25 Ways Generative AI Will Change Healthcare

I find this interesting, especially #6,7 & 9. Could something like this, generate specific treatment plans for chronic pain pt who have had their pain meds decreased or cut and BP increases and 4 or 5 different BP meds and their BP doesn’t change.  Would the AI be smart enough, to realize the cause & effect of increased BP and the reduction of pain management and recommend that pain meds be restarted and recommend increased pain meds dose if the BP goes down some, but not down to expected BP range.

For those of you who watch the TV show Chicago Med,  what they call OR 2.0 seems to have wall to wall large video screens and cameras and a AI interactive voice that monitors just about everything that goes on… including comparing the surgeon’s activity/movement as compare to their previous surgeries and have called out a surgeon that was not up to his “normal movement/proficiencies.

Of course, these AI program can be designed with biases, like prohibited from recommending the implementation or increasing opioids or control meds.

25 Ways Generative AI Will Change Healthcare

https://shulkinblog.com/f/twenty-ways-generative-ai-will-change-healthcare

It seems Generative AI (GA) is all that everyone is talking about.  Some futurists are predicting major changes to the way we live our lives and others even suggest that we are facing an existential risk to mankind. The truth is that we are clearly in unchartered territory and none of us really know where this is going to lead.

There is no doubt that GA will be disruptive to healthcare’s status quo.  As GA grows in sophistication, it will change or even eliminate many traditional healthcare roles. GA will also raise new concerns about ownership and privacy of patient data.  And no doubt there will be other unintended consequences that arise from this technology.  But the potential for improving care and outcomes is probably the most exciting to think about.

Rather than looking too far into my crystal  ball, I’ve chosen to look at the most likely places we will see5 the impact of GA in healthcare. GA is already being used in a number of the areas that I have listed below.  Where possible, I’ve identified companies that are already demonstrating results from their work.

1. Medical Imaging and Pathology –  Generative AI will help will soon become standard of care in radiology and pathology to ensure more accurate diagnosis, improve the efficiency of processing and reading studies, and address workforce shortages. (Ibex is a company using AI to improve diagnostic accuracy in pathology readings)2.

2. Patient Empowerment and Navigation- GA will dramatically improve the ability of patients to get information about their health and treatment options.  This will fundamentally change the nature of the patient-provider relationship  GA will enable chatbots to create personalized medical advise and assistance for patients and enable more efficient navigation of the health system.(Galileo is allowing patients to connect with the right healthcare solution)

3.  Remote Patient Monitoring-  GA will increasingly be used to alert medical professionals to trends seen in vital signs, physiologic and patient reported data that can predict patient risk.  It will also allow monitoring to become more autonomous independent of healthcare professionals. (Cadence is providing remote monitoring solutions and data analysis for several conditions like congestive heart failure and Kaia is providing analysis of data from musculoskeletal conditions)

4.  Improved Diagnosis- GA will be used to analyze patient data (electronic patient records, laboratory test results, radiographic images, genomic data) to improve diagnostic accuracy.(Google Health/Deep Mind and Babylon Health are using machine learning to better match symptoms with diagnoses).

5.  Drug Discovery- GA will help identify new drug candidates faster and cheaper than current methods (Saama is a company that is ingesting data and GA to dramatically improve the time required for drug discovering)

6.  Personalized Treatment Plans-   GA will generate specific treatment plans for patients based on medical history,  lab data, and genetic makeup.

7. Reduce Drug Adverse Events-  GA will be used to identify side effects and pharmacogenomic difference for patients taking multiple medications, OTC products, dietary supplements, and foods.

8. Fraud, Waste, and Abuse-  GA will help detect fraud and inappropriate utilization through pattern recognition and data identification.

9  Health Risk Assessments-   GA will be used to increasingly predict a patients risk of developing disease and help target preventative care and vaccine applicability.

10.  Access to Care-  GA will be used to help match supply and demand of healthcare services, address no-show rates,  and better predict resource utilization in order to ensure more efficient and timely scheduling of services. (Dexcare is a company using technology to address access)

11.  Reduced Documentation- GA will be able to create patient notes and complete other paperwork tasks that take time away from patient time with healthcare professionals.  This will improve efficiency,  the patient experience, and reduce professional burnout.

12. Virtual Assistants and Robotics- GA can create automated processes and robotic devices to speed workflow in clinical settings.  These virtual assistants and new robotic innovations will make medical practices more efficient and help in a variety of ways including logistics and supply chain management.  Robotic patient assistants will become commonplace in long term care and the home settings for assistive care services.

13.  Regulatory Compliance- GA will enable simulation techniques and synthetic data to test new pharmaceuticals, devices, and digital strategies to examine real world evidence, speed regulatory approvals, and to ensure adequate post-marketing surveillance.

14.  Pre-Authorization of Services-  GA can efficiently run data from patient reported data, physician records, and other clinical sources to ensure compliance with guidelines and give rapid authorization to high costs services and products.

15.  Medical Education and Simulation- GA be increasingly be used to train medical professionals,  assess competencies, and test new devices and procedures to improve safety ensure faster regulatory approval (Companies like Indegene and Edocate are  increasingly using interactive data and scientific information to provide interactive education)

16.  Medical Billing –  GA will help with revenue cycle management by improving the accuracy of billing, coding records, finding data from various clinical sources for accurate risk adjustments, and in ensuring accurate revenue capture. (Cedar is using data with behavioral economics to improve transparency and the billing experience).

17. Clinical Trial Design- GA can run various scenarios and use synthetic data to test and identify clinical trial designs with high precision for recruitment, data analysis,  and compliance with protocols.(Trinetx is a company that is using patient data to develop better clinical trials and drug discovery and MD Clone is creating synthetic data sets to better test innovation and new discoveries}

18.  Surgical Performance- using video capture of surgical procedures,  GA can identify unnecessary variations in surgical performance,  identify preventable postoperative complications and improve surgical operating times by predicting surgical resource needs. (Theator is implementing surgical learning systems to improve operative performance)

19.  Improving Outcomes in Behavioral Health – With natural language processing, GA can analyze behavioral health sessions to identify more effective treatment interventions (Eleos uses NPL and AI to identify value based behavioral healthcare and reduce inefficient care)..

20.  Reducing Disparities and Addressing Disabilities- GA will not only help identify where disparities in care exist through data analysis but it will also create solutions.  Through targeted outreach,  educational and behavioral strategies that are targeted to specific needs of communities, more effective health interventions can be implemented.  (Companies like CareJourney and Datavant are using data from a variety of sources to identify opportunities for improvement and Voiceitt is using AI to facilitate better communication for those with severe speech disorders).

21. Reducing Gaps in Care-  When it comes to chronic illness management,  GA can more easily use data and algorhythms to identify gaps in care that often result in poorer outcomes for patients.

22. Early Intervention-  GA can use unstructured data and image analyses to identify patients a risk that would benefit from early intervention.  We are already seeing this with kidney disease, sepsis, early stroke identification, and even suicide prevention.  (AIdoc is using GA to identify early intervention for patients with stoke and a number of other conditions)

23. Improving Point of Care Testing –  GA will allow the smartphone to become an even more useful tool for diagnostic evaluations.  With improved molecular testing and lateral flow analyses,  GA will allow more sophisticated testing to be run in the home setting.  (Ixlayer offers an enterprise system for managing data for point of care testing and TytoCare brings the ability to test right in the home).

24.. Reducing the Cost of Care- GA can help develop tools to identify “low value” care.  GA will help already existing technology getter better at identifying care that is not appropriate or effective and channel resources into areas where effective care can best targeted.

25. Reducing Medical Errors- Using predictive modeling, GA can help identify before they occur and create early warning systems to alert healthcare professionals and patients (or caregivers) of high risk situations.(Sparta Science is a company using predictive data to identifying patients at risk for falls and in speeding rehabilitation).

Whistleblower: Nurse testifies how during COVID-19 – a lot of VERY BAD MEDICINE provided

Did the some million USA citizens really need to die from COVID-19 ?

This the second video that has come my way of nurses testifying of the “wrong medicine” that was provided during the early COVID-19 to pts in hospitals. The above hyperlink is a nurse testifying before some politicians/bureaucrats in Florida.  The above video seems to be in front of a Federal Senate Committee.

Federal Judge Dismisses Patient Death Charges in Opioid Trial of Dr. Thomas Sachy

Federal Judge Dismisses Patient Death Charges in Opioid Trial of Dr. Thomas Sachy

Macon Physician Dr. Thomas Sachy Secures Dismissal of Charges that he Caused the Death of Two Pain Patients

https://ronaldwchapman.com/blog/sachy-dismissal

Dr. Thomas Sachy, a neuropsychiatrist who worked near Macon Georgia, was indicted in 2018 for operating a “pill mill” and causing the deaths of two patients. Both charges carry a mandatory minimum sentence of 20 years in prison – each. After a hard fought victory, Dr. Sachy will walk out of the federal courthouse in Columbus, GA a free man on May 11, 2023 after a five year battle with the federal government and DEA.

His attorneys, Ronald W. Chapman II and Meggan Sullivan are grateful that they could secure freedom for yet another physician targeted by the DEA.

The once well respected neuropsychiatrist was an expert forensic psychiatrist in many high-profile Georgia murder cases, physician board reviewer for the Georgia Board of Medicine and guest speaker for the Georgia Bar.

But in 2016 the DEA received an anonymous tip from a patient’s sister that spawned a DEA investigation. The investigation would land Dr. Thomas Sachy in the crosshairs of the federal government and a five year legal battle for causing the death of two patients and over-prescribing opioids to a Bibb County Deputy Sheriff.

Dr. Sachy Indicted and Jailed for Unlawful Distribution

In 2018, agents from the DEA burst through the door of the neuropsychiatrist’s practice and, as one patient would describe, held patients and staff at gunpoint. Dr. Sachy, the prominent Georgia Physician was arrested along with his 80 year old mother, his wife, and a nurse that worked at the practice.

After an undercover patient visit was unsuccessful in securing a prescription for opioid pain medication, the DEA pivoted and alleged that Dr. Sachy caused the death of two patients. Both patients suffered from significant heart issues.

Dr. Sachy was jailed for nearly three years after his arrest and was only able to secure his release after the landmark Supreme Court decision in Ruan v. United States which clarified the standard for when a physician could be convicted of unlawful distribution.

Under the new standard, Dr. Sachy proceeded to trial in the Middle District of Georgia in May of 2023.

The Trial of Dr. Sachy

The Government opened its case with the testimony of family members of the deceased who provided emotional testimony about their loved ones and their use of opioids. Federal prosecutors, however, ran into problems during the technical aspects of their case.

First, an expert anesthesiologist for the Government, Dr. Barry Straus testified that the standard for drug trafficking for a physician is the same as the standard applied by the Georgia Board.

During his thorough cross examination by Ronald W. Chapman II he attempted to convince the jury that any physician prescribing over 200 morphine milligrams per day of opiates that is not board certified in pain should be prosecuted. No such standard is found anywhere in the law or regulations surrounding opioid prescribing.

Defense Secures Exclusion of Expert Forensic Toxicologist Stacy Hail

The Government then attempted to establish that the opioids prescribed by Dr. Sachy caused the death of two patients – an effort that would later fail resulting in dismissal of the two death charges.

The dismissal came immediately after the testimony of Forensic Toxicologist Stacy Hail was excluded from trial. Dr. Hail began her testimony on the morning of May 9th armed with a whiteboard and marker, engaged in a preformative display in front of the jury where she described how opioids can cause death. Her testimony was abruptly halted by an objection from Ronald W. Chapman II after she testified that medication bottles was found near the body of one of the deceased patients. This was untrue and prosecutors would later admit that the error was due to Stacy Hail mixing up one of her many other assignments as an expert toxicologist.

The objection spawned defense arguments before District Judge Clay Land ultimately resulting in the exclusion of testimony from the medical examiner who conducted the “limited autopsy”. The defense objected to the introduction of toxicology reports that lacked a foundation laid by the lab tech preparing the report. Prosecutors admitted that prior to trial they had not secured the testimony of the lab tech and did not intend to call the person who tested the sample during their case – a violation of Dr. Sachy’s sixth amendment right to confrontation.

Late in the afternoon, its case dismantled by the exclusion of two important witnesses, the prosecution rose to admit that it lacked the basic foundational toxicology evidence needed to move forward with the charges.

The Government rested its case shortly after.

On May 9, 2023, seven days into the trial that was expected to last nearly a month, Judge Clay Land of the Middle District of Georgia dismissed two charges of the indictment which alleged that Dr. Sachy distributed controlled substances causing the death of two patients.

The Defense Calls Patients of Dr. Sachy Who Suffered from Debilitating Pain

Still remaining were charges that Dr. Sachy ran a drug involved premises, engaged in a conspiracy to unlawfully distribute, and unlawfully prescribed to three specific patients.

The next day the defense called 10 witnesses including former patients of Dr. Sachy who described their debilitating ailments, family members of deceased patients, an addictionologist who evaluated pain patients for Dr. Sachy. The defense began to erase a picture created by Federal Prosecutors that tolerance equates to addiction and that aberrant behaviors require dismissal. The brother of a patient who later committed suicide due to untreated pain provided emotionally charged testimony. The patient was abruptly refused pain medication following the arrest and indictment of two of his physicians. The witness described Dr. Sachy as his brother’s savior and told the jury that Dr. Sachy gave him some semblance of his life back.

Two other patients, a husband and wife, both testified after allegations by the Government’s expert Dr. Barry Straus, that it was inappropriate to see patients residing in the same household. The husband and wife duo testified that they both had severe pain, one suffering from fibromyalgia and another suffering from pain as a result of an accident that required him to be cut out of his car by EMS. Meggan Sullivan lead the examinations and walked the jury through the debilitating pain that Dr. Sachy’s patients suffered from.

Prosecutors Agree to Dismiss the Remaining Charges of Drug Conspiracy, Unlawful Drug Distribution, and Money Laundering

At the end of the first day of the Defense case that was expected to last three days and culminate in the testimony of Dr. Sachy’s expert witness Dr. James Murphy, the Federal Prosecutors approached Dr. Sachy with a resolution. The resolution would result in the dismissal of all charges in the indictment related to opioid distribution, no jail time, and the return of $1.2 million in assets seized by the Federal Government.

As a result of the agreement, Dr. Sachy walked out of the Federal Courthouse in Columbus Georgia a free man.

The result was secured by significant efforts from Dr. Sachy’s investigators CCG Healthcare, his attorneys Ronald W. Chapman and Meggan Sullivan and the hard working staff at Chapman Law Group.

Ronald W. Chapman II is a federal defense attorney, author of “Unraveling Federal Criminal Investigations” , and frequent TV news commentator who regularly defends physicians facing allegations of unlawful distribution. He is also the president of CCG Healthcare a healthcare consulting firm devoted to aiding physicians and health care practices with compliance to avoid career ending federal investigations and charges related to health care fraud and opioid distribution.

PAIN AND THE RULE OF LAW

PAIN AND THE RULES OF LAW

DR. HARVEY JENKINS MD HERO FORCE TO PLEA NO PRISON TIME GIVEN…THE STORY OF JUDICIAL ABUSE

WHY HARVEY JENKINS MD., CRIMINAL CASE MUST BE DISMISSED: PETER “THE GREAT PETE,” PISCHKE, THE HAPPY WARRIOR PODCAST: OKLAHOMA PAIN PATIENTS FIGHT BACK TO LAW CHANGE

FREE DR. HOWARD ADELGLASS MD

WHY HOWARD ADELGLASS, MD., IS INNOCENT!!!!! HE’S BEING TRIED BECAUSE HE IS A JEW!!!!! RUAN STANDARDS APPLY!! LECTURE BY JENNIFER OLIVA JD, EXPOSES INJUSTICE

SENATOR RAPHAEL WARNOCK WE NEED SENATE HEARING DEA’S ABUSES OF OUR VETERANS PRONTO !!! NOW!!!!!

TO SENATOR RAPHAEL WARNOCK: DEA’s (A-I) MISBRANDED SOFTWARE PROGRAM UNDERMINES HEALTHCARE OF OUR VETERAN BY CAUSING INCREASE SUICIDE: THERE MUST BE SENATE HEARINGS TO HOLD DEA ACCOUNTABLE!!!!!

SENATOR WARNOCK WE NEED COPS OUT MEDICINE MOVE CONTROL REGISTRATION TO US SURGEON GENERAL

DEAR SENATOR RAPHAEL WARNOCK: DEA’s (A-I) PRESCRIPTION DRUG MONITORING PROGRAMS NARXCARE SOFTWARE TO BE MISBRANDED, CAUSING DEATH: “A MAJOR CONTRIBUTING FACTOR,” IN MAY 3RD ATLANTA’s VA MASS SHOOTINGS!!!

The Government does not agree with treating pain with OPIATES

May be an image of ticket stub, poster and text

Drugs Like Adderall, Xanax Can Be Prescribed Online Into 2024, US Says

Just a few days ago I made this post below, and now the DEA relaxed the rules on prescribing Adderall via tele-video office visits.  I don’t remember seeing that episode on the TWLIGHT ZONE. 

The U.S. is seven months into a shortage of Adderall, a medication for attention-deficit/hyperactivity disorder

https://www.msn.com/en-us/news/technology/drugs-like-adderall-xanax-can-be-prescribed-online-into-2024-us-says/ar-AA1aWRW1

(Bloomberg) — Controlled substances like Adderall will be allowed to be prescribed online into late 2024, US health and drug officials said, reversing their earlier position that restrictions on the drugs would be reinstated as the pandemic eased.  

Health-care providers can prescribe controlled substances online through Nov. 11, according an advance copy of a rule posted online Tuesday. In addition, practitioners who establish relationships with patients on or prior to that date can continue to prescribe controlled substances for an additional year.

The Drug Enforcement Administration, which regulates medications with potential for abuse, had planned on curtailing access to the drugs through telehealth. Remote prescribing was made more available at the start of the Covid-19 pandemic as a result of lockdowns that made doctors’ offices visits less accessible. But after significant pushback, the agency changed its mind and decided to keep the existing, relaxed policies in place for now.

“We recognize the importance of telemedicine in providing Americans with access to needed medications, and we have decided to extend the current flexibilities for six months while we work to find a way forward to give Americans that access with appropriate safeguards,” DEA Administrator Anne Milgram said in a statement. The rule was issued jointly with the Health and Human Services Department.  

Prior to the pandemic, controlled substances could only be prescribed online for patients who had previously gone to an in-person appointment with the same provider. The DEA waived that requirement as the pandemic shuttered doctors’ offices and clinic, making it easier for people with anxiety, attention-deficit/hyperactivity disorder and opioid use disorder to get medications that previously required many time-consuming, in-person appointments.

Relaxed regulations also led to the development of online companies that connected patients with providers to get these prescriptions. Some businesses have come under scrutiny by the federal government over their prescribing practices.

Easier Access

Easier access to controlled substances was seen as a temporary pandemic measure. But some medical and business organizations said the policy change made it easier to take care of patients and therefore should become the new status quo.

The American Psychological Association and the American Telemedicine Association think the current flexibilities should become permanent, representatives said after the DEA rule was released Tuesday. 

“We’re hopeful there will be no imposition of inflexible, blanket, in-person requirements,” said Kyle Zebley, senior vice president of public policy at the ATA, said in an interview. 

The American Medical Association commended the DEA’s extension without commenting on whether it should become permanent. Bobby Mukkamala, chair of the AMA’s substance use and pain care task force, said in a statement that telehealth prescribing of controlled substances is helpful because it makes it easier for patients to secure and attend appointments.

Earlier this year, the DEA proposed removing many of these flexibilities and gave the public 30 days to provide feedback. Advocacy groups pushed back, saying they feared that the February proposal was rushed and did not give telemedicine companies enough time to prepare and comply to new regulations.

The Biden administration received more than 38,000 comments on the proposed rules, according to a document to be published in the Federal Register.

Too Short

Complying with the agency’s six-week window to return to pre-pandemic restrictions would have been untenable for providers, Zebley said in an interview earlier this month. 

“We thought that 30 days was way too short of a comment period window to draft rules responsibly,“ Zebley said.

The short timeline may have played a part in the DEA’s decision to postpone new restrictions on prescribing, said Mimi Winsberg, cofounder at Brightside Health, an online therapy company.

“I think the DEA had no choice but to extend this ruling because they didn’t have time to process the over 38,000 comments they received on it,” Winsberg said in an interview. “They knew it wasn’t feasible.”