HealthIT Twitter: VA Privatization Debate, Alexa's Healthcare Play, and Gottlieb Talks AI

In a sitdown with CNBC reporter Meg Tirrell a few months ago, FDA Commissioner Scott Gottlieb, MD, was asked if he was some sort of machine, given his prolific Twitter presence despite a busy workload.

“Well, the tweeting isn't the robot. That's really me,” he quipped.

And the Commissioner hasn’t slowed down at all. This morning, he unleashed a pair of new messages describing his agency’s approach to artificial intelligence (AI) medical tools and linking to the FDA’s recent Digital Health Software Pre-Cert Program:

#FDA's approach to #artificialintelligence must be flexible to keep pace with its unique traits, and it must also establish appropriate guardrails for patients - to meet our standards for safety and effectiveness - so we instill confidence in these tools: https://t.co/YgCGbxDWys

— Scott Gottlieb, M.D. (@SGottliebFDA) May 25, 2018

We recognize the tremendous promise of #artificialintelligence technologies for the future of medicine. Our #digitalhealth team is actively developing a new regulatory framework to promote and support innovation in this rapidly advancing field #FDAPrecert https://t.co/YgCGbxDWys

— Scott Gottlieb, M.D. (@SGottliebFDA) May 25, 2018

The FDA continued to show its work this week, approving marketing of an AI-based algorithm for detection of wrist fractures.

Of course, Gottlieb isn’t the only healthtech stakeholder who seems to live on Twitter. At the recent HLTH conference in Las Vegas, one attendee joked to a Healthcare Analytics News™ that Andy Slavitt had been retweeting messages from the stage.

As the Memorial Day Weekend closes in, let’s look back at some of the other important conversations raging on the industry’s preferred social media platform.

Alexa Mulls a Career in Healthcare

Amazon’s escalating efforts to make Alexa a healthcare tool caught a lot of attention over the last week or so. The tech and online retail giant has been reliant on third-party partners—including Mayo Clinic—to build the technology’s medical “skills.” The recent shift, according to reports, is to an in-house model: The company is looking to hire staff to build proprietary medical technology.

That news set Twitter off. Some, like Southern Cross University Professur Stuart Smith, rolled their eyes:

Yet another tech company with designs on changing the face of healthcare. It is a well-worn path yet we still face massive challenges. Tech alone just isn’t enough, engaging people in health-related behaviours is the crucial piece of the puzzle https://t.co/N9FPFFMYvm

— Prof Stuart Smith (@StuSmith2454) May 17, 2018

While others, like Defense One tech editor Patrick Tucker mulled the wider implications:

Amazon is building off Alexa to venture into healthcare. Done right, this could be a boon. But Amazon is also the top cloud provider to the U.S. Intelligence Community and (perhaps) soon the military. Too much data / power comes concentration? Thoughts? https://t.co/yd3Z1CSUC9

— Patrick Tucker (@DefTechPat) May 14, 2018

News that an Alexa device had inadvertently recorded a couple talking and sent the transcript to one of their contacts further complicated the conversation. Healthcare Analytics News™ editor Jack Murtha wrote a column on the matter, while Adherent Health CEO Rod Dhoble had some choice words:

Excited by prospect of Alexa enabled healthcare? Too bad Alexa is a bucket that leaks private information. https://t.co/YTasquNRP5 https://t.co/ExT6CGLOBO

— Rob Dhoble (@rdhoble) May 24, 2018

As always, healthcare will be following closely as Amazon's strategy unfolds.

VA MISSION Act, Wilkie Nomination Stir Privatization Debate

The week after Cerner and VA finally announced their long-awaited contract and President Trump announced Acting Secretary Robert Wilkie would be nominated for the full-time job, Congress passed a sweeping, $55 billion piece of legislation to modernize the agency. The bill drew praise and criticism from the usual suspects:

I applaud the Senate for passing the #VAMISSIONAct, which includes major reforms I cosponsored with @JerryMoran to expand health care choices for veterans & transform the VA into an integrated 21st century health care system https://t.co/IS4dtZdXwI

— John McCain (@SenJohnMcCain) May 23, 2018

I am concerned that despite some very good provisions in the VA MISSION Act, it continues a trend toward the slow, steady privatization of the VA. I will vote against it.

— Bernie Sanders (@SenSanders) May 23, 2018

That last point was a continuation of the privatization debate that has swirled since Trump took office, but accelerated since David Shulkin, MD, was fired as VA Secretary and Wilkie was nominated to fill the role. The Iraq and Afghanistan Veterans of America Twitter account made sure its feelings were known:

"We also look forward to seeing if Wilkie plans to expand privatization at VA, which vets nationwide continue to overwhelmingly oppose." -@IAVA

— IAVA (@iava) May 18, 2018

While others, like Johns Hopkins University economist Steve Hanke endorsed the idea (although some might dispute his characterization of VA care):

The Department of Veterans Affairs struggles to provide adequate services to disabled veterans. #Privatization of the VA would solve the the its lousy service problem.https://t.co/JOG6YolEA5

— Prof. Steve Hanke (@steve_hanke) May 22, 2018

Wilkie's nomination hearings are expected to begin in early June.

Final Thought

And, to close out this week's roundup, we'll leave you with the thoughts of Shereese Maynard, MS, MBA, a prolific tweeter and occasional contributor to this site. She thinks that the industry could do a better job considering patient experience ("PatEx") and user experience ("ux") when developing medical tech...and when assembling conferences to talk about it:

T2 Often developers forget for whom they're designing tech. #ux or #PatEx takes a second seat to investor relations. It can cause flaws in our thinking. #HITsm

— ShereeseM, MS/MBA (@ShereesePubHlth) May 25, 2018

I don't know how many have noticed; many conferences are designed around attracting investors, not designing for patients. #HITsm

— ShereeseM, MS/MBA (@ShereesePubHlth) May 25, 2018

T2 Also systems need to adopt standard languages, suitable for patient ex. If patients can't use tech, its a failure in scope #HITsm

— ShereeseM, MS/MBA (@ShereesePubHlth) May 25, 2018

Agree with that sentiment? Have feelings about the other important topics in health technology that you’d like to share? Follow @HCA_News on Twitter and let us know.

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