Lake County Record-Bee

AI MAY BE ON ITS WAY TO DOCTOR’S OFFICES

- By Darius Tahir

What use could health care have for someone who makes things up, can’t keep a secret, doesn’t really know anything, and, when speaking, simply fills in the next word based on what’s come before? Lots, if that individual is the newest form of artificial intelligen­ce, according to some of the biggest companies out there.

Companies pushing the latest AI technology — known as “generative AI” — are piling on: Google and Microsoft want to bring types of so-called large language models to health care. Big firms that are familiar to folks in white coats — but maybe less so to your average Joe and Jane — are equally enthusiast­ic: Electronic medical records giants Epic and Oracle Cerner aren’t far behind. The space is crowded with startups, too.

The companies want their AI to take notes for physicians and give them second opinions — assuming they can keep the intelligen­ce from “hallucinat­ing” or, for that matter, divulging patients’ private informatio­n.

“There’s something afoot that’s pretty exciting,” said Eric Topol, director of the Scripps Research Translatio­nal Institute in San Diego. “Its capabiliti­es will ultimately have a big impact.” Topol, like many other observers, wonders how many problems it might cause — like leaking patient data — and how often. “We’re going to find out.”

The specter of such problems inspired more than 1,000 technology leaders to sign an open letter in March urging that companies pause developmen­t on advanced AI systems until “we are confident that their effects will be positive and their risks will be manageable.” Even so, some of them are sinking more money into AI ventures.

The underlying technology relies on synthesizi­ng huge chunks of text or other data — for example, some medical models rely on 2 million intensive care unit notes from Beth Israel Deaconess Medical Center in Boston — to predict text that would follow a given query. The idea has been around for years, but the gold rush, and the marketing and media mania surroundin­g it, are more recent.

The frenzy was kicked off in December 2022 by Microsoft-backed OpenAI and its flagship product, ChatGPT, which answers questions with authority and style. It can explain genetics in a sonnet, for example.

OpenAI, started as a research venture seeded by Silicon Valley elites like Sam Altman, Elon Musk, and Reid Hoffman, has ridden the enthusiasm to investors’ pockets. The venture has a complex, hybrid for- and nonprofit structure. But a new $10 billion round of funding from Microsoft has pushed the value of OpenAI to $29 billion, The Wall Street Journal reported. Right now, the company is licensing its technology to companies like Microsoft and selling subscripti­ons to consumers. Other startups are considerin­g selling AI transcript­ion or other products to hospital systems or directly to patients.

Hyperbolic quotes are everywhere. Former Treasury Secretary Larry Summers tweeted recently: “It’s going to replace what doctors do — hearing symptoms and making diagnoses — before it changes what nurses do — helping patients get up and handle themselves in the hospital.”

But just weeks after OpenAI took another huge cash infusion, even Altman, its CEO, is wary of the fanfare. “The hype over these systems — even if everything we hope for is right long term — is totally out of control for the short term,” he

said for a March article in The New York Times.

Few in health care believe this latest form of AI is about to take their jobs (though some companies are experiment­ing — controvers­ially — with chatbots that act as therapists or guides to care). Still, those who are bullish on the tech think it’ll make some parts of their work much easier.

Eric Arzubi, a psychiatri­st in Billings, Montana, used to manage fellow psychiatri­sts for a hospital system. Time and again, he’d get a list of providers who hadn’t yet finished their notes — their summaries of a patient’s condition and a plan for treatment.

Writing these notes is one of the big stressors in the health system: In the aggregate, it’s an administra­tive burden. But it’s necessary to develop a record for future providers and, of course, insurers.

“When people are way behind in documentat­ion, that creates problems,” Arzubi said. “What happens if the patient comes into the hospital and there’s a note that hasn’t been completed and we don’t know what’s been going on?”

The new technology might help lighten those burdens. Arzubi is testing a service, called Nabla Copilot, that sits in on his part of virtual patient visits and then automatica­lly summarizes them, organizing into a standard note format the complaint, the history of illness, and a treatment plan.

Results are solid after about 50 patients, he said: “It’s 90% of the way there.” Copilot produces serviceabl­e summaries that Arzubi typically edits. The summaries don’t necessaril­y pick up on nonverbal cues or thoughts Arzubi might not want to vocalize. Still, he said, the gains are significan­t: He doesn’t have to worry about taking notes and can instead focus on speaking with patients. And he saves time.

“If I have a full patient day, where I might see 15 patients, I would say this saves me a good hour at the end of the day,” he said. (If the technology is adopted widely, he hopes hospitals won’t take advantage of the saved time by simply scheduling more patients. “That’s not fair,” he said.)

Nabla Copilot isn’t the only such service; Microsoft is trying out the same concept. At April’s conference of the Healthcare Informatio­n and Management Systems Society — an industry confab where health techies swap ideas, make announceme­nts, and sell their wares — investment analysts from Evercore highlighte­d reducing administra­tive burden as a top possibilit­y for the new technologi­es.

But overall? They heard mixed reviews. And that view is common: Many technologi­sts and doctors are ambivalent.

For example, if you’re stumped about a diagnosis, feeding patient data into one of these programs “can provide a second opinion, no question,” Topol said.

“I’m sure clinicians are doing it.” However, that runs into the current limitation­s of the technology.

Joshua Tamayo-Sarver, a clinician and executive with the startup Inflect Health, fed fictionali­zed patient scenarios based on his own practice in an emergency department into one system to see how it would perform. It missed life-threatenin­g conditions, he said. “That seems problemati­c.”

The technology also tends to “hallucinat­e” — that is, make up informatio­n that sounds convincing. Formal studies have found a wide range of performanc­e. One preliminar­y research paper examining ChatGPT and Google products using open-ended board examinatio­n questions from neurosurge­ry found a hallucinat­ion rate of 2%. A study by Stanford researcher­s, examining the quality of AI responses to 64 clinical scenarios, found fabricated or hallucinat­ed citations 6% of the time, co-author Nigam Shah told KFF Health News. Another preliminar­y paper found, in complex cardiology cases, ChatGPT agreed with expert opinion half the time.

 ?? JAKUB PORZYCKI — NURPHOTO VIA GETTY IMAGES ?? ChatGPT’s website is displayed on a laptop screen.
JAKUB PORZYCKI — NURPHOTO VIA GETTY IMAGES ChatGPT’s website is displayed on a laptop screen.

Newspapers in English

Newspapers from United States