Analysis | A conversation about the HHS plan on AI in health care

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Today’s Edition: President Biden is expected to sign an executive order that would expand research on women’s health. The Supreme Court will hear oral arguments on whether the White House improperly pressured social media companies to remove misinformation about Covid. But first

Micky Tripathi on HHS’s Next Strategic Plan on AI

The federal government is struggling to keep pace with the rapid evolution of artificial intelligence in health care.

The Department of Health and Human Services Approximately six months remain to develop a strategic plan on the responsible use of rapidly evolving technology in medicine, as mandated by President Biden in one executive order last year.

I recently caught up Micky Tripathi, HHS’s national health information technology coordinator and co-chair of the task force responsible for developing the plan, about the broad effort. This interview has been edited for brevity and clarity.

Health 202: What are some of the more common ways artificial intelligence, or AI, is now being used in healthcare?

Tripathi: There are two different places where you see a lot of activity. One of them is the image. For example, if you look at the 700 or so AI-enabled devices, the Food and Drug Administration has passed, most of them are radiology.

But most of that right now, I would say, is happening in the user experience, like helping doctors manage their inboxes, as well as the administrative stuff.

Health 202: What are some of your top priorities when starting the panel?

Tripathi: There are four things that were working for the executive orders [interim] deadline at the end of April. One is a plan to look at the uses of AI in public benefits and HHS activities. The second is a global strategy to be able to evaluate the quality of AI tools. The third is specific to the National Institutes of Health in terms of synthetic nucleic acid screening and things like that, which is very much tied to biosafety. Finally, I was looking at whether there are more appropriate actions to advance non-discrimination compliance.

Heading into October, we have an overall strategic AI plan that we need to develop. There is a safety program that we want to plan. And finally a strategy to regulate the use of AI in drug development, which the NIH and the Food and Drug Administration will be the main tracks.

Health 202: With technology advancing rapidly, is there concern that regulatory guidance may be left behind?

Tripathi: It’s a totally fair point. We’re trying to envision areas where there’s a lot of dynamic energy in technology, and we’re wondering how do you write a regulation that balances the need for flexibility to allow that kind of innovation to happen, but also channel it in a way that we can. to say that it would constitute responsible use.

Right now we think it’s self-adjusting a little bit, but obviously we’ll be reviewing it and fine-tuning it. But we are concerned that regulatory cycles are much slower than the pace of innovation in the sector.

Health 202: Is the federal government equipped to effectively regulate and oversee AI technology today?

Tripathi: I think we will almost certainly need new authorities and resources. We’ve tried to be very cautious in doing this by identifying things we think we can achieve with our existing authorities and budgets. What you see in the executive order are all the things we believe we can accomplish today. But part of the task force’s mandate will be to identify where gaps exist and how to fill them.

Recipes from the White House

Biden pushes for stronger women’s health research

Today on tap: Biden is expected sign an executive order intended to strengthen the federal governments’ study of women’s health.

The president’s executive order will direct federal agencies to develop and strengthen research and data standards in an effort to address longstanding gender disparities. It will also call for a comprehensive research agenda on health conditions and diseases that disproportionately affect women.

In addition, Biden will announce more than 20 new actions and commitments by federal agencies, including:

  • The launch of a $200 million effort at the National Institutes of Health in fiscal year 2025 to fund new interdisciplinary research in women’s health.
  • A $10 million investment from the Department of Defense to learn more about health issues affecting women in the military, such as cancer and mental health.
  • An effort at the Centers for Disease Control and Prevention to expand training in women’s health research and public health surveillance for obstetricians/gynecologists and nurses.

Yes, but: Biden asked the legislators for 12 billion dollars in new funding for women’s health research, but its prospects are murky in a divided Congress.

The Supreme Court will weigh in on the White House’s social media requests

Today on tap: The Supreme Court will hear oral arguments in a case that could have broad implications for the federal government’s authority to combat public health misinformation online.

The Department of Justice has asked the court to overturn a lower court ruling it found Top officials in the Biden administration likely violated the First Amendment inappropriately pressuring tech companies to remove what they considered problematic posts about the coronavirus, vaccine safety and the effectiveness of masks at the height of the pandemic.

Key context: The case was started from Republican attorneys general in Louisiana and Missouri, who allege the administrations’ conduct amounts to illegal censorship. The Department of Justice, on behalf of the administration, says that the Constitution allows the use of the bully pulpit to protect the public, our colleagues Naomi Nix, Cat Zakrzewski i Ann E. Marimow report

The case is expected to be resolved before the end of June.

From the notebooks of our journalists

Trump granted clemency to Medicare fraudsters before pledging to cut entitlement program waste

Before donald trump pledged to crack down on abuse of the entitlement program, used his clemency powers helping several people convicted in major Medicare fraud casesmy colleagues Amy B Wang i Azi Paybarah report

The details: During his last year in office, Trump commuted the sentences at least five people which collectively presented almost 1.6 billion dollars in fraudulent claims through Medicare or Medicaid.

  • Among them was Philip Esformesdescribed by Department of Justice like having orchestrated one of the major health fraud schemes in US history.

Key context: Trump has long said he will protect Social Security, Medicare and Medicaid, breaking with conservatives who argue the U.S. should cut benefits to keep them financially solvent.

Asked if his view had changed last week, Trump he offered a meandering reply which was widely interpreted as open to the idea. While his campaign later clarified who was talking about reducing waste and fraud, the comments provided to the Biden campaign fresh ammunition for its 2024 re-election.

  • The Centers for Medicare and Medicaid Services deployed new flexibilities aimed at supporting providers affected by the cyberattack on Change Healthcareincluding allowing states to make retroactive payments.
  • Independent advisers to the Food and Drug Administration voted in favour to allow the use of Bristol Myers Squibb i Johnson & Johnsons CAR T-cell therapies as earlier treatments for blood cancer, Bhanvi Satija i Sneha SK report for Reuters.
  • South Dakota Gov. Kristi Noem (R) faces one storm of criticisma lawsuit and a possible ethics investigation questioning whether he engaged in undisclosed advertising or used state resources to promote a Texas dental practice, The Posts Maegan Vazquez reports

Welcome back! The House and Senate will meet starting tomorrow. Here’s what they were looking at:

Today on tap: The Ways and Means Committee of the House will hold a field hearing in Denton, Tex., on emergency medical care in rural and underserved communities.

Wednesday: Secretary of Health and Human Services Xavier Becerra will testify Before Ways and Means Committee of the House already House Addresses Subcommittee on Health to the president’s budget request.

On the other side of the Capitol, the Senate Judiciary Committee will examine reproductive health care; a Senate Subcommittee on National Security and Governmental Affairs will discuss fentanyl trafficking; the Environment and Public Works Committee of the Senate will take into account whether chemicals should forever be classified as hazardous to human health.

Thursday: A House Energy and Commerce Subcommittee will scrutinize federal government regulation of diagnostic tests; the House Select Subcommittee on the Coronavirus Crisis will examine the country’s injury compensation and vaccine safety reporting systems; a House Veterans Affairs Subcommittee will review several bills, including one aimed at improving coordination of maternal care.

On our radar: Congress is setting another deadline to avoid a partial government shutdown this weekend. Some members had been pushing to include policies in the spending package that would reform the business practices of pharmacy benefit managers and increase hospital transparency, but House and Senate leaders nullified the effortfor axess Peter Sullivan i Victoria Knight.

ALS drug failure highlights controversial FDA approvals (By Daniel Gilbert | The Washington Post)

Inside a push to create an NIH office for chronic post-infectious diseases (By Isabella Cueto | Stat)

Medicare pays millions for remote monitoring of vital signs. Is it worth it? (By Phil Galewitz and Holly K. Hacker | KFF Health News )

Thanks for reading! See you tomorrow.

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