Analysis | A conversation about the HHS plan on AI in health care – The Washington Post

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Today’s edition: President Biden is slated 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 covid misinformation. But first …

Micky Tripathi on HHS’s upcoming strategic plan on AI

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

The Department of Health and Human Services has roughly six months left to develop a strategic plan on the responsible use of the fast-moving technology in medicine, as mandated by President Biden in an executive order last year. 

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

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

Tripathi: There are two different places where you’re seeing a lot of activity. One of them is imaging. For example, if you look at the 700 or so AI-enabled devices the Food and Drug Administration has approved, the majority of them are for radiology. 

But most of it right now, I would argue, is happening in user experience, like helping physicians manage their inboxes, as well as administrative things. 

Health 202: What are some of your top priorities in getting the panel off the ground?

Tripathi: There are four things that we’re working on for the executive order’s [interim] end-of-April deadline. One is a plan to look at the uses of AI in public benefits and HHS activities. The second is an overarching strategy for being able to assess the quality of AI tools. The third is specific to the National Institutes of Health regarding synthetic nucleic acid screening and other things like that, which is very tied to biosecurity. Finally, we’re looking to see if there are any more appropriate actions to advance nondiscrimination compliance. 

Looking to October, we’ve got an overarching AI strategic plan that we’ve got to put together. There’s a safety program we want to plan for. And then finally a strategy for regulating the use of AI in drug development, which the NIH and the Food and Drug Administration will be the primary leads on. 

Health 202: With technology advancing rapidly, is there a concern that regulatory guidance might lag behind?

Tripathi: It’s a totally fair point. We try to anticipate areas where there is a lot of dynamic energy in technology and ask ourselves how do you write a regulation that is balancing the need for flexibility to allow that kind of innovation to take place, but also channels it in ways that we can say would constitute responsible uses of it. 

Right now we feel like it’s a little bit self-adjusting, but we will obviously revisit it and fine tune it. But it is a concern of ours that the regulatory cycles are much slower than the pace of industry innovation. 

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

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

White House prescriptions

Biden pushes to bolster women’s health research

On tap today: Biden is slated to sign an executive order aimed at bolstering the federal government’s 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 long-standing gender disparities. It will also call for a comprehensive research agenda into 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 women’s health research.
  • A $10 million investment by the Defense Department into learning more about health issues affecting women in the military, including 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 OB/GYNs and nurses. 

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

In the courts

Supreme Court to weigh White House social media requests

On tap today: 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 Justice Department has asked the panel to overturn a lower-court ruling that found top Biden administration officials probably violated the First Amendment by improperly pressuring tech companies to take down what they saw as problematic posts about the coronavirus, vaccine safety and mask effectiveness at the height of the pandemic. 

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

A ruling in the case is expected before the end of June. 

From our reporters’ notebooks

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

Before Donald Trump pledged to crack down on entitlement program abuse, he used his clemency powers to help several people convicted in major Medicare fraud cases, my colleagues Amy B Wang and Azi Paybarah report. 

The details: During his final year in office, Trump commuted the sentences of at least five people who collectively filed nearly $1.6 billion in fraudulent claims through Medicare or Medicaid.

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

Asked whether his outlook had changed last week, Trump offered a meandering answer that was widely interpreted as being open to the idea. While his campaign later clarified that he was talking about cutting “waste and fraud,” the remarks provided the Biden campaign with fresh ammunition for its 2024 election rematch. 

In other health news

  • The Centers for Medicare and Medicaid Services rolled out new flexibilities aimed at supporting providers affected by the cyberattack on Change Healthcare, including allowing states to make retroactive payments. 
  • Independent advisers to the Food and Drug Administration voted in favor of allowing the use of Bristol Myers Squibb and Johnson & Johnson’s CAR T-cell therapies as earlier blood cancer treatments, Bhanvi Satija and Sneha S K report for Reuters
  • South Dakota Gov. Kristi Noem (R) is facing a firestorm of criticism, a lawsuit and a potential ethics inquiry questioning whether she participated in an undisclosed advertisement or used state resources to promote a Texas dental practice, The Post’s Maegan Vazquez reports. 

📅 Welcome back! The House and Senate are both in session starting tomorrow. Here’s what we’re watching: 

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

On Wednesday: Health and Human Services Secretary Xavier Becerra will testify before the House Ways and Means Committee and a House Appropriations’ health subcommittee on the president’s budget request. 

Across the Capitol, the Senate Judiciary Committee will examine reproductive health care; a Senate Homeland Security and Governmental Affairs subcommittee will discuss fentanyl trafficking; the Senate Environment and Public Works Committee will consider whether “forever chemicals” should be categorized as hazardous to human health. 

On Thursday: A House Energy and Commerce subcommittee will scrutinize the federal government’s regulation of diagnostic tests; the House select subcommittee on the coronavirus crisis will examine the country’s vaccine safety reporting and injury compensation systems; a House Veterans’ Affairs subcommittee will review several bills, including one aimed at improving maternity-care coordination. 

On our radar: Congress is staring down another deadline to avert 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 quashed the effort, per Axios’s Peter Sullivan and Victoria Knight

Health reads

Failure of ALS drug puts a spotlight on controversial FDA approvals (By Daniel Gilbert | The Washington Post)

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

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

Sugar rush

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