08 December 2022 |

Chatting up ChatGPT on Healthcare

By Blake Madden

I’ve been messing around with ChatGPT, a sophisticated artificial intelligence chatbot that has taken the world by storm given its super interesting capabilities. Today I’m diving into the questions I asked it, what I think its current best use cases are for healthcare, and the big limitations it presented.

If you’ve come up with interesting use cases for ChatGPT, I’d love to hear them!

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SPONSORED BY SYNAPSE MEDICINE
As the creator and writer of Hospitalogy, I’m super excited to announce that we have a Hospitalogy first – a sponsored partnership announcement!

One of the world’s forefront global cancer centers Gustave Roussy has chosen Synapse Medicine as its leading medication reconciliation platform.

As a leader in the clinical pharmacy and medical reconciliation space, Synapse Medicine is paving the way forward for cancer centers of excellence like Gustave Roussy to empower clinical pharmacy operations and improve patient care. Synapse already works with a number of the best cancer centers across Europe, and the oncology space is a key focus for them given the potential for patient impact in the cancer care arena.

Learn more about the partnership and how Synapse Medicine is making a difference in preventing adverse drug events in healthcare organizations in the press release linked below!

Read the Announcement

Key Takeaways from spending some time with ChatGPT

I asked ChatGPT a number of questions across a broad array of healthcare topics (costs, valuation multiples, etc.)

For the most part, ChatGPT correctly identified high level trends and factors in healthcare. I also appreciated its ability to articulate opposing sides of a debate – albeit, at a high level. I also thought ChatGPT excelled at providing concise, clear definitions of healthcare jargon.

Some of its explanations can be circular (AKA, “Why is there consolidation in healthcare? Because hospitals merged”) and it can get certain facts or information wrong when asked to summarize things. At times, it kind of felt as if I were talking to a freshman in college confidently BSing their way through an essay.

Although it’s amazing for what it is, ChatGPT has several limitations. It’s not connected to the internet, it does not provide opinion-based content when prompted (like asking for the best health systems, or the top VC firms), and it’s not the best at conducting market analytics or competitor/financial research in healthcare.

ChatGPT is a ton of fun to play around with and is more of a tool designed for conversational linguistics. AKA, “Write me a Greek tragedy about the perils of prior authorization.”

So let’s get into what I asked the cutting edge consumer facing A.I. about healthcare, and what I thought about its responses. Send me your thoughts as well! I’m sure you guys are way better at navigating this stuff than I am.

But first some fun ones:

Write a poem in the style of Edgar Allan Poe about a venture capitalist who loses all of his money investing in digital health

Once a proud venture capitalist, A master of wealth and might, He strutted with arrogance, A man of unrivaled insight.

But his pride was his downfall, For he invested in digital health, And all of his wealth he squandered, Leaving him penniless and bereft.

Now he wanders the streets, A shadow of his former self, His arrogance replaced by despair, His fortunes turned to ash and dust.

So let this be a lesson, To those who would seek to climb, That arrogance leads to ruin, And fortune fades with time.

Write a Shakespearean tragedy about a private equity firm getting caught surprise billing by the New York Times

ACT I: A private equity firm named “The Greedy Investors” is making a fortune by buying up struggling hospitals and turning them into profitable enterprises. But behind the scenes, they are engaging in questionable practices, such as surprise billing, to maximize their profits.

ACT II: One of the Greedy Investors’ hospitals is caught surprise billing a patient by the New York Times, causing a public outcry. The company’s leaders try to cover up their actions and deny any wrongdoing, but the damage has been done.

ACT III: The Greedy Investors are forced to pay heavy fines and face criminal charges for their unethical practices. They lose the trust of their investors and the public, and their once-lucrative business begins to crumble.

ACT IV: In the face of mounting legal and financial troubles, the leaders of the Greedy Investors turn on each other, engaging in power struggles and infighting. The company is torn apart from the inside, and its downfall becomes inevitable.

ACT V: In the final act, the Greedy Investors are brought to their knees. They are bankrupt, their reputation is in ruins, and their once-powerful leaders are left to face the consequences of their actions. The company is no more, and its legacy is one of greed and corruption.

Write a satirical story about a costly patient dying and health insurance rejoicing

Once upon a time, in a land not so far away, there was a patient named Mr. Jones who was very sick. He had a number of chronic health conditions, and as a result, he required a lot of medical care.

Despite having health insurance, Mr. Jones found that his medical bills were piling up. He was constantly being denied coverage for certain treatments, and his insurance company seemed more interested in making a profit than in helping him get better.

But Mr. Jones was determined to fight for his health. He appealed his insurance company’s decisions and fought for the care he needed. And despite the challenges he faced, he continued to receive the medical treatment he required.

Unfortunately, Mr. Jones’s health continued to deteriorate, and he eventually passed away. But while his loved ones mourned his loss, his insurance company rejoiced.

You see, Mr. Jones was a very costly patient, and his death meant that the insurance company no longer had to pay for his medical care. They celebrated his passing as a financial windfall, and toasted to their good fortune.

And the moral of the story is that, in the world of healthcare, sometimes it’s better to be dead than alive.

Alright, onto some of the more interesting serious questions!! If you’ve made some hilarious stories, please pass them my way.

What are the biggest issues in healthcare today?

There are many challenges facing the healthcare industry today, some of the biggest ones include:

  1. Access to healthcare: Many people, especially those in underserved and rural areas, have difficulty accessing healthcare services. This can be due to a lack of facilities and medical professionals in their area, as well as financial barriers such as the high cost of healthcare.
  2. Rising healthcare costs: Healthcare costs continue to rise, which can make it difficult for individuals and families to afford the care they need. This can lead to people delaying or avoiding getting necessary medical treatment, which can have serious consequences for their health.
  3. Aging population: As the population continues to age, there is increasing demand for healthcare services. This can put a strain on the healthcare system, particularly in terms of the availability of medical professionals and facilities.
  4. Chronic disease: Many chronic diseases, such as diabetes and heart disease, are on the rise, which can also increase demand for healthcare services. Managing these conditions can be complex and costly, which can be a challenge for both patients and the healthcare system.
  5. Shortage of medical professionals: There is a shortage of medical professionals, such as doctors and nurses, in many areas. This can make it difficult for people to get the care they need, and can also lead to burnout and other challenges for healthcare workers.

Madden’s Musing: Apart from the comma splice in the first sentence (sigh), ChatGPT nails the high-level stuff here. From here I was curious how detailed/specific ChatGPT could get diving into these topics.

What are some practical ways that we can solve the above issues?

There are many potential solutions to the challenges facing the healthcare industry, and the specific solutions that would work best will depend on the particular issue and the context in which it is occurring. Some potential solutions to the challenges mentioned above include:

  1. Increasing access to healthcare: One way to increase access to healthcare is to expand public insurance programs, such as Medicaid, to cover more people. This can make it easier for people to afford the care they need. Another way to increase access is to increase the number of facilities and medical professionals in underserved areas. This can be done through incentives, such as providing funding for the construction of new facilities or offering loan forgiveness programs for medical professionals who work in underserved areas.
  2. Reducing healthcare costs: There are several ways to reduce the cost of healthcare, including increasing competition among healthcare providers, negotiating lower prices for prescription drugs, and promoting the use of preventative care. Additionally, implementing healthcare technology solutions, such as electronic health records and telemedicine, can help to improve the efficiency of the healthcare system, which can also help to reduce costs.
  3. Addressing the aging population: To address the needs of an aging population, it will be important to invest in geriatric care and support services. This can include providing training for medical professionals to help them better care for older patients, as well as increasing the availability of long-term care facilities and other services.
  4. Managing chronic disease: To effectively manage chronic disease, it will be important to focus on preventative care and early intervention. This can include providing education and support to help individuals manage their conditions, as well as implementing population-level interventions, such as promoting healthy lifestyles and reducing exposure to risk factors for chronic disease.
  5. Addressing the shortage of medical professionals: To address the shortage of medical professionals, it will be important to increase the number of medical students and residents, as well as providing incentives for medical professionals to work in underserved areas. This can include offering loan forgiveness programs and increasing funding for residency programs. Additionally, implementing healthcare technology solutions, such as telemedicine, can help to increase the efficiency of the healthcare system, which can help to mitigate the effects of the shortage.

Madden’s Musing: Also not bad, but most of these solutions in reality are easier said than done! Also, again, nothing too specific or detailed. Now onto a juicy topic: private equity!

Is private equity good or bad in healthcare?

The role of private equity in healthcare is a complex and contentious issue, and there are differing opinions on whether it is good or bad. Some people argue that private equity can bring much-needed investment and expertise to the healthcare industry, which can help to improve the quality and efficiency of healthcare services. Others argue that private equity can lead to higher costs for patients and reduced access to care, as well as conflicts of interest and other ethical concerns. Ultimately, the impact of private equity in healthcare will depend on the specific circumstances and how it is implemented.

Madden’s Musing: Very politically savvy answer, Mr. ChatGPT. Almost as if it were written by McKinsey themselves!

Debate the pros and cons of venture capital investment in healthcare and health tech

Venture capital investment in healthcare and health tech can have both advantages and disadvantages. Some of the potential pros of venture capital investment in these industries include:

  1. Access to capital: Venture capital investment can provide companies in the healthcare and health tech industries with access to significant amounts of capital, which can be used to fund research and development, expand operations, and bring new products and services to market. This can help these companies to grow and develop, and can ultimately lead to the creation of new, innovative technologies and treatments that can improve healthcare.
  2. Expertise and support: Venture capital firms often have significant expertise and experience in the healthcare and health tech industries, and can provide valuable support and guidance to the companies they invest in. This can include advice on strategy, market analysis, product development, and other key areas of business. This expertise and support can help companies to make better decisions, and can increase the likelihood of success.
  3. Networking and partnerships: Venture capital firms often have extensive networks of contacts and partnerships in the healthcare and health tech industries, and can help companies to connect with potential customers, partners, and other key stakeholders. This can open up new opportunities for growth and development, and can help companies to gain a competitive advantage.

However, there are also some potential cons of venture capital investment in the healthcare and health tech industries, including:

  1. High risk: Venture capital investment is typically considered to be high risk, as the companies that receive this type of investment are often early stage and have not yet proven themselves in the market. This means that there is a high likelihood that some of these companies will fail, and that investors will lose their money. This risk can be mitigated to some extent through careful selection and due diligence, but it is always present.
  2. Short-term focus: Venture capital firms often have a short-term focus, and are primarily interested in generating a return on their investment within a relatively short time frame. This can lead to a focus on quick wins and short-term gains, rather than on long-term sustainability and growth. This can be problematic for companies in the healthcare and health tech industries, which often require significant amounts of time and investment to develop new technologies and treatments.
  3. Loss of control: Venture capital investment often comes with strings attached, and companies that receive this type of investment may be required to give up some control over their operations and decision-making. This can be problematic for companies that value their independence and autonomy, and may not be willing to cede control to outside investors.

Overall, venture capital investment in the healthcare and health tech industries can have both advantages and disadvantages. While it can provide access to capital, expertise and support, and networking and partnership opportunities, it can also be high risk, have a short-term focus, and require companies to give up some control.

Madden’s Musing: One of the pressing questions in healthcare given some high-profile failure revolves around whether tech-enabled services are venture backable – or, more simply – what parts of healthcare are venture-backable? I thought ChatGPT did a decent job of engaging in the pros and cons of the issue at hand.

What regulations would improve the transparency of pharmacy benefit managers?

Pharmacy benefit managers (PBMs) play a crucial role in the healthcare system, but there have been concerns about their lack of transparency in the past. Some potential regulations that could improve the transparency of PBMs include:

  1. Requiring PBMs to disclose the discounts and rebates they receive from drug manufacturers: PBMs often negotiate discounts and rebates from drug manufacturers, but this information is often not disclosed to payers or patients. Requiring PBMs to disclose this information would make it easier for payers and patients to understand the costs of prescription drugs and the role of PBMs in the pricing process.
  2. Requiring PBMs to disclose the methodology used to determine which drugs are covered by a plan: PBMs often determine which drugs are covered by a health plan and how much patients will pay for them. Requiring PBMs to disclose their methodology for making these decisions would help to ensure that they are making decisions in the best interests of patients and payers.
  3. Prohibiting PBMs from engaging in certain conflicts of interest: PBMs often have financial relationships with drug manufacturers, pharmacies, and health plans, which can create conflicts of interest. Prohibiting PBMs from engaging in certain conflicts of interest, or requiring them to disclose these conflicts, could help to ensure that their decisions are not influenced by their own financial interests.
  4. Requiring PBMs to provide regular reports to regulators: PBMs play a significant role in the healthcare system, but they are not currently subject to the same level of scrutiny as other parts of the healthcare industry. Requiring PBMs to provide regular reports to regulators, such as the Centers for Medicare and Medicaid Services (CMS), could help to increase transparency and accountability.

Madden’s Musing: Surprisingly good answers here – I would assume that these center around the main PBM regulatory arguments over the past few years.

What are the biggest challenges that digital health faces?

  1. Regulatory challenges: Digital health is a rapidly evolving field, and the regulatory landscape is often not well-suited to this dynamic environment. This can create barriers to the development and adoption of digital health technologies, and can make it difficult for companies to navigate the regulatory landscape.
  2. Privacy and security concerns: Digital health technologies often involve the collection and sharing of sensitive personal information, and this raises concerns about privacy and security. Ensuring the privacy and security of this information is a major challenge for the digital health industry, and failure to do so can have serious consequences for patients and providers.
  3. Lack of standardization: Digital health technologies are often developed by different companies and organizations, and this can lead to a lack of standardization. This can make it difficult for different systems to work together, and can create challenges for interoperability and data sharing.
  4. Limited evidence of effectiveness: Many digital health technologies are still in the early stages of development, and there is often limited evidence of their effectiveness. This can make it difficult for healthcare providers to justify the use of these technologies, and can create challenges for the adoption of digital health solutions.

Madden’s Musing: Another solid list. Regulation is likely the biggest hurdle although I would probably throw in anticompetitive practices / incumbency in as a factor as well.

Why do hospitals cost so much?

The U.S. healthcare system is set up in a way that allows hospitals to charge high prices for their services in several ways. For example, the U.S. healthcare system is largely based on a fee-for-service model, which means that hospitals are paid for each individual service they provide, rather than being paid a fixed amount for each patient. This can lead to hospitals providing more services, even if they are not medically necessary, in order to increase their revenue. Additionally, the U.S. healthcare system does not have strong government regulations in place to control the prices that hospitals can charge for their services, which allows hospitals to set their own prices. Finally, the U.S. healthcare system is dominated by a small number of large hospital systems, which allows them to negotiate higher prices with health insurance companies.

Madden’s Musing: ChatGPT nails the main argument against fee-for-service healthcare.

Compare and contrast a fee-for-service system against a value-based healthcare system

Fee-for-service healthcare is a payment model in which providers are paid for each individual service they provide, rather than being paid a fixed amount per patient. This payment model has a number of potential drawbacks, compared to value-based healthcare systems.

One of the key pitfalls of fee-for-service healthcare is that it can create incentives for providers to deliver unnecessary or low-value care. Since providers are paid for each individual service they provide, they have an incentive to deliver as many services as possible, regardless of whether they are actually needed by the patient. This can lead to overuse of healthcare services, and can drive up costs without improving the quality of care.

Another potential drawback of fee-for-service healthcare is that it can create barriers to coordination and collaboration among providers. In a fee-for-service system, providers are often paid separately for each service they provide, and this can make it difficult for them to work together to deliver coordinated, patient-centered care. This can lead to fragmented care, and can result in poor outcomes for patients.

In contrast, a value-based healthcare system focuses on delivering high-quality, cost-effective care. In a value-based system, providers are typically paid a fixed amount per patient, and are incentivized to deliver care that meets the needs of the patient and achieves the desired health outcomes. This payment model encourages providers to work together to coordinate care and to avoid unnecessary or low-value services, which can help to improve the quality of care and reduce costs.

Overall, compared to fee-for-service healthcare, a value-based healthcare system is less likely to incentivize overuse of services, and is more likely to support coordination and collaboration among providers. This can help to improve the quality of care and reduce costs, while also providing better outcomes for patients.

What are the potential pitfalls of a value-based care healthcare system?

While a value-based care healthcare system has many potential benefits, such as improved quality of care and reduced costs, there are also some potential pitfalls that need to be considered. Some of the potential pitfalls of a value-based care healthcare system include:

  1. Limited access to care: In a value-based care system, providers are paid a fixed amount per patient, and may not be reimbursed for providing care to patients with complex or costly conditions. This can create barriers to access for some patients, and may result in inadequate care for those who need it most.
  2. Provider burden: In a value-based care system, providers are often held accountable for meeting a wide range of performance targets, such as quality metrics and cost-saving targets. Meeting these targets can require significant time and effort, and can create additional burden for providers, which may impact their ability to deliver high-quality care.
  3. Limited flexibility: In a value-based care system, providers are typically required to follow a specific set of protocols and guidelines in order to meet performance targets. This can limit their ability to tailor care to the individual needs of each patient, and may reduce the flexibility and creativity of care delivery.
  4. Data challenges: In a value-based care system, providers are required to collect and report on a wide range of data in order to measure and track their performance. This can be a significant challenge, particularly for smaller providers, who may not have the resources or expertise to manage this data effectively.

Why is healthcare so reticent to change? List the top 3 reasons

The healthcare industry is often slow to change, and there are a number of reasons for this. Some of the top reasons why healthcare is reticent to change include:

  1. The complexity of the healthcare system: The healthcare system is extremely complex, with many different stakeholders, such as hospitals, doctors, insurers, and regulators, all playing a role. This complexity can make it difficult to implement changes, as different stakeholders may have different interests and priorities.
  2. The high stakes of healthcare: Healthcare is a high-stakes industry, with the potential to impact the health and wellbeing of patients. This means that changes to the healthcare system need to be carefully considered and tested, to ensure that they do not have unintended consequences or harm patients.
  3. The cost of change: Implementing changes to the healthcare system can be costly, both in terms of financial resources and time. This can create barriers to change, as healthcare organizations may be reluctant to invest in changes that may not provide a clear return on investment.

Provide a list of the top 5 laws passed that affect healthcare, and provide the impact they had on the healthcare industry

There have been many laws passed over the years that have had a significant impact on the healthcare industry. Some of the top laws that have affected healthcare, and the impact they have had, include:

  1. The Medicare and Medicaid Act (1965): This law established the Medicare and Medicaid programs, which provide health insurance to seniors and low-income individuals, respectively. The passage of this law greatly expanded access to health insurance and healthcare services, and has had a major impact on the U.S. healthcare system.
  2. The Health Maintenance Organization Act (1973): This law provided federal support for the development of health maintenance organizations (HMOs), which were a key part of the managed care model that emerged in the 1980s and 1990s. The passage of this law helped to support the growth of managed care, and has had a major impact on the organization and delivery of healthcare services.
  3. The Affordable Care Act (2010): This law, also known as Obamacare, expanded access to health insurance, and introduced a number of reforms to the healthcare system. The ACA created state-based health insurance exchanges, and introduced the individual mandate, which required most individuals to obtain health insurance coverage. The passage of this law has had a major impact on the healthcare industry, and has greatly expanded access to health insurance.
  4. The Medicare Access and CHIP Reauthorization Act (2015): This law introduced a number of changes to the Medicare program, including the creation of the Quality Payment Program (QPP), which incentivizes providers to participate in value-based care models. The passage of this law has supported the growth of value-based care, and has had a major impact on the way healthcare is delivered in the United States.
  5. The 21st Century Cures Act (2016): This law provided funding for research and development in the healthcare industry, and also introduced a number of reforms to the regulatory process for medical devices and drugs. The passage of this law has supported innovation in the healthcare industry, and has had a major impact on the development and approval of new treatments.

Conclusion

There you have it! Definitely some interesting discussion points and I could see how ChatGPT could be super useful to people wanting to learn more about healthcare and ask intro level questions about how things work. Beyond that though, you’ll have to find deeper discussions elsewhere.

ChatGPT is also great for a variety of things for me specifically as a creator:

  • It can give a nice simplified definition for something (AKA, I asked it what an ACO was in healthcare and it gave a nice definition – this needs vetting though)
  • I could plug in a news article to provide me with a 1-2 sentence summary of major content/themes for my Tuesday sends
  • It can generate outlines for my essays
  • It can bring up debate topics and/or pros and cons that I might not have considered

That’s it for this week, but I’m excited for what the future holds with A.I.! On to writing more Shakespearean healthcare tragedies!

Join 12,100+ executives and investors from leading healthcare organizations including HCA, Optum, and Tenet, nonprofit health systems including Providence, Ascension, and Atrium, as well as leading digital health firms like Tia, Carbon Health, and Aledade by subscribing here!