industryterm:health care systems

Warnings of a Dark Side to A.I. in Health Care - The New York Times
▻https://www.nytimes.com/2019/03/21/science/health-medicine-artificial-intelligence.html

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Similar forms of artificial intelligence are likely to move beyond hospitals into the computer systems used by health care regulators, billing companies and insurance providers. Just as A.I. will help doctors check your eyes, lungs and other organs, it will help insurance providers determine reimbursement payments and policy fees.

Ideally, such systems would improve the efficiency of the health care system. But they may carry unintended consequences, a group of researchers at Harvard and M.I.T. warns.

In a paper published on Thursday in the journal Science, the researchers raise the prospect of “adversarial attacks” — manipulations that can change the behavior of A.I. systems using tiny pieces of digital data. By changing a few pixels on a lung scan, for instance, someone could fool an A.I. system into seeing an illness that is not really there, or not seeing one that is.

_ Software developers and regulators must consider such scenarios, as they build and evaluate A.I. technologies in the years to come, the authors argue. The concern is less that hackers might cause patients to be misdiagnosed, although that potential exists. More likely is that doctors, hospitals and other organizations could manipulate the A.I. in billing or insurance software in an effort to maximize the money coming their way. _

In turn, changing such diagnoses one way or another could readily benefit the insurers and health care agencies that ultimately profit from them. Once A.I. is deeply rooted in the health care system, the researchers argue, business will gradually adopt behavior that brings in the most money.

The end result could harm patients, Mr. Finlayson said. Changes that doctors make to medical scans or other patient data in an effort to satisfy the A.I. used by insurance companies could end up on a patient’s permanent record and affect decisions down the road.

Already doctors, hospitals and other organizations sometimes manipulate the software systems that control the billions of dollars moving across the industry. Doctors, for instance, have subtly changed billing codes — for instance, describing a simple X-ray as a more complicated scan — in an effort to boost payouts.

Hamsa Bastani, an assistant professor at the Wharton Business School at the University of Pennsylvania, who has studied the manipulation of health care systems, believes it is a significant problem. “Some of the behavior is unintentional, but not all of it,” she said.

#Intelligence_Artificielle #Médecine #Manipulation #Economie_santé

Roche says flexible pricing ready for cancer, not MS drugs | Reuters
▻http://uk.reuters.com/article/us-roche-novartis-pricing-ms-idUKKBN132159

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new data-driven flexible pricing schemes the Swiss drugmaker and others in the industry are pushing to replace today’s “pay-per-pill” approach are well advanced in cancer treatment (…)

Such schemes foresee drug pricing based on measurable benefits for a patient or health care systems, an approach seen as becoming more important as aging populations and chronic disease put the squeeze on health care systems.

Roche has introduced flexible pricing for cancer drugs in about a dozen European countries, including Italy, Belgium, Hungary, Switzerland and Austria. For instance, it already prices drugs like Avastin differently in some markets depending on the cancer being targeted.

#cancer #pharma #prix_à_la_tête_du_patient

Inequality Is a Choice - NYTimes.com
▻http://opinionator.blogs.nytimes.com/2013/10/13/inequality-is-a-choice/?_r=0

American inequality began its upswing 30 years ago, along with tax decreases for the rich and the easing of regulations on the financial sector. That’s no coincidence. It has worsened as we have under-invested in our infrastructure, education and health care systems, and social safety nets. Rising inequality reinforces itself by corroding our political system and our democratic governance.

And Europe seems all too eager to follow America’s bad example. The embrace of austerity, from Britain to Germany, is leading to high unemployment, falling wages and increasing inequality. Officials like Angela Merkel, the newly re-elected German chancellor, and Mario Draghi, president of the European Central Bank, argue that Europe’s problems are a result of a bloated welfare spending. But that line of thinking has only taken Europe into recession (and even depression).

The result is a race to the bottom. Wages and working conditions are being threatened. Pioneering firms like Apple, whose work relies on enormous advances in science and technology, many of them financed by government, have also shown great dexterity in avoiding taxes. They are willing to take, but not to give back.

The Possible Cancer Toll of CT Scans - NYTimes.com
▻http://well.blogs.nytimes.com/2013/07/15/the-possible-cancer-toll-of-ct-scans/?smid=tw-nytimeshealth

Each year more than four million CT scans are performed on children, and they are increasing the risk for future cancer, a new study suggests.

Researchers writing online last month in JAMA Pediatrics counted the number of CT scans performed on children under 15 from 1996 to 2010 in seven American health care systems, and calculated the average dose of radiation delivered to the head, abdomen, chest or spine.

There was wide variability, but the scientists found that up to a quarter of children with a single abdominal scan received 20 millisieverts or higher. (The average dose for a chest X-ray is 0.1 millisievert.)

The researchers estimate that one year’s CT scanning in the United States would produce 4,879 future cancers in children under 15 — a small but significant increase.

The researchers calculate that if the highest doses — those in the top one-quarter — could be reduced to match the average dose, future cancers would be reduced by 43 percent.

The lead author, Diana L. Miglioretti, a professor of biostatistics at the University of California, Davis, recommends that parents ask questions: How will a scan change my child’s medical care? Are there other tests that can be used?

“If the doctor says he needs the CT,” Dr. Miglioretti said, “then the parent should ask, ‘What are you doing to make sure the dose is as low as possible?’”