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Utah to let AI examine patients and prescribe medication without human oversight

https://www.techspot.com/news/114111-utah-become-first-state-ai-examine-patients-prescribe.html
35•healsdata•48m ago

Comments

blinkbat•46m ago
what could go wrong
verdverm•44m ago
it's about scaling, trillion is the new billion

https://www.justice.gov/opa/pr/opioid-manufacturer-purdue-ph...

https://www.propublica.org/article/purdue-settlement-leaves-...

I'm curious if this will hold up, the people of Utah rejected that mega data center iirc, maybe they feel differently on this one because of what private equity has done to rural healthcare

imglorp•36m ago
Oooh, good point. I bet the pharmas love this. Get that expensive, foot-dragging doctor out of the sales loop and write several prescriptions for every patient encounter! The KPI goes from minimizing MD minutes to maximizing med profits.

big /s

jmorenoamor•41m ago
Is it already a cliché to cite Idiocracy?
throw904309•27m ago
why? spending $100 for doctor visit, to get $2 prescription is idiocracy.
1Kajsh•21m ago
Maybe the doctor does not resell your data to Facebook so you get anti-acne cream ads in perpetuity.
Choco31415•17m ago
Presumably an AI system would still be held accountable to HIPAA laws.
johnnyanmac•39s ago
[delayed]
mulderc•17m ago
Isotretinoin is a common acne medication and a bit of a breakthrough that also has potentially serious side effects. My take is more that if the medication is safe enough to be given out by an AI then maybe it should just be over the counter.
bogwog•12m ago
The "I know you are but what am I" debate strategy is always a solid choice.
assimpleaspossi•38m ago
If it works out anything like AI helping with the settings on my new phone, they're in a world of trouble.
hamdingers•36m ago
Specifically for acne treatments, seems fine.

If a 20 minute telehealth visit with a PA is a sufficient level of screening for a medication, it's hard to imagine a compelling reason why an AI system would not be.

hansonkd•21m ago
Amazon's pharmacy prescribes a large swath of medications over text. No call or video necessary.

To make things more complicated, every message I sent was responded to by a different nurse practitioner. So it seemed everytime i sent a response or question, it would get routed to a random NP and she would respond without reviewing the full conversation.

Works if you know what you need, and I can't imagine AI being a worse process than whatever Amazon is doing.

rglover•33m ago
> The good news is that the program is currently very limited in its scope. It's just one year long and only for patients with mild-to-moderate acne.

Just in case anyone else has the gut "oh ffs" reaction to this.

janice1999•23m ago
It's the narrow end of the wedge.
1Kajsh•16m ago
The Nolla bro Luis Wenus was at Worldcoin before ...
dghlsakjg•8m ago
While I am too ignorant to have an opinion about whether AI is a good idea, I do think that ungating relatively safe medications from needing an MD's prescription is a good idea.

You don't have to go to medical school to know what bad acne looks like, or how to treat a UTI. We should be working on tiering prescriptions based on ease of diagnosis and risk.

augment_me•33m ago
This is great. It removes a big time waste of appointments and procedures for things that you know you need.

I have for example had tonsilitis 5+ times, and a lot of common colds/flus/etc. I know how my body reacts and how it feels when I have one or the other.

Yet, I have to be screened by nurses, sent around, given weak antibiotics, and in general wasting a lot of time when I could just convince a model to give me the prescription.

I have a friend with acne who has the same issues with tretinoin prescriptions. Endless appointments and time waste.

Step in the right direction

bogwog•13m ago
I agree, this is great.

I have for example hypersensitivity to radio waves. I know how my body reacts and how it feels when I'm exposed to such radiation, especially during vaxxine toxicity flareups.

Yet, I have to be screened by nurses, go through appointments with psychologists, and in general wasting a lot of time when I could just convince a model to prescribe the radium water I need.

Step in the right direction.

doubletwoyou•6m ago
Please tell me this is satire?
bogwog•4m ago
Based on this: https://futurism.com/future-society/alternative-health-influ...
ofjcihen•2m ago
If it is it’s beautiful.
1Kajsh•29m ago
They are going to data-mine this so hard. First acne, then other exemptions will be made. Utah is of course on the side of the industry.
AnimalMuppet•27m ago
For acne treatments. (Currently.) Not general medicine.
janice1999•24m ago
Prescribing medication for acne, some of which can have serious side affects like depression, is general medicine.
Quinner•8m ago
These are well tolerated topical medications
compiler-guy•18m ago
This is a good way to evaluate the technology.

Acne is a real problem for some people, but comparatively low stakes, mostly visual evaluation, and with pretty well-known solutions. (Of course everything has corner cases, but in general this is a well understood area.)

I have no idea how well this will go, but starting here rather than, say, robotic cancer treatments, can help AI medicine develop into more.

If it does go badly, then after a year we can re-evaluate and either give up or refine the system.

EA-3167•12m ago
What you’re describing wouldn’t be ethical even if everyone participated voluntarily, experiments on humans have to clear high hurdles.
bogwog•6m ago
Yes, and there's no shortage of historical examples showing why we need those hurdles to be so high.
slg•17m ago
What is the actual benefit here? If we believe the doctor's oversight is required, the AI introduces a dangerous potential for error. If we don't think a doctor's oversight is required, the medication shouldn't require a prescription in the first place. What positive value does the AI actually add that isn't circumventing a legal requirement that we decided to put in place?
abirch•10m ago
The removing a prescription is a federal law, something that Utah can't overrule. Unfortunately some prescriptions are good for some medication and not great for others.
socializer•9m ago
I think we came up with this dubious category of things that supposedly require oversight, but only to a minimal extent. Viagra, contraceptives, eyeglasses. You can already get these with near-zero diligence if you take the telehealth route, but I guess there's still someone who feels it would be a pressing societal issue if you took matters into your own hands and ordered the wrong kind of eyeglasses.

So here, AI isn't doing anything clever, it's just asking "are you sure you don't have a heart condition" and "are you sure you're not a crazy person". We don't really need LLMs for that, but if it's a catalyst for liberalization, fine.

toddmorey•4m ago
Yes and if you need a controlled prescription, it’s super painful. Can’t be transferred to another pharmacy, etc. extremely difficult to fill reliably.

And the medications that are controlled vs uncontrolled (at least here in Texas) seem completely random.

toddmorey•
HarHarVeryFunny•15m ago
> Being a doctor is one of the jobs expected to be least at risk from AI replacement

I wouldn't say that, but it's certainly one where the consequences are high and doctor-in-the-loop seems highly desirable for the foreseeable future, especially since most patients are not going to be knowledgeable enough to realize the shortcomings of an LLM and make an informed decision about whether they're OK taking an LLM-prescribed medication.

qubex•13m ago
#whatcouldpossiblygowrong
xp84•8m ago
This is the type of reform that has been difficult to achieve in the US (And I presume other high-regulation, Western countries).

We usually regulate a one-size-fits-all approach to everything in medicine. An M.D. (or whatever NPs have?) is required to prescribe medicines, even medicines which are just the same or slightly stronger formulations of OTC medications like a 400mg Ibuprofen or a 1% hydrocortisone cream. Compare this to Mexico, where you can buy many of our "prescription-only" meds OTC.

A lot of healthcare issues are just not high-stakes. Requiring a doctor in these cases doesn't help the average patient, because the average patient would rather ignore the problem, or now, ask ChatGPT how to treat it with OTC options, than deal with the mess of scheduling doctor appointments, dealing with insurance (or in Canada, long wait times to see the doctor for free), only to get just 5 minutes with the actual doctor who may not even listen to you.

I know it's a tough pill to swallow for doctors, and I recognize that it's not doctors who chose the terrible healthcare system we have or decided that they should have 5-10 minutes with a patient. But I do think we need to change the rules for things that have little risk of causing harm but a great chance of improving the aggregate outcomes by increasing access to healthcare.

dyauspitr•3m ago
I’m all for this, but I think this is wild. I hope they have some hard programmed limits and guidelines baked in because otherwise people are going to turn these into the new pill mills.
tibbydudeza•3m ago
I have severe backpain - some opioid will do nicely.
bena•3m ago
Who is accountable when this thing does something harmful?
redox99•3m ago
> Being a doctor is one of the jobs expected to be least at risk from AI replacement

Is it? At least as a customer I'd love to replace a doctor with AI. Humans suck, you have to wait so long for an appointment, they spend like 10 minutes on your case, and often have very outdated knowledge. The main issue is that vision still sucks and lack of embodiment is a problem. It could invoke "human subagents" for that.

johnnyanmac•2m ago
[delayed]
OkayPhysicist•13m ago
Why haven't they yanked those suckers out? My brother got his tonsils out out after infection number 2.
dghlsakjg•11m ago
There's other solutions that can also be explored.

Where I am in BC, Canada, pharmacists can prescribe specific medications for certain pre-approved conditions, and there is also the concept of an "emergency" refill for if you lose your medication or are unable to get an appointment in time, a few days of a previously prescribed medication can be provided.

At the end of the day, a better solution is to have tiers of prescription meds. Not everything needs to be gate-kept by MDs. If an AI can prescribe it, there is no reason a nurse, pharmacist or other medical professional shouldn't be able to as well.

8m ago
AI is already being used to guide care outcomes and overrule doctors via “utilization management”.

I am a big believer in AI for drug discovery. But AI applied to patient care will never be used to benefit the patient or increase quality of care.

Cost reductions will be absorbed for profits. The medical industry has already aggressively implemented AI automation (imaging, automated note taking, etc) and in that period, costs have only increased.

matt_heimer•6m ago
People can be uneducated about medication, acetaminophen overdose is a leading cause of acute liver failure in the United States. A little bit of a barrier and forced information about the concern might not be a bad thing but it doesn't require a doctor. A lot of medication probably falls in the same category but is on the other side of the prescription fence.

And doctors aren't infallible, AI (and rule based systems) can act as an extra safeguard for them as long as they don't blindly trust it.

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