The AI worries that keep HHS up at night

Oct 04, 2024

Presented by the Coalition for Medicare Choices

With Sophie Gardner

Driving The Day

HHS Deputy Secretary Andrea Palm speaking at a DOJ podium

HHS Deputy Secretary Andrea Balm said her agency plans to introduce a strategy for using AI in January. | Chip Somodevilla/Getty Images

TOP HHS OFFICIAL ON AI USE — As the Department of Health and Human Services considers how to regulate artificial intelligence in the multibillion-dollar health care sector, Pulse spoke with one of the agency’s leading AI policy experts, Deputy Secretary Andrea Palm.

Palm discussed HHS’ plans to release a new AI strategy in January to comply with President Joe Biden’s executive order on AI practices, how she intends to manage the more than 150 ways AI is used at the agency and what worries her the most about the technology.

The conversation, which took place after POLITICO reported that HHS is one of the biggest users of AI-related purchases in the federal government, has been edited for length and clarity.

POLITICO has reported on the many ways HHS uses AI. Which tools have been the most meaningful?

Our role is to not only understand all of what’s going on across the department, but how it all aligns to our mission and our commitment to serve the American people well, and how we make sure that the ways we’re using it ourselves is walking the walk on responsible use of AI.

One of the things I think is particularly cool is an NIH pilot to match potential patients with clinical trials. As a doctor, how do you know what might be available for your patients? And this AI tool is a way to help start to sift through that in a more efficient way, so that we are better able to capture patients who would benefit from a trial.

How might HHS be limited on policy it can propose?

We did this with cybersecurity: We spent some time figuring out where we had levers, what we needed Congress for, what we could do ourselves. And that exercise is happening in the AI space as well.

One very concrete example is things that fall outside of the definition of medical device. Who else might have authority within the department to enter into that space? And if we don’t have [authority], what do we do about that?

What keeps you up at night when it comes to AI?

The intersection between AI and cyber threats. As a person who cares so very much about the public’s trust in government and our responsibility to the American people, the way we defend the assets … at HHS and in the broader ecosystem is really important to the health and well-being of the American people. And that's a place where a lot of my attention goes.

WELCOME TO FRIDAY PULSE. An NIH-supported team has unveiled the first-ever neural map of the common fruit fly brain, an important development because fruit flies share 60 percent of human DNA including the genes for learning and jet lag. Who knew a little fly meant so much to research into the human brain? Send your tips, scoops and feedback to ccirruzzo@politico.com and bleonard@politico.com and follow along @ChelseaCirruzzo and @_BenLeonard_.

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Public Health

A bottle containing the drug Remdesivir is held by a health worker

Gilead is sending 5,000 vials of remdesivir to Rwanda. The antiviral will be used to treat Marburg virus. | Zsolt Czegledi/MTI via AP

CDC’S MARBURG RESPONSE — Rwanda is seeing an outbreak of a highly deadly virus called Marburg, Sophie reports. In response, the CDC has taken measures to combat the potential of the virus spreading in the U.S.

In an alert Thursday, the CDC said that any health care workers who were in any health facility in Rwanda — including outpatient settings or traditional healers — shouldn’t return to work in the U.S. for at least 21 days, Sophie reports.

The agency also instructed public health departments to contact any health care personnel who return from a Rwanda facility, conduct an “exposure risk assessment” and give them information on self-monitoring and what to do if they develop symptoms. Public health departments must notify CDC about any high-risk exposures.

“Currently, the risk of Marburg virus exposure in returning healthcare personnel is unknown,” the CDC wrote in the alert.

The advisory comes as California-based drugmaker Gilead said it will send 5,000 vials of its antiviral remdesivir to Rwanda. The drug is only authorized for emergency use as a Marburg treatment in Rwanda.

“Remdesivir is not approved for the treatment of MVD anywhere globally, and the safety and efficacy of this use is not known,” the California company said in a statement Thursday. No other treatments or cures are approved for the virus.

Key context: At least 36 cases and 11 deaths have been reported in Rwanda that are tied to the outbreak — which hasn’t spread outside of the country. The Ebola-like virus spreads through direct contact between broken skin or mucous membranes and the body fluids of an infected person.

COVID ANTIVIRALS ESCHEWED — About half of adults 65 years and older who get Covid-19 are prescribed outpatient antiviral treatments, with the oldest adults the least likely to receive treatment, according to a new CDC report.

Paxlovid, a Covid antiviral drug, reduces the risk of hospitalization and death for unvaccinated patients by 87 percent, with similar results among vaccinated populations. Adults 65 and older are still at the highest risk of Covid-related hospitalizations, accounting for 70 percent of all such hospitalizations from Oct. 2023 to April 2024.

According to the CDC, among more than 393,300 nonhospitalized 65+ patients who got Covid from April 2023 to September 2023, more than 48 percent of those ages 65-75, more than 43 percent of those 76-89 and about 35 percent of those 90 and older received an antiviral.

Among the patients who had severe symptoms, 21 percent had received an antiviral.

“In addition to vaccination and access to early sensitive diagnostics such as polymerase chain reaction testing, COVID-19 treatment should be routinely discussed with older adults with mild or moderate COVID-19,” researchers wrote.

HEALTH DATA PRIVACY

DOCTOR GROUP SETTLES AFTER RANSOMWARE ATTACK — A nonprofit physician group in Southern California will pay HHS $240,000 in a settlement the agency announced after the group suffered a ransomware breach.

This is the fifth time HHS’ Office for Civil Rights has sought enforcement actions against health care providers that have had their data breached in a ransomware attack and comes as large breaches involving ransomware skyrocket in health care.

Providence Medical Institute reported a breach to OCR in 2018 that involved the personal health insurance of 85,000 patients. OCR’s subsequent investigation found that the health care system had violated the HIPAA Security Rule by failing to have a business associate agreement in place with an outside vendor and failing to implement procedures to allow only authorized people to access programs that contain personal health information.

Providence did not respond to requests for comment.

As POLITICO previously reported, health care data breaches have risen sharply in recent years. In the first three months of 2024 alone, the health care data for 17.2 million patients was compromised in a breach. Ransomware attacks, where cybercriminals hold records or entire health care systems hostage until they’re paid, have risen 264 percent over the past five years, according to OCR.

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Names in the News

Marc Miller, president and CEO of Universal Health Services, has been named chair of the Federation of American Hospitals’ Board of Directors for 2025.

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STAT reports on new research into why people with schizophrenia hear voices.

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