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How IQVIA’s unchecked growth could come to a halt
Health data giant IQVIA’s unbridled growth might come to a halt as regulators begin to rein in its acquisitions, Casey Ross writes. A Federal Trade Commission lawsuit aims to block IQVIA’s plan to scoop up digital advertising company DeepIntent, and argues that the scope and sprawl of the company’s data could lead to a deluge of ads targeting patients and doctors.
“How did all of this information end up in private hands?” Georgetown’s Adriane Fugh-Berman asked, explaining that IQVIA’s data repository positions it to use the information for its own gain instead of the public good. “It’s all about marketing,” Fugh-Berman said. “This isn’t about public health.”
The FTC lawsuit could determine IQVIA’s business prospects and the level of control it wields over data on patients’ medical conditions and treatments — data which could also answer crucial questions about health outcomes, Casey points out. Get the full story on the suit and IQVIA’s path to dominance.
Also on FTC…
A handful of Democratic lawmakers are calling on the agency to ensure that digital health companies don’t misuse their data, and that consumers are informed of breaches.
In a letter this week to FTC chair Lina Khan, Reps. Adam Schiff (D-Calif.), Greg Casar (D-Tex.), André Carson (D-Ind.), Sara Jacobs (D-Calif.), Seth Magaziner (D-R.I.), and Kim Schrier (D-Wash.) voiced support for an FTC proposal that would require health data companies that aren’t governed by HIPAA to notify customers, the FTC, and in some cases, the media about personal health data exposures.
The lawmakers pointed to the data sharing practices of GoodRx and BetterHelp — both recently targets of recent FTC crackdowns — as examples of companies violating promises to consumers and even their own privacy policies.
“Consumers using these resources place a level of trust into these apps – only for it to be exploited by the very apps claiming to provide care,” reads the letter.
The lawmakers’ missive comes just a few days after the FTC and HHS’ Office for Civil Rights, which enforces HIPAA, warned hospitals and telehealth companies to beware of online tracking tools that might be sharing customers’ data with third parties, citing an investigation by my colleague Katie Palmer and our partners at The Markup. Their reporting revealed that dozens of telehealth company websites contained embedded tools that shared sensitive patient data with big tech companies, including Facebook.
“When consumers visit a hospital’s website or seek telehealth services, they should not have to worry that their most private and sensitive health information may be disclosed to advertisers and other unnamed, hidden third parties,” Samuel Levine, director of the FTC’s Bureau of Consumer Protection, said a press release.
Companies should use “extreme caution when using online tracking technologies,” he said. The two agencies sent their joint letter to about 130 hospital systems and telehealth providers.
Q&A with AMA’s Jesse Ehrenfeld
American Medical Association president Jesse Ehrenfeld‘s already set some records since his inauguration in June: In addition to being the first openly gay person in that role, he’s also the first board certified clinical informaticist to take the AMA’s top spot. It’s a qualification that uniquely positions him to prepare for medicine’s rapid technological evolution. Katie chatted with Ehrenfeld about telehealth, EHRs, and AI. Here’s a sneak peek of their chat — and read the full Q&A here.
What forms and applications of AI do you think will change the practice of medicine the most in the next few years?
Well, 20% of practices tell us in our latest survey data that they’re using AI today. Most of them are using it for the unsexy back office operations stuff. Supply chain, scheduling, billing, which are obvious applications. I think more interesting places that have not come to fold are things like helping support a clinical decision being made, which is really exciting to think about. I don’t believe that it’s too far off when every radiology film, MRI, CT scan is primarily read by a machine first and then overread by a human — that seems to be pretty straightforward.
But even the most advanced algorithms and AI-enabled tools still can’t diagnose and treat diseases. And I think we’re all waiting to see what the FDA does, but the forthcoming regulatory framework for AI-enabled devices is proposing to be much more stringent on AI tools that make diagnoses and recommendations, especially if it’s an algorithm that adapts and learns over time, these so-called continuous learning systems. So I think from a technological and a regulatory standpoint where AI can excel and should be leveraged is unburdening physicians, detethering us from our computers, allowing me to spend more time with my patients and getting rid of some of these administrative hassles.
What could the AMA’s role be in setting guidelines for the appropriate use of LLMs?
So there are two things that are really important. First, we have to have a regulatory framework that works and makes sure that we only have safe and effective products in the marketplace for FDA-regulated products. The second is that we’ve got to make sure that patients and physicians understand what these technologies do. And there are limitations. Large language models are designed to predict what you want them to tell you, but the challenge is that most of these publicly available approaches do not prioritize accuracy.
We have an implementation playbook series, and we’re working on one for AI in practice because we know that there’s demand. We know that our members are trying to figure out how to implement these technologies in appropriate ways. So that is something that the AMA is going to be putting out soon.
How Villanova tested out VR for nursing training
I’ve reported on virtual reality’s prospects in health care — especially for behavioral therapy and physical therapy — as well as the pernicious reimbursement challenges that might keep the technology from becoming a medical mainstay. But it could have more near-term success in medical training, including nursing education.
Villanova, for instance, beta-tested a VR system developed by software firm Wolters Kluwer Health and medical education company Laerdal Medical, for some of its own nursing students. The technology simulated scenarios in which students would need to manage demands from multiple patients at once.
While VR lets students explore a range of challenging clinical settings, and “hone assessment skills and provide care without jeopardizing real patient safety,” the future of nursing education requires a combination of direct patient care, real-world simulations, and computer simulations, said Patricia Prieto, assistant director at the simulation learning resource center within Villanova’s College of Nursing.
A newly graduated nurse “may be unprepared to prioritize care, delegate tasks,
communicate effectively, make clinical judgments, and organize time in the complex management of a full patient assignment,” Prieto told STAT. And while clinical settings might only give students one or two patients at a time, the VR forced students to juggle four patient’s care. “This was the first software I’ve tested that allows learners to move smoothly from one patient to the
next, while tracking their actions for feedback,” she said.
Villanova’s goal is to eventually offer a VR experience to students at home, but “the software is not quite there yet, as it requires facilitation,” she said.
How medical device makers fared in Q2
- Abbott kicked off earnings season late last week, reporting a decrease in sales and revenue as Covid-19 test demand continues to drop, Lizzy Lawrence tells us. Its core devices business is booming, though, with continuous glucose monitors bringing in $1.3 billion in sales.CEO Robert Ford fielded a question about Abbott’s acquisition of Cardiovascular Systems International — a device company that treats artery blockages and also featured in a recent New York Times story about profiting from unnecessary medical procedures. Ford said Abbott is still working on integrating the company’s devices with their own, but is excited about the path forward.
- Intuitive Surgical, maker of the Da Vinci surgical robots, also reported second-quarter earnings last week — its revenue is up 15% compared to last year’s second quarter. But the company saw less growth in bariatric surgery, which CFO Jamie Samath linked to growing patient interest in the new weight loss drugs.
- Philips said it has produced 99% of replacement devices for patients impacted by its recall of millions of defective breathing machines. But the company is still being investigated by the DOJ for how it handled the recall, Lizzy writes.
What we’re reading
- The race for early Alzhiemer’s detection is heating up, STAT
- A former medical device company employee sold unapproved devices, Lehigh Valley Live
- White House unveils plan to make insurers cover mental health care, STAT