ChatGPT Won’t Fix Healthcare, But It Might Save Doctors Some Time

Nicolas Ortega for forbes

Every week, Eli Gelfand, chief of general cardiology at Beth Israel Deaconess Medical Center in Boston, wastes a lot of time on letters he doesn’t want to write — all of them to insurers disputing his recommendations. A new drug for a heart failure patient. A CAT scan for a patient with chest pain. A new drug for a patient with stiff heart syndrome. “We’re talking about appeal letters for things that are life-saving,” says Gelfand, who is also an assistant professor at Harvard Medical School.

So when OpenAI’s ChatGPT began making headlines for generally coherent artificial intelligence-generated text, Gelfand saw an opportunity to save some time. He fed the bot some basic information about a diagnosis and the medications he’d prescribed (leaving out the patient’s name) and asked it to write an appeal letter with references to scientific papers.

ChatGPT gave him a viable letter — the first of many. And while the references may sometimes be wrong, Gelfand told Forbes the letters require “minimal editing.” Crucially, they have cut the time he spends writing them down to a minute on average. And they work.

Gelfand has used ChatGPT for some 30 appeal letters, most of which have been approved by insurers, he says. But he’s under no illusion that ChatGPT or the AI that powers it is going to save the U.S. healthcare system anytime soon. “It’s basically making my life a little easier and hopefully getting the patients the medications they need at a higher rate,” Gelfand says. “This is a workaround solution for a problem that shouldn’t really exist.”

That problem: The U.S. spends more money on healthcare administration than any other country. In 2019, around a quarter of the $3.8 trillion spent on healthcare went to administrative issues like the ones bemoaned by Gelfand. It’s estimated around $265 billion of that was “wasteful” — unnecessary expenditures necessitated by the antiquated technology that undergirds the U.S. healthcare system.

Gelfand can use a chatbot to electronically generate an appeal letter. But he has to fax it to the insurer. And that encapsulates the challenge facing companies hoping to build time-saving AI back-office tools for a healthcare system stuck in the 1960s.

Cut The “Scut”

The fax machine isn’t going away anytime soon, says Nate Gross, cofounder and chief strategy officer of Doximity, a San Francisco-based social networking platform used by two million doctors and other healthcare professionals in the U.S. That’s why Doximity’s new workflow tool, DocsGPT, a chatbot that helps doctors write a wide range of letters and certificates, is connected to its online faxing tool.

“Our design thesis is to make it as easy as possible for doctors to interface with the novel digital standards, but also be backwards compatible with all the old stuff that healthcare actually runs on,” says Gross.

Often referred to as a “LinkedIn For Doctors,” Doximity has a $6.3 billion market cap and generates most of its revenue ($344 million in its fiscal year 2022) from pharma companies looking to advertise and health systems looking to hire. But it also offers a range of tools for doctors to help “cut through the scut” – medical slang for reducing administrative burden. The basic versions are generally free with upsells for enterprise integrations, says Gross.

DocsGPT is built on ChatGPT but is trained on healthcare data, such as anonymized insurance appeals letters. Doctors can use the tool to draft letters, including patient referrals, insurance appeals, thank you notes to colleagues, post-surgery instructions and even death certificates. It provides a library of curated prompts based on what other doctors have searched for in the past, and is designed to remind doctors who use it that it is not a medical professional.

Before each response DocsGPT generates, a disclaimer runs across the top, asking the user to “PLEASE EDIT FOR ACCURACY BEFORE SENDING.” In an earnings call earlier this month, cofounder and CEO Jeff Tangney was asked how Doximity planned to monetize DocsGPT. “I’ll make a joke here,” he replied. “We probably spent more time worrying about the liability of that product than the monetization of it so far.”

Bot-To-Bot

While DocsGPT might save some time for the doctor, the subsequent back and forth with insurance companies over fax and phone means it can still take days to verify a patient’s insurance benefits or get a prior authorization for a surgery approved. Currently, a person in a doctor’s office or hospital staring at a screen needs to call a person at an insurance company who is also staring at a screen to manually sort through the specific details of each patient’s insurance benefits.

That eats up a lot of time for both insurers and doctors, and a shortage of workers isn’t helping, “It’s not just about it being slow, it’s stuff is not getting done,” says Ankit Jain, cofounder and CEO of conversational AI startup Infinitus Systems. “There was [an insurer] we were talking to who had 32 trailers of faxes that they’re backlogged on.”

With Infinitus, which raised more than $50 million since he cofounded it in 2019, Jain is trying to build a future where instead of people endlessly discussing benefits and approvals, bots do the talking for them.

“When a doctor makes stuff up, that’s called lying. When a model makes stuff up, we use this odd phrase called hallucination.”

Jain, a former Googler and cofounder of the tech giant’s AI-focused fund Gradient Ventures, says the problem is that every doctor, insurer and health system records information in different formats. Unlike long-suffering health industry employees, AI can very quickly make sense of it. Infinitus has built its own models and doesn’t rely on OpenAI’s technology, but Jain says the underlying premise is the same: “What large language models do is, they say, ‘Throw all that data at us.’ And the large language models can extract the right connections between phrases and concepts.”

So far, the conversation is one-sided: Infinitus used large language models to create Eva Lightyear, a robot that has made more than 1 million calls to insurance companies on behalf of doctors to verify insurance benefits and prior authorization requirements. One day, he hopes Eva won’t be calling a human on the other end of the phone, but another robot — though not literally.

“It’s not robots talking to robots in English or exchanging faxes with each other,” says Jain. “That becomes an API. The future needs to be digital highways, where you just submit information, it’s judged, it’s adjudicated, and you get a response instantaneously.”

Crawling Ahead

While Jain may be optimistic about end-to-end automation, when it comes to adoption, chatbots and other kinds of AI-powered technology are facing a serious hurdle: Models like ChatGPT spout falsities as if they were true and have to be constantly retrained with the most up-to-date information out there.

“When a doctor makes stuff up, that’s called lying. When a model makes stuff up, we use this odd phrase called hallucination,” says Nigam Shah, chief data scientist at Stanford Healthcare.

ChatGPT was only trained on data available until 2021, and isn’t regularly updated. The field of medicine is constantly changing, with new guidelines, drugs and devices coming on the market, which means outdated data would pose a problem. Shah says he doesn’t see the possibility for broad adoption of generative AI in healthcare until there are systems in place to regularly retrain the models on new information and detect when the answers are wrong.

“We have to figure out how to verify the veracity and truthfulness of the output,” he says. There is also the risk that a doctor, no matter how well-intentioned, enters protected health information into ChatGPT. While anonymization and encryption are two ways to protect patient data, these measures alone may not be enough, says Linda Malek, a partner at the law firm Moses Singer.

“Even if you try to de-identify the data that is stored in ChatGPT, the AI capabilities can re-identify information,” she says. “ChatGPT is a particular target for cyber criminals as well, because it can be utilized for ransomware and different types of cyber attacks.”

Potential dangers aside, generative AI’s achievements continue to wow users. In January, researchers found that ChatGPT could pass the US medical licensing exam with “moderate accuracy” without any special training. (It’s not alone in this – at least two other AI programs, Google’s Flan-PaLM and Chinese AI-powered bot Xiaoyi, have also passed national medical licensing exams.)

The motivation was to get ChatGPT to perform standardized tasks without being specifically trained on any healthcare datasets, says Morgan Cheatham, a vice president at Bessemer Venture Partners and medical student at Brown University, who co-authored the study, which was published in PLOS Digital Health. While Cheatham says the results suggest ChatGPT’s large language models “have inherent value in healthcare applications,” he says any path forward is going to require a “crawl, walk, run approach.”

For now, the hope is generative AI could help doctors bring their attention and time to the most important part of their jobs: their patients. “What got me excited about becoming a doctor was the face-to-face interaction in the exam room with another human being,” says David Canes, a urologist at Beth Israel Lahey Health and cofounder of patient education startup Wellprept. “What’s intruded now is thousands of mouse clicks and keyboard entries.”

Canes says he plans to use ChatGPT for “low-stakes communications,” and he looks forward to the day when he can spend less time dealing with never-ending bureaucracy.

“My days would be perfect if they were just filled with patient care. I love that as much now as I ever did,” he says. “I look at these improvements and it makes me really hopeful that we’re on the verge of maybe a new era where the worst aspects of medicine can be minimized.”

Correction: The research involving ChatGPT taking the U.S. medical licensing exam was published in PLOS Digital Health in February.

I’m a senior writer at Forbes covering healthcare technology. I was previously a healthcare reporter for POLITICO covering the European Union from Brussels and the New Jersey

Rashi Shrivastava

I am an assistant editor based in Columbia, Missouri covering consumer technology. I graduated from the Missouri School of Journalism with a master’s degree in magazine journalism

Source: ChatGPT Won’t Fix Healthcare, But It Might Save Doctors Some Time

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Reputor   https://jvz8.com/c/202927/380159/
ResilienceMoms   https://stressilience.systeme.io/4442a198?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
ReStory  https://jvz8.com/c/202927/391053/
Restrosuite   https://jvz3.com/c/202927/390810/
ReVideo  https://jvzoo.com/c/202927/381761
ReviewReel   https://jvz6.com/c/202927/382663/
Rewardsly  https://jvz1.com/c/202927/390109/
Rewriter   https://jvz4.com/c/202927/353373/
RotateTraffic   https://www.rotatefortraffic.com/?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
RSI SEO   https://jvz8.com/c/202927/388594/
Scriptdio   https://jvz4.com/c/202927/385387/
Self Validation   https://jvz6.com/c/202927/389174/
Sendiio   https://jvz3.com/c/202927/391876/
Seniors Income    https://jvz2.com/c/202927/383888/
Senuke  https://jvz6.com/c/202927/279944
SesitiveCreative   https://creative-edge-coaching.systeme.io/sensitivecreative?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
ShopABot   https://jvz2.com/c/202927/291955
ShopFunnels   https://jvz3.com/c/202927/384069/
ShortAI   https://jvz6.com/c/202927/392061/
SocialAgency360   https://jvz1.com/c/202927/385357/
SocialBossCoaching   https://sio.thejfranco.com/tpsb-coaching?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
SocialMediaMarketing   https://jvz2.com/c/202927/243553/
SociCake  https://jvz2.com/c/202927/321987
Socifeed   https://jvz6.com/c/202927/375706
SociJam  https://jvz2.com/c/202927/309649
SociLinks   https://jvz4.com/c/202927/391595/
Soronity  https://jvz6.com/c/202927/368736
SqribbleEbook   https://jvz6.com/c/202927/283867
Stackable Picture   https://jvz1.com/c/202927/385046/
Steven Alvey’s   https://jvz2.com/c/202927/351754
Stock Mages   https://jvz2.com/c/202927/388669/
Stoodaio   https://jvz6.com/c/202927/388794/
Storymate    https://jvz3.com/c/202927/320972
StoryReel   https://jvz3.com/c/202927/387813/
StreamPilot   https://jvz2.com/c/202927/385431/
Studioninja   https://jvz1.com/c/202927/374965
SuccessfulLife   https://aanjeku.systeme.io/practicalstepsforasuccessfulfast?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
Sunday Freebie  https://jvz1.com/c/202927/267113/
Super backdrop   https://jvz8.com/c/202927/376524
Survai    https://jvz8.com/c/202927/380933/
Syndranker    https://jvz3.com/c/202927/378143/
Systemeio     https://systeme.io/?sa=sa00386916227d755116a01578a5e00a942b8a2f2c
Talkingfaces   https://jvz3.com/c/202927/375550
The Internet Marketing   https://jvz2.com/c/202927/289944
Tonai Voice Content   https://jvz8.com/c/202927/383119/
Toon Video Maker    https://jvz2.com/c/202927/357201
TrafficForU   https://jvz3.com/c/202927/381950/
Trendio  https://jvz3.com/c/202927/381003/
TubePal   https://jvz6.com/c/202927/379863/
Tubeserp   https://jvz3.com/c/202927/370472
TubeTargeter  https://jvz6.com/c/202927/377211
TuneMingo    https://jvz3.com/c/202927/386556/
TV Boss Fire  https://jvz6.com/c/202927/379480/
Ultrafunnels A.I   https://jvz2.com/c/202927/381129/
VIADZ Ad Template  https://jvz4.com/c/202927/379307/
Vidcentric   https://jvz4.com/c/202927/376095
Viddeyo    https://jvz6.com/c/202927/382326/
ViddleInteract   https://jvz8.com/c/202927/388716/
Videevolve   https://jvz4.com/c/202927/381011/
Vidently   https://jvz1.com/c/202927/387798/
Video Campaignor      https://jvz4.com/c/202927/387058/
Video Games   https://jvz3.com/c/202927/184902/
VideoEnginePro     https://jvz2.com/c/202927/372916
VideoGameSuite    https://jvz3.com/c/202927/366537/
VideoRobot Enterprise   https://jvz8.com/c/202927/291061
Vidjack   https://jvz6.com/c/202927/364795/
VidKreate   https://jvz6.com/c/202927/386029/
VidMingo   https://jvz6.com/c/202927/378359/
VidRaffle   https://jvz2.com/c/202927/386840/
VidSnatcher    https://jvz3.com/c/202927/342585
VidVoicer    https://jvz1.com/c/202927/379983/
Vidzura   https://jvz4.com/c/202927/385754/
Viral dash   https://jvz6.com/c/202927/375959
Viral Quotes      https://jvz2.com/c/202927/386984/
VirtualReel   https://jvz8.com/c/202927/376849
Vocalic  https://jvz2.com/c/202927/383848/
VoiceBuddy    https://jvz1.com/c/202927/342854
Voiclet   https://jvz4.com/c/202927/388755/
VR Studio  https://jvz8.com/c/202927/388296/
WebCop  https://jvz4.com/c/202927/378683/
Webinarkit   https://jvz3.com/c/202927/383937/
Webprimo   https://jvz1.com/c/202927/379455/
WordPress Mastery   https://jvz1.com/c/202927/386249/
WowBackgraounds   https://jvz2.com/c/202927/381556/
WP GDPR    https://jvz8.com/c/202927/299907
WP Simulator    https://jvz3.com/c/202927/46987/
Writer Arc   https://jvz1.com/c/202927/386602/
writing job   https://jvz8.com/c/202927/213027
XBrain Forex   https://jvz3.com/c/202927/372305/
XFUNNELS   https://jvz2.com/c/202927/310335
Xinemax  https://jvz1.com/c/202927/381749/
YoDrive   https://jvz2.com/c/202927/384700/
YoSeller   https://jvz4.com/c/202927/387544/
Your 3DPal   https://jvz2.com/c/202927/381685/
YTSuite   https://jvzoo.com/c/202927/381179
Zappable   https://jvz6.com/c/202927/367328/

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