Things & Thinks-Issue LI

??Research Digest

Using AI for coverage decisions in US Healthcare

Health insurance companies cannot use algorithms or artificial intelligence to determine care or deny coverage to members on Medicare Advantage plans, the Centers for Medicare & Medicaid Services (CMS) clarified in a memo sent to all Medicare Advantage insurers . Here's a summary-

• Using internal coverage criteria only when Medicare criteria are not fully established and making them publicly accessible and based on current evidence and widely used treatment guidelines or clinical literature
• Following Traditional Medicare coverage criteria for inpatient admissions, including the "two-midnight rule" and the "interrupted stay" policy.
• Not denying or terminating post-acute care services based on algorithms or artificial intelligence alone, but considering the individual patient's circumstances and level of care requirements.
• Establishing a Utilization Management Committee to review and ensure consistency with Traditional Medicare policies and guidelines
• Using prior authorization appropriately to confirm medical necessity or clinical appropriateness, and providing a minimum 90-day transition period for new enrollees
• CMS enforcement and oversight: The memo also states that CMS will conduct both routine and focused program audits of MA plans in 2024 to assess compliance with the new rule, and may issue compliance and enforcement actions if needed

Challenges and future directions in federated learning for healthcare using micro-computing

This recent paper in Lancet Digital Health highlights a study by Soltan and colleagues that used federated learning, a technique that allows multiple sites to collaboratively train a model without sharing patient data, to improve COVID-19 prediction using routine blood tests and vital signs.

It highlights the difficulties of developing and deploying artificial intelligence (AI) models for health care, such as data availability, diversity, privacy, security, and computing power. Key learnings from my perspective-

• The study used a low-cost microcomputer, the Raspberry Pi, to implement the federated learning solution across four UK hospitals, enabling rapid and scalable deployment of AI models without requiring expensive hardware or technical expertise.
• It shows that federated learning has the potential to become a new standard-of-practice for privacy-preserving health data research, reducing barriers to participation and bias within training sets and enabling cross-border collaboration while upholding data sovereignty.
• It shows the potential benefits of federated learning and microcomputing for advancing health-care research and practice, especially for sites that lack data infrastructure or resources.
• The authors also noted some limitations including manual data harmonization, requiring prior knowledge of data format, thereby limiting scalability, Physical security concerns and Collaboration challenges due to Initial onboarding efforts as federated learning is new in healthcare.

??Digital Healthcare News

#GenAI and #BigTech in #Healthcare

China Medical University Hospital will collaborate with Google Cloud's to use its MedLM, a healthcare-specific gen AI based on the large language model, Med-PaLM 2.

During the Microsoft AI Tour event in Bengaluru, a select developer showcase was hosted by the company to give an overview of how developers in India are discovering opportunities in AI to solve real-world challenges.

Amazon will cut jobs across its healthcare units including One Medical and Amazon Pharmacy.

Cera, Europe’s largest provider of digital-first home healthcare, announced a new partnership with Google Cloud , that will ensure rapid insight discovery.

Community Health Systems , a 71-hospital health system, migrated its data systems onto a single Google Cloud data platform that will use the Fast Healthcare Interoperability Resources (FHIR) standards.

Pingoo.AI announced it has joined NVIDIA Inception, a program that nurtures startups revolutionizing industries with technological advancements.

Regulatory Brief

The U.S. Food and Drug Administration warned consumers against using smartwatches or smart rings that claim to measure blood glucose levels without piercing the skin, regardless of manufacturer or brand.

Pharma/Device Brief

Biofourmis confirmed four new agreements with Top-20 Pharma for Digital Clinical Trials and Digital Biomarkers focusing on oncology therapies.

Aptar will collaborate with Biogen to develop digital health solutions aimed at enhancing care for patients with neurological and rare diseases.

Funding, Deals, Mergers & acquisitions

Ambience Healthcare , a provider of software tools for hospitals and other healthcare organizations, raised $70M, backed by OpenAI.

Digital chronic condition management company DarioHealth is buying Twill to build out its mental health capabilities and boost revenue, $10M in cash plus stock valued at over $20M

Ezra , a company developing AI powered Full Body MRIs AI to make early detection for cancer and several other diseases, raised $21M.

Consumer Digital Health & Other News

Patients across the US have been unable to get their prescriptions filled as health tech company Change Healthcare responds to a cyberattack.

??Longread of the Month

This is a mix of Long-Listen/Longread- an excellent podcast by the Acquired team on Novo Nordisk Pharmatech A/S and #Ozempic

??Tweet of the Month

Not really a digital health tweet, but does work for us too!

??Chart of the Month

Liked this graph showing the differences between how US payers and providers differ in their approach to innovation

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