"e-Patient Dave" - Patient Empowerment evangelist. #PatientsUseAI. No pitches please.
This is DISGUSTING and is a perfect example of why "Medicare Advantage" (aka "Not actually Medicare, folks") is a stupid choice for nearly any American senior. ACTUAL MEDICARE NEVER DOES §hit like this. "Medicare Advantage" means you DECLINE actual Medicare AND REDIRECT THE MONEY INSTEAD TO AN ORDINARY INSURANCE COMPANY. Which can do THIS stuff to you, because you're not actually on Medicare - you said no thanks, I'll stick with this crap.
Catalyst, Entrepreneur, 2X Founder, Board of Directors Member, Consultant, Advocate, Health Data Governance, Health IT Policy, Patient Mobilization, Genomics, Trust Frameworks and AI
STAT News ran a MUST READ story recently that highlights the potential peril of poorly designed AI in health care and illustrates my greatest fear about the costs to health and life that can result from poorly designed algorithms. The article provides accounts from former employees of NaviHealth, an AI company purchased by UnitedHealth Group/Optum, who cite cases where the NaviHealth algorithm determined that Medicare recipients needed to be discharged, despite the fact clear evidence of their need for continued care. When employees attempted to approve the care based on patient need, NaviHealth executives intervened, insisting the AI’s decision be followed. Algorithms aimed at maximizing savings (profits) will put cost savings ahead of patient needs, despite clear clinical evidence that the patient needs additional or different care. If the algorithm is trained with data representing the “average” amount of days needed to recover from any single clinical event/condition, it’s likely to recommend care that’s inappropriate for complex patients. Each patient is unique. Their care needs to be based on their needs, not the “average” needs derived from studies of large populations of people. Each patient’s care MUST be based on that patient’s clinical and personal circumstances. Anything less than that is unethical. It’s not impossible to incorporate this kind of complexity into AI, but doing so will require a much more sophisticated approach by those who develop and deploy AI. AI has the potential to improve care while reducing costs. But for that type of AI to emerge, AI developers must focus on designing algorithms to serve the patient first. The best way to ensure this happens is by including patients, caregivers and clinicians in developing the algorithms, determining the inputs – data and assumptions – and choosing the objectives of the outputs – patient care then cost savings, not just cost savings justified by data that provides an “average” derived from large populations of patients. The Office of the National Coordinator for Health Information Technology (ONC) of the National Coordinator for Health IT (ONC) is currently developing guidelines for incorporating AI tools, known as “decision support interventions” (DSI) into the clinical setting through certified Health IT. Through my work as a member of the Health IT Advisory Committee (HITAC), along with other safeguards, I worked with other committee members to ensure HITAC recommend that ONC require developers to include patients in the development of any DSI that will connect with clinically used health IT. This is an essential but not sufficient safeguard. We must find a way to ensure that the emergence of AI in healthcare works FOR patients not against them. Kudos to STAT and reporters Casey Ross and Bob Herman for this excellent article! #AI #artificialintelligence #healthtechnology #HITAC #patients Dave deBronkart Grace Cordovano, PhD, BCPA Donna Cryer Jane Sarasohn-Kahn
I can’t read the STAT+ article due to paywall. But MA plans are a great option for many people.
Senior Vice President, Innovation and External Affairs at MyDirectives
1yThe worst, most dangerous coverage tool ever. My mom was denied coverage twice in spite of complete dependency in major ADL categories. The MD stood his ground, the SNF fought alongside us, and still they sent her home without being able to walk or transfer herself. It was appalling, we dropped her Med Advantage plan as soon as we could and I blame NaviHealth too for their unwillingness to hear her doctor, SNF appeals, and me advocating loudly for continued care.