“Culture crushes innovation.”  Here, we must not point the finger of blame for the dysfunctional health ecosystem at physicians, nurses and allied health professionals on the hospital floor.  Healers want to heal as much as those who need their help seek answers and solutions. The shared problem is not how to utilize this “hot” evolving technology but are we prepared to make the investment in time and training!  Time to input (usable) data into EMRs and learning technologies that can sort and “scrape” through and highlight information to accelerate clinical decision-making. 

Using AI to Reject Patient Claims and Care

One part of the challenge is understanding how to cognitively maximize and explore vast amounts of information is another. The other is to come to agreement in how AI can and cannot be used ethically and responsibility. As we saw recently, a nascent AI system must not be used by major health insurance companies to deny patients coverage for medicines and procedures.

While the “system” is resistant to significant change and science has become politicized and misunderstood, we must rally to the dual-goal of saving lives and reducing costs.  Can information technologies and “intelligent health systems” do what people in power have not achieved?  Are we able to educate consumers about being partners in data security? Can information bring people – professionals and consumers – together and transform this country’s post-WWII build health system? Yes!

Cardiologist Eric Topol, MD, reflects on the tension between patient care and AI in a Time Magazine interview about his bestselling book Deep Medicine:

“AI will always need human backup. A machine could handle certain things autonomously–diagnosing a skin rash, for example. Doctors shouldn’t be dealing with things that machines will do better than them. But serious conditions, like getting a cancer diagnosis, are what doctors should be working on. I think once patients understand that there are things they don’t need doctors to do, they would love it–once they get used to it.”

Many health professionals (and patients) are understandably wary! In one Medscape interview a physician shared this experience:

“We’ve played around with it. It was very early on in AI and we noticed it gave us incorrect information with regards to clinical guidance,” said Monalisa Tailor, MD, an internal medicine physician at Norton Health Care in Louisville, Kentucky. “We decided not to pursue it further,” she said.

Don’t close the door on an evolving technology! Care professionals work within a system that hinges on economics – how the institution is paid and how it must cover costs.  What is to be done if the system cannot support the health professional’s efforts or make the best use of their training, abilities, energy and dedication?  What will happen as more and more health professionals ghost the provider system that they feel no longer addresses their emotional and economic needs? These are questions that must be addressed sooner than we think! AI is inescapable. It’s an evolutionary process that will improve – improve health professionals and care output – over time.

Perhaps the biggest question is whether we can wait to resolve all these questions while health costs soar and people risk dying from treatable illnesses.  We should already know that answer! If you’re living in the question, that’s great. One way to resolve your angst and uncertainty is to follow people – some pioneers and others pundits – who are also asking those questions, doing the necessary research and exploring sensible possibilities.

20 AI/ChatGPT Champions to Follow

It was a challenge to select only 20 influentials for this listing. There countless people writing, speaking and commenting about AI and ChatGPT. It’s a hot topic and “trendy.” This list is not about “trends” and it isn’t an exclusive roster of people. However, these people are key voices of influence at the frontlines of AI and ChatGPT and are boldly considering how the health sector will need to support and adapt to these technologies ethically. It is important to follow their social posts, speeches and writings. They are theorists, physicians and teachers. What they say and where they say it can inform your opinion and direction. Follow them and get smarter faster!

Acknowledgements

As always, thanks to my friend and Medika Life Founding Editor-in-Chief Dr. Robert Turner, and Cullen Burnell for their encouragement and suggestions, and to Carolyn Neugarten, Medika Life Editorial Assistant for her efforts in making this feature possible, and Tyler Mayers, whose expertise sharing content across social platforms makes important information widely accessible. Special appreciation to colleagues from numerous professional circles who shared their thoughts and contributed recommendations. Special acknowledgement to people who appeared on previous Medika Life Lists and continue on the path to improve the wellbeing of people and planet. These exemplary people are dedicated to improving people’s health and know their efforts will make a difference.

AI and ChatGPT are frightening to some and mysteries to others. Humanity must decide how to best deploy these evolving and “thinking” technologies. What to do next is a mindful choice in the hands of people, and must be for the sake of people.

Gil Bashe, Editor–in-Chief, Medika.Life

AI and ChatGPT Global Voices of Influence

Here is our Medika Life roster of 20 people to follow in alphabetical order; all-important voices – to track and learn from in the coming years We have included wherever available links to the social media platforms and bios.

Follow these Voices and Leaders of Influence – They are writing the future of how AI and ChatGPT will be essential to health care delivery.

Ran D. Balicer, MD

Dr. Ran D. Balicer, a public health physician, executive and researcher, serves as Chief Innovation Officer & Deputy-DG at Clalit – Israel’s largest health insurance organization, and is Founding Director of the Clalit Research Institute.

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Regina Barzilay, MD

Dr. Regina Barzilay is a School of Engineering Distinguished Professor for AI and Health in the Department of Electrical Engineering and Computer Science, and a member of the Computer Science and Artificial Intelligence Laboratory at the Massachusetts Institute of Technology (MIT).

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Kirk Borne, PhD

Dr. Kirk Borne is a Data Scientist, providing thought leadership, global speaking, content creation, mentoring, training, and consulting activities in data science, machine learning, and AI across multiple disciplines.

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Atul Butte, MD, PhD

Atul Butte, MD, PhD is the Priscilla Chan and Mark Zuckerberg Distinguished Professor and inaugural Director of the Bakar Computational Health Sciences Institute (bchsi.ucsf.edu) at the University of California, San Francisco (UCSF). 

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Lex Fridman, PhD

Lex Fridman, PhD, is a Russian-American computer scientist, podcaster, and artificial intelligence researcher. He is a research scientist at the Massachusetts Institute of Technology (MIT), and hosts the popular Lex Fridman Podcast, a podcast and YouTube series.

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Mo Gawdat, MBA

Mohammad “Mo” Gawdat is an Egyptian entrepreneur and writer. He is the former chief business officer for Google X and author of the bestselling business books Solve for Happy and Scary Smart – The Future of Artificial Intelligence and How You Can Save Our World.

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John Halamka, MD, MS

John D. Halamka, M.D., M.S., president of the Mayo Clinic Platform, was trained in emergency medicine and medical informatics, Dr. Halamka has been developing and implementing healthcare information strategy and policy for more than 25 years.

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Eric Horvitz, MD

Microsoft’s Chief Scientific Officer and an early AI champion for health and medicine going back many years, Dr. Eric Horvitz is among the founders and funders of Stanford’s 100-year longitudinal study of the impact of AI on Society.

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Daniel Kraft, MD

Daniel Kraft, MD, is a Stanford and Harvard-trained physician-scientist, inventor, entrepreneur, and innovator and is serving as the Chair of the XPRIZE Pandemic & Health Alliance. With more than 25 years of experience in clinical practice, biomedical research and health innovation.

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Tom Lawry

A leading AI transformation advisor to health and medical leaders around the world. Lawry is the best-selling author of Hacking Healthcare – How AI and the Intelligent Health Revolution Will Reboot an Ailing System, former Microsoft National Director of AI and now the managing director of Second Century Tech LLC, and partner in Aspire Health Innovations.

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Fei-Fei Li, PhD

Dr. Fei-Fei Li is the inaugural Sequoia Professor in the Computer Science Department at Stanford University, and Co-Director of Stanford’s Human-Centered AI Institute. She served as the Director of Stanford’s AI Lab from 2013 to 2018.

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Berci Mesko, MD, PhD

Bertalan Meskó, PhD is known as “The Medical Futurist” and the Director of The Medical Futurist Institute analyzing how science fiction technologies can become a reality in medicine and healthcare. He holds a PhD in genomics and is an Amazon Top 100 author. 

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Mira Murati

Mira Murati is the Chief Technology Officer at OpenAI, and one of the most influential innovators in technology and AI. She oversees efforts to commercialize OpenAI products and improve them through human feedback. She serves on the leadership teams that developed the OpenAI ChatGPT and Dall-E systems.

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Andrew Ng, PhD

Dr. Andrew Ng is a globally recognized leader in AI. He is Founder of DeepLearning.AI, Founder & CEO of Landing AI, General Partner at AI Fund, Chairman and Co-Founder of Coursera and an Adjunct Professor at Stanford University’s Computer Science Department.

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John Nosta

John Nosta is a cutting-edge thinker in the world of technology, science, medicine and innovation. He is a globally recognized among the foremost voices constantly pushing the envelope on how AI and ChatGPT will transform health settings and work flow. Nosta is non-stop power thinker (and contrarian) and has more than 500 articles published on innovation topics.

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Tam C. Nguyen

Associate Professor Tam Nguyen has more than 20 years of working in clinical trials, health and medical research and research management sector including tertiary teaching hospitals, medical research institutes and universities across Australia. He is the co-editor of the recent book: AI in Medicine (Springer).

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Ziad Obermeyer, MD

Ziad Obermeyer, MD, is the Blue Cross of California Distinguished Associate Professor of Health Policy and Management. He is a physician and researcher who works at the intersection of machine learning and health.

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Brian Roemmele

Brian Roemmele is a scientist, researcher, analyst, connector, thinker and doer. Brian became an early adopter of AI and neural networks and pioneered Prompt Engineering technologies and techniques to understand and extract information from AI platforms.

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Mihaela van der Schaar, MD

Mihaela van der Schaar, MD, is the John Humphrey Plummer Professor of Machine Learning, Artificial Intelligence and Medicine at the University of Cambridge and a Fellow at The Alan Turing Institute in London. In addition to leading the van der Schaar Lab, Mihaela is founder and director of the Cambridge Centre for AI in Medicine (CCAIM).

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 Eric Topol, MD

Eric Topol, MD, is the founder and director of the Scripps Research Translational Institute; Executive Vice President, Scripps Research; Professor, Molecular Medicine, Scripps Research; and the Gary and Mary West Endowed Chair of Innovative Medicine, Scripps Research. In many ways, Dr. Topol was he kindled that started the AI transformation with his more than 1,300 publications and bestselling books.

Dr, Topol appears last – alphabetically – on this Top 20 Voices in AI and ChatGPT to follow. His ideas and prodding the system, perhaps place him first!

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Spot a broken link, typo, forgotten degree or name misspelled?

Oops! Apologies! While care has been taken in compiling this list and adding social media links, things go wrong or a name is misspelled or a link broken. Please do get in touch to address typos, amendments, or omissions by reaching gil.bashe@medika.life.

Thanks in advance and be healthy!

The post Medika’s Top 20 AI Voices to Watch. Follow These Experts as They Demystify AI and Its Future appeared first on Medika Life.

The Republican-dominated SCOTUS expanded First Amendment rights for private operations in the public marketplace in a controversial June 2023 decision, opening the doors for continual blows to LGBTQ+ and other unprotected parties’ legal rights. This setback in anti-discrimination law must be put to good use — not to discriminate against social identity groups that deserve legal protection, but to discriminate against entities that continue to exploit the environment.

The Supreme Court decision has dismantled state public accommodation laws for those who manufacture “expressive goods” — services offered by marketing firms to family photographers all fall under that umbrella. Any business involved in conveying a customer’s message that conflicts with their own ethical or religious beliefs (say, a Ukrainian film director commissioned to create a pro-Putin documentary) reserves a right to reject the offer, according to the majority opinion of 303 Creative LLC v. Elenis. Though sensible in some cases, the decision is also a victory for religious conservatives seeking to expand the reach of the First Amendment into the rights of previously protected classes.

Given the power of businesses to exercise such broad discriminatory powers, ensuring that those obstructing climate progress be shut out of the public marketplace is a way to utilize this free expression to advance a pro-climate agenda. Imagine if large oil companies had limited access to consulting firms, attorneys, accounting firms, and marketing agencies, who all disapproved of the continued burning of fossil fuels — perhaps then the oil and gas industry would elect to incorporate a more climate-conscious attitude.

The Implications of 303 Creative

The U.S. Supreme Court delivered its 6–3 decision regarding 303 Creative LLC v. Elenis on the final day of one of the most contentious terms in history, siding with a Christian web designer who refused to create custom wedding websites for gay couples.

Colorado’s current anti-discrimination law CADA prohibits businesses in the public marketplace from discriminating against customers’ “disability, race, creed, color, sex, sexual orientation, marital status, national origin, or ancestry.” (Colorado is one of twenty-one U.S. states that includes sexual orientation as a protected class.) Devout Coloradan Christian and successful litigant Lorie Smith, seeking to expand her web design services to custom wedding websites, refused to “communicate ideas or messages… inconsistent with [her] religious beliefs”.

According to the majority opinion penned by Trump-appointed justice Neil Gorsuch, the win rested on the notion that free expression outweighs the duty of anti-discrimination when providing “expressive” goods and services. “Expressive” businesses can cite both ethical and religious reasons for refusing to sell to or service certain members of the public, falling under the grounds of free speech.

Critics of the court and members of the LGBTQ+ community are outraged. The decision ultimately expands religious freedom to allegations of LGBTQ+ discrimination, and confirms that sexual orientation is not protected against discrimination under federal law.

Yet had the decision swung the opposite way, free expression by individual companies and public services may have looked a lot different in the future. Businesses may no longer have had the ability to cut ties with tobacco companies or gun manufacturers. Attorneys would be required to represent ideas they were ethically against, and marketing professionals would be legally required to promote goods and companies they deemed harmful. Through that lens, the 303 Creative decision is a crucial promoter of free speech and individual advancement of important social causes. Simultaneously, unprotected groups like undocumented immigrants, those with criminal records, and trans individuals may continue to be turned away from businesses that profit from the public market.

A ruling in either direction seems to promote discrimination and/or compelled speech. Whether in agreement with the ruling or not, it still stands; and since companies are granted this expansive discriminatory power, it is imperative to utilize it against harmful, destructive groups, turning a controversial SCOTUS decision into a mode of climate activism.

How to Take Action

With a regression in anti-discrimination laws on one end, we need to see a progression in ending the climate crisis on another.

The November 2023 United Nations’ Conference of the Parties (COP28), an internationally recognized and respected climate summit, is projected to have the most attendees of any COP to date. New energy transition and carbon cutting goals are set to take hold by the end of the year, and climate finance policies will expand now more than ever before. True progress is being made and nations are mobilizing for tangible climate impact; individual companies must take part.

In the new movement Clean Creatives, over 350 advertising agencies and public relations firms have pledged to use both their platform and reinforced ability to turn away unethical groups to stop fueling the climate crisis.

Public relations firms are instrumental to the oil and gas industry’s greenwashing and brand-building strategies, deflecting responsibility from fossil fuel companies and downplaying the severity of continued emission output. Ending associations with the gas and oil industry, the “largest contributor to climate change” according to UN Secretary-General Antonio Guterres, is the first step of many to accelerate climate activism.

Public relations and marketing professionals are all charged with allowing fossil fuel giants to continue to operate, and it is up to them to say no to those who hinder climate progress. Utilizing the 303 Creative LLC v. Elenis decision is a necessary, positive exertion of expanded First Amendment rights to promote climate activism, and a way to shut out fossil fuel companies resistant to global pro-climate efforts.

The post How To Use a Controversial Supreme Court Ruling for Good appeared first on Medika Life.

With its barebones layout and shockingly inexpensive merchandise, these dollar store retail powerhouses have emerged as an American cultural icon, and more importantly, an absolute necessity for lower-income shoppers. They serve as a convenient nearby option for suburban and rural communities and have historically remained resistant to inflation. The one-dollar price tags have sheltered consumers from economic ups and downs and persistent price climbs; for over 70 years, prices have barely budged (barring recent COVID-related modifications). Some 88% of Americans flock to these discount retailers yearly in search of a range of products, and in response, dollar stores’ footprint across America continues to expand.

Unsurprisingly, rural America holds the largest percentage of regular dollar store shoppers. The establishments are disproportionately concentrated in the Sun Belt and Midwest, catering to consumers with limited options. These discount stores are some families’ local grocer, convenience market, and health store all rolled into one — a rural American’s means of survival.

With the dollar store as the only convenient possibility, Dollar General’s new health clinic rollout can be a revolutionary move in rural health, providing accessible treatment options to those who might not be able to even see a clinician otherwise. Proposed clinics will provide urgent care and lab testing within easy reach when hospitals may be many miles and in some cases many hours away.

Yet two questions remain: Are dollar stores harming or helping rural America? And how much can we really trust dollar stores to administer treatment?

How Dollar Stores Work

Having more locations than Starbucks, Walmart, and McDonald’s combined is no easy feat, yet the dollar stores of America seem to be one of the most resilient establishments in our economy. During COVID-19, similar-sized stores crumbled and declared bankruptcy. Dollar stores, on the other hand, flourished.

What makes the dollar store such a successful model, even in a time of crisis? Most of these discount retailers operate the same way — selling a small selection of cheap wholesale goods to a smaller consumer pool. In many rural areas, the dollar store is the only source of food, health, home, and other vital items for miles. Accordingly, they received an ‘essential’ classification during COVID-19 and enjoyed 16% growth in the year 2020. Dollar stores have historically thrived against similar recessionary backdrops and financial downturns, including the 2008 economic recession, drawing in customers forced to turn away from more expensive establishments in search of cheaper options.

These discount chains employ many tactics to generate profit. First off, some goods aren’t worth a dollar. Dollar stores profit off eighty and ninety cent products; when looking at a Dollar Tree laundry detergent brand, there is a high proportion of water compared to cleaning liquid. Dollar stores also shrink package sizes. The Dollar Tree aluminum foil offering, priced at $1, was only 15 square feet long, while Walmart sold a 75 square foot roll for $4.06, the equivalent of more than 18 square feet per dollar. That’s not to say dollar stores do not offer discounted items; some dollar store merchandise may just be deceptively more expensive per unit. All businesses need to make a profit to survive, after all.

Dollar stores manage to cut venue-related costs by leasing their properties rather than buying them, and having relatively few employees. Their physical layout is also precisely manufactured. Dollar store aisles, particularly in the larger chains, are incredibly tiny, with an overload of merchandise surrounding customers from all angles. Towers of potato chips and party straws jut out into the aisle, so that you must make a point to move around them, and perhaps you’ll make an impulse buy you otherwise wouldn’t if those potato chips look particularly enticing.

Perhaps shoppers do score granola bars for one dollar instead of five, but dollar stores know they most likely won’t leave without a basket full of other things.

The Dollar Store Distribution

Dollar stores are now opening at a rate of 3 a day, and larger chains currently have a whopping 35,421 locations nationwide.

Targeting retail and food deserts, locations are typically situated on remote roads away from downtowns and more populated town centers. However, the selection system is more complex for America’s three dollar store titans: Dollar General, Family Dollar, and Dollar Tree.

The big three employ strikingly similar practices when searching for new sites to occupy, targeting devastated, lower-income areas, areas where no supercenter would dare go for fear of a too-small customer base. In distressed urban and suburban cities and towns, it is common to see three, four, or even five of these dollar stores within a few block radius, choking out smaller chains and grocery stores.

Rural America has seen a disproportionate share of the dollar store frenzy. Three-quarters of Dollar Generals serve communities of less than 20,000 residents, and dollar store giants favor locations that share a proximity with landmarks like a post office or a church, typically situated together in rural towns. These towns also have plenty of customers within the dollar retailer demographic — the “typical” shopper is an older, rural worker with a high school education, and a yearly salary of $40,000. An overwhelmingly high proportion of racial minorities in rural households also shop at dollar stores.

These trends are worrying. Dollar store regulars are not getting high-quality essentials they need and have no way to access them in the first place; these seemingly small sacrifices add up and contribute to a larger issue of health and consumer inequity.

The Rural Food Crisis

Though dollar stores claim they are not a grocery store, many rural Americans still utilize it as one. According to a Tufts University study, They are one of the fastest-growing food retailers in the country.

To increase store revenue, dollar stores do their best to offer the least amount of perishable items; they have lower profit margins and a shorter shelf life. As a result, any fresh produce, meats, and typically nutrient-dense foods are hard to come by, while artificial, packaged, and highly processed options are abundant. Boxes of macaroni and cheese and sour gummies line the aisles, and why not? They’re shelf stable, more visually appealing choices. It’s not hard to understand why rural consumers naturally reach for more convenient and cheaper foods, as outside of the odd farm stand or farmer’s market, the next package of strawberries or fresh green beans may be miles away.

Unsurprisingly, independent grocers struggle in the face of discount giants. A 30% decline in produce shopping is observed in areas with multiple nearby dollar stores, which is enough to harm the fresh food market. To make a problem even worse, soda, snacks, candy, and crackers account for the largest share of consumer spending at dollar stores, only incentivizing more stock of these goods, and making healthy food completely inaccessible to rural Americans.

As regions already plagued with high rates of obesity and food insecurity with no nearby health clinics or hospitals, it appears that rural Americans are doomed to increased risk of heart disease and diabetes. They are deprived of essential food options and adequate health literacy and experience increased rates of poverty due to rising healthcare bills.

Of all potential mediators, Dollar General has emerged as a paradoxical savior with its new healthcare clinics — both contributing to the problem, and helping to fix it.

DG Wellbeing — A Rural Health Lifeline? Or A Disaster?

75% of Americans live within 5 miles of a dollar store. Only 60% are that distance from a hospital.

Dollar General is the first of the discount stores to dip its toes in medical care, outpacing other retail giants in their quest to “retail-ize the healthcare system”. This has been met with some thinly veiled alarm from the media — how can a company known for constantly cutting corners and its discount model adequately take on an entire rural population’s healthcare challenges?

The new initiative, DG Wellbeing, plans to attach health clinics to select Dollar General locations and expand in-store health merchandise, seeking to fill the gaps of rural healthcare deserts. As it stands, the initiative is in its infancy — large vans are positioned outside three Dollar General locations in Clarksville, Tennessee, providing “basic, preventative, urgent care and chronic condition-management services along with lab testing”. Next in the rollout process, Dollar General plans to expand its stock of healthcare products by 30% in its more than 18,000 stores.

Dollar General may be ill-prepared to tackle an entirely new to them $808 billion dollar health sector, and is providing potentially inadequate health treatment to a struggling population a risk worth taking? The company is currently battling employee protests about worker safety violations, claims of provoking neighborhood increases of violent crime, and a disproportionate amount of robberies and customer complaints. The same problems may travel to Dollar General’s healthcare clinics, raising concern about the staffing of underpaid, underqualified workers and low-quality care, effectively shortchanging the already budget-tight rural American population.

Dollar stores began as a budget-friendly, easy way to get crafts, toys, and the occasional snack. They were never intended to dominate the pantry and medicine cabinets of the American public. Growing the dollar store’s foray into the healthcare market only expands its reach into territory where it shouldn’t belong, and risks diverting focus away from longer-lasting, more effective treatment options for vulnerable populations like rural Americans.

While Dollar General’s entry point into the healthcare system is financially advantageous, what if improving existing locations took precedent over endless expansion and experimentation? Offering higher quality goods and accommodating nearby local grocery stores would likely be worlds more beneficial than instituting perfunctory healthcare clinics that may leave rural Americans with unsatisfactory medical treatment. The rural healthcare system is a far more complex, overwhelmed organization that the simple dollar store model is unlikely to successfully combat — perhaps dollar stores should first work on putting fewer cola bottles on their shelves.

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