AI Corner Lauterbach at Harvard Kennedy School

 I typed some rough laptop notes with many typos during the Kennedy School talk (Lauterbach/Tripathi) on US and Germany health systems and digital advances.   I asked Chat GPT to convert the typed bullets and phrases into an essay.  2023 Sep 22.

Main blog here - https://www.discoveriesinhealthpolicy.com/2023/09/lecture-notes-german-health-ministers.html

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CHAT GPT:  CREATES A GOOD ESSAY FROM TYPOS & FRAGMENTS IN MY NOTES 

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On the 22nd of September, 2023, at the Harvard German American Club, an enlightening discussion took place on the topic of "Data and AI in Healthcare." The distinguished speakers were Dr. Lauterbach, the Health Minister of Germany, and Dr. Tripathi, the head of the Office of the National Coordinator (ONC) for US health data. The conversation, held at the Kennedy School of Government, was skillfully moderated by Dr. Agrawal of Harvard University.

Dr. Agrawal, who boasts affiliations with Heidelberg, Johns Hopkins University, and Dana Farber, opened the session by introducing the central theme - the critical role of health data in saving lives every day.

In response to the question of where the most tangible benefits of health data lie, Dr. Lauterbach underscored the need for Germany to catch up in health IT technology. He emphasized two key priorities: transitioning to fossil-free energy and fostering digital advancements, particularly in healthcare. Dr. Lauterbach outlined four forthcoming laws that would address these priorities, highlighting their collaboration with Dr. Lennerz and colleagues at Harvard.

The first set of laws pertains to two circles of data: the outer circle for Care and the inner circle for Research, both interconnected. By 2025, Germany aims to connect 70 million individuals to an Electronic Health Record (EHR), allowing for opt-out options. Within this network, 20,000 pharmacies, 1,800 hospitals, 180,000 doctors' offices, and laboratories would enable immediate EHR access to patient reports. This data can also be accessible to patients, with doctors potentially granted permission to access comprehensive medical information, including hospital and radiology reports.

The outer circle is encrypted but not anonymized, ensuring data security. 

In contrast, the inner circle can access clinical, cohort, and genomic data, residing in the Federal Research Space (FRS). The FRS is a confidential, non-encrypted research space, open for analysis, and will serve as a valuable resource for AI systems. Researchers and organizations, including pharmaceutical companies, will gain access to this data for various purposes.

Addressing the challenges of data privacy and structure, Dr. Lauterbach stressed the importance of making data accessible yet keeping it confidential. He also recognized the need to structure narrative data for retrospective analysis, possibly through partnerships like "Lewins [?]."

Dr. Tripathi, speaking on ONC priorities, expressed admiration for the top-down authority held by Dr. Lauterbach. In contrast, the United States faces fragmentation in its healthcare delivery system. Instead of a unified database, the U.S. system comprises loosely connected providers and payers, making interoperability a complex challenge.

Dr. Tripathi highlighted the significant investments made in the U.S. to lay the foundation for digital health, including incentives for Electronic Health Record adoption. He discussed the need for modern interoperability, emphasizing health equity, safety, and security. Additionally, Dr. Tripathi mentioned draft regulations regarding transparency for AI tools, ensuring data origin, uses, and potential risks are known.

The discussion delved into audience questions, with Dr. Agrawal posing inquiries to both speakers. Dr. Lauterbach detailed Germany's legislative efforts, including digitalizing bills, universal EHR implementation by 2025, and a strong focus on medical research acceleration. [for example, a goal to approve research protocols in Germany in 30 days, much faster than today.]

 Dr. Tripathi addressed the challenges of interoperability and the role of AI in closing these gaps. He also mentioned efforts to standardize data sets and promote accessibility, including through Application Programming Interfaces (APIs). [ONC rulemaking on AI here]

In closing, Dr. Agrawal touched on the importance of digital trust and transparency in AI algorithms. Dr. Lauterbach emphasized the need for transparency in AI systems and data usage.

The session concluded with brief audience questions, including inquiries about Germany's approach to health data accessibility and the challenges faced by patients in the U.S. regarding their medical records. Dr. Lauterbach highlighted Germany's granulated opt-out system and patient ownership of data, while Dr. Tripathi discussed the nuances of patient rights and data access in the U.S.

In summary, the discussion shed light on the evolving landscape of healthcare data and AI, highlighting both the progress and challenges faced by Germany and the United States in harnessing the potential of these technologies to improve healthcare outcomes.