|THIS WEEK IN HEALTHCARE
What happened in healthcare this week—and what we think about it.
- Doximity unveils ChatGPT tool for physicians. Doximity, a digital collaboration and workflow platform for medical professionals, released a beta version of a ChatGPT-powered tool that offers to streamline time-consuming administrative tasks for providers, including prior authorization requests and insurer appeals. Developed by San Francisco-based OpenAI, ChatGPT is a versatile artificial intelligence (AI) large language model that launched in November 2022, immediately garnering attention for its ability to process complex commands and present relatively intelligent (though occasionally wildly incorrect) answers. Doximity’s beta site, DocsGPT.com, integrates ChatGPT into the company’s free fax service, which Doximity’s CEO sees as its most promising early use case, but other prompts on the site include post-procedure and treatment instructions.
The Gist: While there is justified skepticism around the sweeping premise that AI will revolutionize healthcare, this application of next-generation chatbots seems well-targeted to address a painful problem for doctors. Doximity has begun at a logical starting point, by enabling AI to manage repetitive tasks like faxes to insurers, while keeping the final stamp of approval in providers’ hands. This is essential because ChatGPT struggles with accuracy, which could be worrisome when it comes to patients. Rather than replacing providers, AI’s current potential in healthcare is to make basic tasks more efficient, freeing up providers’ time so they can focus on patient care.
- FDA advisers recommend selling Narcan over the counter (OTC). On Wednesday, a joint Food and Drug Administration (FDA) advisory panel unanimously recommended that the anti-opioid overdose drug Narcan (known generically as naloxone) be made available in nasal spray form without a prescription. It’s highly likely the FDA will grant OTC approval to Narcan next month, which could make it more widely available to the public as soon as this summer.
The Gist: Narcan has become one of the most essential tools to combat the unrelenting epidemic of opioid-related drug overdoses, which claimed a record 107K lives in 2021. Even though the medication can be prescribed to at-risk individuals and others who are in close contact with drug users, access thus far has been limited mostly to emergency responders and outreach workers. While the US has successfully reduced the availability of the prescription opioids that initially sparked the crisis, a majority of recent deaths are attributed to synthetic opioids like fentanyl. This much-needed policy change acknowledges that efforts to restrict drug supply have stalled, and shifts the focus to broadening access to effective harm-mitigation tools. As community leaders on the frontline of the opioid epidemic, hospitals and providers can play a valuable role in publicizing expanded Narcan availability.
- Biden administration announces three new drug pricing pilots. This week, the Biden administration released a roadmap for implementing three new drug pricing pilots through the Centers for Medicare and Medicaid Innovation (CMMI). These models seek to offer certain common generic drugs to Medicare beneficiaries for two dollars per month, test new ways for how Medicaid pays for expensive cell and gene therapies, and explore alternative reimbursement models for drugs that receive accelerated Food and Drug Administration approval.
The Gist: On the heels of last week’s State of the Union Address, the announcement of these pilots exemplifies the kind of health policy efforts we expect across the remainder of President Biden’s current term: smaller, incremental initiatives to curb healthcare costs at the margins. But given that all these initiatives have lengthy timelines, in part to allow for industry input, they will likely require the support of the next administration, Biden’s or otherwise, to reach full implementation.
Plus—what we’ve been reading.
- An unprecedented mental health crisis for adolescent girls. Responding to the Centers for Disease Control and Prevention’s (CDC) latest Youth Risk Behavior Survey for 2011-2021, an article in The Atlantic attempts to make sense of the historic levels of anxiety and depression being reported by today’s teens, especially girls and those who identify as lesbian, gay, or bisexual (the survey does not track trans identity). The survey, which is the definitive measure of youth behavior and mental health in the country, found nearly 60 percent of teenage girls reported “persistent feelings of sadness or hopelessness”, and that the share contemplating suicide grew by 50 percent since 2011. The article explores several possible drivers, including a pandemic-induced effect that could subside, pervasive exposure to social media, the normalization of discussing mental distress, and the outcome of growing up with ongoing crises like school shootings and climate change. But none of the explanations fully accounts for the alarming crisis, nor do any of them present easily workable solutions.
The Gist: Echoing the drug overdose epidemic, the unfolding crisis in teen mental health is difficult for providers to address because many victims don’t access healthcare services until their conditions deteriorate to the point of requiring hospitalization, often from a suicide attempt or an overdose. And when teenagers in mental health crisis present to emergency departments, hospitals are often forced to board them for days, as the number of psychiatric treatment facilities for teens has dropped by 30 percent from 2012 to 2020. These data should be a call for providers to focus more upstream diagnosis and care, by partnering with children, families, schools, and other community organizations.