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Mobile healthcare. Hospital-at-home momentum grows.
AI Bot Docs, yea or nah? America’s nurses have PTSD
Supper Team
March 15, 2024
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Happy Friday. “Just press SEND!”
“Health is the greatest gift, contentment the greatest wealth, faithfulness the best relationship." - Lao Tzu
Part 1 of 2. In this week’s email:
Bot doctors? - 69% of patients are uncomfortable with AI diagnosing them
Mobile healthcare “Wheel” revolutionizing virtual care
Hospital-at-home momentum grows
America’s nurses have PTSD. Registered Nurse Tara Rynder’s story
Secondary Traumatic Stress Disorder (STS/VT)
The Dual Nature of AI Bot Docs: Good and Bad In the world of artificial intelligence, the creation of AI bot doctors, known as AI Bot Docs, has led to an interesting discussion about their positive and negative aspects. On one side, there are worries about the negative issues like bias and stereotypes. On the other side, there's excitement about how AI can change healthcare for the better.
The Negative Side: Bias and Stereotypes Studies have found that some AI chatbots, even after being trained to be fair, still show bias. For example, when asked about texts written in African American English, AI chatbots like GPT-4 and GPT-3.5 sometimes give negative answers, like suggesting the writers are aggressive or ignorant. This bias shows a problem with the AI models and raises concerns about whether AI healthcare systems are fair to everyone.
The Positive Side: Changing Healthcare Despite the challenges, AI has the potential to improve healthcare. AI bot doctors can provide personalized care, be available all the time, and use data to give accurate diagnoses and treatments. For example, AI bots can schedule appointments, greet people in a personal way, and even understand how someone is feeling during a conversation. These abilities make healthcare better for patients and make the healthcare system more efficient.
Building Trust and Reducing Bias To make sure AI is used well in healthcare, it's important to deal with bias and stereotypes. This means constantly training and checking AI models to make sure they understand different kinds of people. It also means building trust between people and AI. This can be done by being open about how AI makes decisions, involving people in important healthcare decisions, and using AI as a helper, not a replacement, for human doctors.
AI bot doctors show us both the good and bad sides of technology. While they have the potential to greatly improve healthcare, we need to make sure they are used fairly and ethically. As we continue to develop AI in healthcare, we must balance the excitement of new possibilities with the responsibility to make sure everyone is treated fairly and inclusively.
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In the rapidly evolving healthcare landscape, Wheel emerges as a trailblazer in the virtual care sector, leveraging technology to address the growing consumer demand for convenient, personalized, and comprehensive healthcare services. With its next-generation virtual care platform, Wheel is at the forefront of the consumer-centric care movement, empowering organizations to deliver seamless care experiences that cater to the evolving needs of today's healthcare consumers.
Wheel's platform is designed to support the shift towards consumerization of care, where healthcare experiences are tailored to meet individual needs and preferences. The platform's configurable virtual care programs, seamless consumer experience, and nationwide clinician network are key components that enable organizations to deliver high-quality virtual care at scale. This approach has allowed Wheel to power large enterprises and Fortune 50 companies in retail, health plan, and pharmaceutical and life science industries, including as a third-party provider for Amazon Clinic.
Wheel's platform stands out for its patented smart routing and marketplace technology, which matches consumers with the right clinicians based on their comfort and preferences for care delivery. This technology supports 24/7 virtual visits across all 50 states, ensuring that clinicians can connect with consumers in minutes. The platform's configurable virtual care programs, seamless consumer experience, and nationwide clinician network are key components that enable organizations to deliver high-quality virtual care at scale.
From the initial intake to follow-up, Wheel ensures a personalized virtual care experience that meets consumers' needs. Clinicians are equipped with clinical tools designed to support simple, personalized workflows, including requesting lab orders, ordering prescriptions and diagnostics, sharing educational materials, and recommending referrals to specialists. This approach has led to a high satisfaction rate among Wheel clinicians, with 93% reporting satisfaction with delivering care via Wheel's EMR.
Wheel's platform is not just about delivering care; it's about creating a connected care experience. By integrating customers' existing partners and Wheel's pre-integrated ecosystem partners, the platform ensures a comprehensive virtual care experience that can be easily configured, deployed, and optimized. This approach has allowed Wheel to power large enterprises and Fortune 50 companies in retail, health plan, and pharmaceutical and life science industries, including as a third-party provider for Amazon Clinic.
Wheel's next-generation virtual care platform represents a significant leap forward in the consumer-centric care movement. By focusing on convenience, personalization, and comprehensive care, Wheel is redefining the healthcare experience for consumers. As the platform continues to evolve, it's poised to play a crucial role in addressing the challenges of limited access and high costs within the healthcare system, ultimately empowering enterprise organizations to deliver seamless care experiences that meet the needs of today's healthcare consumers.
Demographic trends, such as the aging population, are expected to drive the demand for at home services. With the global population aged 65 and above projected to rise from 10% in 2022 to 16% in 2050, at-home care will become increasingly vital to meet healthcare needs and support seniors to age in place.
As of March 1, 315 hospitals across 131 systems in 37 states have been approved for the Acute Hospital Care at Home program, a significant increase from the 20 programs that existed across the U.S. before the waiver. However, the CMS waiver is set to expire at the end of the year, necessitating legislative action to extend the waiver or make the program permanent.
In 2020, the Centers for Medicare and Medicaid Services (CMS) significantly expanded hospital-at-home programs with the introduction of the Acute Hospital Care at Home Waiver, a response to the COVID-19 pandemic. This initiative enabled certain Medicare-certified hospitals to provide inpatient-level care to patients directly in their homes, utilizing Section 1135 waivers of the Social Security Act. This waiver bypassed specific hospital Conditions of Participation that mandate 24-hour onsite nursing, allowing for more flexible care options.
Proponents argue that home-based services for patients with lower acuity levels help hospitals tackle capacity issues by freeing up beds for sicker patients, all without increasing overall healthcare system costs. Healthcare at Home at Mass General Brigham, one of the largest programs in the country, highlighted the program as a "pressure release valve," benefiting both patients and the healthcare system by alleviating some of the burden on traditional hospital facilities.
Healthcare leaders, including the American Medical Association, the American Telemedicine Association, and major health systems like Geisinger and Mass General Brigham, have joined tech-enabled companies in calling for at least a five-year extension to the CMS waiver. They argue that without an extension, Medicare beneficiaries will lose access to Hospital-at-Home programs, which have shown to provide excellent clinical outcomes and reduce care costs.
Organizations such as the American Academy of Home Care Medicine, Moving Health Home, Best Buy Health, DispatchHealth, and Biofourmis have also signed the letter, emphasizing the need for the waiver to be extended to allow hospitals and health systems nationwide to continue developing the infrastructure, supply chain, and workforce for Hospital-at-Home programs. They also urge the inclusion of multiple payers outside the Medicare program, including Medicaid programs, to enter the Hospital-at-Home market.
America’s nurses have PTSD. Registered Nurse Tara Rynder’s story
During my first clinical rotation as a nursing student, I was tasked with delivering the devastating news of pancreatic cancer to a young Hispanic man with four children, the only Spanish speaker on the floor. This experience, coupled with the loss of my mother to cancer, deeply affected me. The phrase "lo siento," meaning "I feel it," became a poignant reminder of the profound impact of nursing on my emotional well-being.
The emotional toll of nursing, especially during the COVID-19 pandemic, has led to an increased understanding of post-traumatic stress disorder (PTSD) and secondary traumatic stress among healthcare workers. Unlike the traditional association of PTSD with soldiers, the pandemic has highlighted its prevalence among nurses and healthcare professionals.
Nurses are taught to desensitize themselves to the pain of others as a coping mechanism. However, this desensitization can lead to a loss of empathy and connection, making the job of nursing incredibly challenging. Recognizing the need to soften rather than harden myself, I sought solace in dance, a form of expression that allowed me to process my grief and trauma.
My journey led me to create workshops that combined nursing and dance, providing a space for nurses to share their experiences and find healing through the arts. These workshops have become a lifeline for nurses across the country, offering a sense of community, hope, and healing.
The pandemic has underscored the importance of these spaces for healthcare workers, highlighting the need for support, understanding, and the expression of grief. As we navigate the aftermath of the pandemic, it's crucial to acknowledge the resilience of nurses and the importance of prioritizing their well-being.
Secondary Traumatic Stress Disorder (STS/VT) is a condition that arises from indirect exposure to trauma, rather than direct experience. It was defined by Dr. Charles Figley as "the natural consequent behaviors resulting from knowledge about a traumatizing event experienced by a significant other. It is the stress resulting from helping or wanting to help a traumatized or suffering person.” This form of stress is distinct from PTSD, which is caused by direct exposure to traumatic events, and burnout, which results from long-term non-supportive work environments.
STS can manifest after a single exposure or over a prolonged period, with common sources including the death of a family member, investigating abuse reports, and frequent exposure to detailed accounts of traumatic events by children. It's a common occupational hazard for professionals working with traumatized individuals, such as therapists, child welfare workers, and case managers, who may experience significant emotional and behavioral problems as a result of listening to trauma stories.
Symptoms of STS can be similar to those of PTSD, including hypervigilance, avoidance, re-experiencing, mood changes, guilt, anger, irritability, feelings of powerlessness, emotional outbursts, sleep problems, and challenges with concentration. It's particularly prevalent among professionals who work with trauma victims, including medical and mental healthcare providers, emergency response personnel, and law enforcement officers. Risk factors for developing STS include gender, mental health challenges prior to the event, geographical proximity to the event, acquaintance with those affected, insufficient social support networks, and difficulties with emotion regulation or stress management.
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