022, January 6). Teachers on these islands will get FFP2(rightly so).Healthcare workers on other parts of these islands..nah!..Surgical masks/spit guards/not PPE,for working with COVID-positive patients risking other patient’s, our own & our family’s health.”Protect the NHS”🤔@CMO_England https://t.co/OngrD5BBPU [Tweet]. @BarryMcAree. https://twitter.com/BarryMcAree/status/1478883258305814536
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Shaun Lintern. (2021, December 30). Leeds Hospital to host one of the first “Nightingale hubs” based in a car park at St James’s Hospital. NHS wants space for up to 4k extra beds nationally...but who will staff these beds? Https://t.co/dzntJniPhq [Tweet]. @ShaunLintern. https://twitter.com/ShaunLintern/status/1476464984926339076
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shinydoc. (2021, December 12). I love how I, an actual GP...who was involved in the initial covid vaccination programme ...has to tune in at 8pm with the public to find out that apparently we are vaccinating the entire adult population with boosters by the end of the year [Tweet]. @irishayesha. https://twitter.com/irishayesha/status/1470123478221303810
Shaun Lintern. (2021, December 5). Just one of many msgs I’ve received today: Https://t.co/jgRqeZPuIe [Tweet]. @ShaunLintern. https://twitter.com/ShaunLintern/status/1467621369420697600
Progressive International. (2021, November 29). BREAKING: 2.5 million nurses from 28 countries have filed for a UN investigation of human rights violations by the EU, UK, Switzerland, Norway, and Singapore for blocking the waiver on Covid-19 vaccine patents as new strains proliferate: Http://covid19criminals.exposed https://t.co/Rj37RqDA4J [Tweet]. @ProgIntl. https://twitter.com/ProgIntl/status/1465202919687348227
gianluca c 🏴☠️🇻🇪 #TeamFauci #MaskUp #no GBD. (2021, November 29). Gauteng just updated 47 week and its shit https://t.co/yu5aLzwoJE [Tweet]. @gianlucac1. https://twitter.com/gianlucac1/status/1465300644336738308
Bundesverfassungsgericht: Bundesnotbremse war verfassungsgemäß. (2021, November 30). tagesschau.de. https://www.tagesschau.de/inland/bundesnotbremse-bundesverfassungsgericht-101.html
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Benjamin Veness. (2021, November 2). Singapore’s 🇸🇬 Senior Minister of State for Health, Dr Janil Puthucheary, told Parliament on 1 November: “I hope my explanation has helped members understand why although we say we are living with COVID-19, we cannot just open up, and risk having the number of cases shoot up.” [Tweet]. @venessb. https://twitter.com/venessb/status/1455396047765733376
ReconfigBehSci. (2021, November 2). interestingly the Singapore Health Minister also mentions “boosting through mild infections”—A concept that is currently generating much furore in the UK in the wake of the release of the JCVI minutes on child vaxx decisions 1/n [Tweet]. @SciBeh. https://twitter.com/SciBeh/status/1455445587910922240
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Unfortunately, some patients receive "surprise doctor bills" when treated at an in-network facility (e.g., hospital) but not all the physicians who practice at that facility participate in their health plan's network. If you need to go to the hospital for a procedure that's not an emergency, ask whether every provider is in your health plan's network.
A hospital might accept a specific insurance plan, but the doctor treating you might not. This means that patients have to do their due diligence in finding out if their physicians are in their net-work. This will avoid 'surprise doctor bills'.
Talk to your nurses. Studies routinely identify nursing as the profession most trusted by the public. People feel comfortable talking to nurses. Do not hesitate to ask nurses questions about your health or treatment plan. Nurses are patient advocates. They are adept at interpreting people's questions and responding using easily understood terms. Every day, nurses help patients, families and the community navigate the complex health system
Talk to your nurses!
Provide more opportunities for new talent. Because healthcare has been relatively solid and stagnant in what it does, we're losing out on some of the new talent that comes out — who are developing artificial intelligence, who are working at high-tech firms — and those firms can pay significantly higher than hospitals for those talents. We have to find a way to provide some opportunities for that and apply those technologies to make improvements in healthcare.
Intestesing. Mr. Roach thinks healthcare is not doing enough to attract new types of talent (AI and emerging tech) into healthcare. We seem to be losing this talent to the technology sector.
I would agree with this point. Why work for healthcare with all of its massive demands and HIPPA and lack of people knowing what you are even building. Instead, you can go into tech, have a better quality of life, get paid so much more, and have the possibility of exiting due to a buyout from the healthcare industry.
To advance healthcare reform and new/innovative population health initiatives, hospital leaders need to focus on aligning our interests with our patients. For too long, our fee-for-service reimbursement system has provided incentives for providers to develop services that generate revenue based on more utilization (caring for people who are sick), when our patients obviously would prefer less utilization (to be healthy). There will always be a role for hospitals to care for the sick and injured, but if we are going to truly bend the cost curve and be successful in the world of population health, we must find new ways to align our incentives with our patients' incentives, so that "improving the health of our community" is not only a clinical goal for providers, but a financial goal as well.
Dr. Kniffin says that the incentivies for healthcare do not align with those of the patients. The current payment structure incentivizes hospitals to have more tests and use more resources (caring for those that are sick). While patients would like less resources to be used and get back to being healthy. This is at odds with each other. So it would be best if we (healthcare) could realign with the patient's incentive of being healthy and use less resources.
Keep in mind potential for waste or unnecessary spending. I think patients are starting to pay closer attention to the necessity of care rendered now because as more patients have high-deductible insurance plans, how they spend their money becomes critically relevant to them.
A high-deductiable plan is an insurance which has a lower monthly payment at the cost of higher fees before the insurance covers the cost (deductible).
Dr. Bauer from Hackensack Meridian Health sees more patients having higher-deductible insurance plans. This results in patients scrutinizing costs and tests because they have to pay for those directly.
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Zeke Emanuel on Twitter: “Masks are off, theaters and indoor dining are back: Life seems to be returning to normal. But the highly transmissible Delta variant is spreading quickly, & we aren’t even halfway to a fully vaccinated population. It’s time for employer vaccine mandates. Https://t.co/34UArFfHN5” / Twitter. (n.d.). Retrieved August 1, 2021, from https://twitter.com/ZekeEmanuel/status/1418266496749428737?s=20
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If we had truly robust standards for electronic data interchange and less anxiety about privacy, these kinds of data could be moved around more freely in a structured format. Of course, there are regional exchanges where they do. The data could also be created in structured format to begin with.
This does exist. Fast Healthcare Interoperability Resources (FHIR; pronounced 'fire') is an open standard that describes data formats and elements (the 'resources' in the name), as well as an application programming interface (API) for exchanging electronic health records.
See more here: https://hl7.org/fhir/
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Sarah Kliff on Twitter: “Coronavirus vaccines are free—But 9 percent of Americans say they’re not getting one because they are worried about cost. I see this a lot in my reporting: Patients who don’t seek care because they’re become so accustomed to surprise bills that follow. Https://t.co/gu6oDnlvhB” / Twitter. (n.d.). Retrieved July 2, 2021, from https://twitter.com/sarahkliff/status/1395032095819542528?s=20
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the Guardian. “‘They Stormed the ICU and Beat the Doctor’: Health Workers under Attack,” June 7, 2021. http://www.theguardian.com/global-development/2021/jun/07/they-stormed-the-icu-and-beat-the-doctor-health-workers-under-attack.
We didn't have papers. On top of that, we're not from there. So we don't have papers. Not papers, but you know how you have to get the medical shots. We had to redo all of that stuff. So my mom got the shots, did all the immunization records and all that stuff.
Time in US - immigration status - being secretive - in the shadows - healthcare
When I was really young, I had gotten accident that required surgery and I needed to get that surgery done, so when I went to the hospital and get it done there was actually a couple of people from a criminal organization that were supposed to, I guess, kill somebody in there. I remember this like it was yesterday. I had a little breathing mask on and the doctor was telling me to breathe when he counted the eight, I could just hear the gunshots.
before the US - family, healthcare
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Within three to six months. It didn't take that long … immediately kind of. I think one of my uncles took it upon himself to take care of us, and since my mom … my mom at the time, we did not know she had a tumor in the back of her brain. Right where her brain stem is, she had a huge tumor there and we had no idea. Nobody knew. She doesn't remember a lot of this. I don't know if it's because of the emotional trauma or because of the tumor, but once we got to Chicago, it was evident that something was wrong with my mother and she started going to the doctor.
Homelife - family taking care of each other Mother and need for medical intervention
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