ACE

Tag: Support

  • Understanding the Debate on AI in Electronic Health Records

    Understanding the Debate on AI in Electronic Health Records

    Background

    Artificial Intelligence (AI) refers to the use of computer algorithms to process data and make decisions, ultimately streamlining administrative processes. In healthcare, AI is being increasingly integrated with Electronic Health Records (EHRs)—digital systems that store and manage patient health information, such as medical history and diagnoses. By 2021, almost 80% of office-based physicians and virtually all non-federal acute care hospitals had implemented an EHR system. As part of this widespread adoption, various AI applications in EHRs are beginning to emerge. So far, the main functions of AI in EHRs include managing datasets of patient health information, identifying patterns in health data, and using these patterns to predict health outcomes and recommend pathways for treatment. 

    Arguments in Favor of AI in EHRs

    The use of AI in EHRs presents opportunities to improve healthcare by increasing efficiency as well as supplying administrative support. Supporters of AI integration argue that it can significantly improve diagnostic accuracy. AI-integrated EHR systems can analyze vast amounts of patient data, flagging potential issues that might otherwise be overlooked by human clinicians. Machine learning algorithms can identify patterns across multiple cases and recommend diagnoses or treatments based on evidence from similar cases. Proponents contend that by reducing human error and providing real-time insights, AI could support doctors in making more accurate and quick decisions, leading to better patient outcomes.

    Proponents of AI in EHRs also argue that AI has the potential to significantly reduce healthcare inequities by providing better access and more personalized care for underserved populations. AI-powered tools can identify at-risk patients early by analyzing complex data, including demographic and behavioral factors, and help prioritize interventions for those who need it most. Additionally, AI can bridge communication gaps for patients facing language barriers or low health literacy, ensuring they receive clear and relevant information about their health. Supporters also suggest that AI’s ability to reduce human biases in clinical decision-making, such as disparities in pain assessment or treatment recommendations, could lead to fairer, more equitable healthcare outcomes for all.

    From the workforce perspective, supporters argue that AI integration in EHRs has the ability to significantly reduce physician burnout by streamlining the documentation process. With the increasing time spent on EHR tasks, AI-driven tools like voice-to-text transcription, automated note generation, and data entry can cut down the time physicians devote to administrative duties. For instance, one 2023 study reported that AI integration in health records led to a 72% reduction in documentation time, equating to approximately 3.3 hours saved per week per clinician. This allows doctors to spend more time on direct patient care and less on paperwork, which supporters contend will improve job satisfaction and reduce stress.

    Arguments Against AI in EHRs

    While some argue that AI in EHRs will lead to more accurate and equitable healthcare, others raise concerns regarding data bias, privacy, and transparency. Critics of AI integration argue that modern legal frameworks lack adequate safeguards for individuals’ health data, leaving sensitive information vulnerable to breaches. For example, data collected by AI tools may be hacked or gathered without consent for marketing purposes. Additionally, certain genetics testing companies that operate without sufficient legal oversight may sell customer data to pharmaceutical and biotechnology companies.

    Moreover, some critics share concerns about whether AI integration in EHRs aligns with standards for informed consent. Informed consent is a key ethical principle that ensures patients are fully informed and in control of decisions regarding their healthcare. It includes elements such as the patient’s ability to understand and make decisions about their diagnoses, treatment options, and any risks involved. Ethical responsibility dictates that consent should be specific, voluntary, and clear. The rise of AI in healthcare applications has increased concerns about whether patients are fully aware of how their data is used, the risks of procedures, and potential errors in AI-driven treatments. Autonomy principles state that patients have the right to be informed about their treatment process, the privacy of their data, and the potential risks of AI-related procedures, such as errors in programming. Critics say that patients must be more informed about how AI is integrated into health records systems in order for them to truly provide informed consent. 

    Another significant ethical concern in the use of AI and machine learning (ML) in healthcare is algorithmic bias, which can manifest in racial, gender, and socioeconomic disparities due to flaws in algorithm design. Such biases may lead to misdiagnosis or delayed treatments for underrepresented groups and exacerbate inequities in access to care. To address this, advocates push for the prioritization of diverse training data that reflects demographic factors. They hold that regular evaluations are necessary to ensure that AI models consistently remain fair over time, upholding the principles of justice and equity. 

    Future Outlook

    Building on the potential of AI in healthcare, H.R. 238, introduced on January 7, 2025, proposes that AI systems be authorized to prescribe medications if they are approved by the Food and Drug Administration (FDA) and if the state where they operate permits their use for prescribing. This bill represents a significant step in integrating AI into clinical practices, going beyond data management to reshape how medications are prescribed and managed. The arguments for and against H.R. 238 mirror the debate around AI integration in EHRs; while proponents of the bill argue that AI could enhance patient safety, reduce errors, and alleviate clinician burnout, critics highlight concerns regarding the loss of human judgment, data privacy, and the potential for AI to reinforce biases in healthcare. As AI continues to play a central role in healthcare, bills like H.R. 238 spark important discussions about AI’s ethical, practical, and legal implications in clinical decision-making.

    Summary

    In conclusion, the integration of AI into EHRs has forced medical stakeholders to balance a need for improvements in accuracy and efficiency with a concern for medical ethics and patient privacy. On one hand, AI can support more accurate diagnoses, enhance patient care, and help reduce the burnout faced by healthcare providers. Additionally, AI may contribute to reducing healthcare inequities by providing better access and more personalized care, especially for underserved populations. However, the implementation of AI also raises concerns regarding data privacy, algorithmic bias, and informed consent, suggesting a need for more careful implementation and oversight. As AI’s presence in healthcare settings continues to expand, addressing these concerns will be key to ensuring it benefits patients and healthcare providers alike.

  • Pros and Cons of Congressional Term Limits

    Pros and Cons of Congressional Term Limits

    Background: What are Congressional Term Limits?

    While members of the U.S. House of Representatives serve two-year terms and U.S. Senators serve six-year terms, all Congresspeople are eligible for re-election indefinitely. As of 2023, U.S. Representatives served an average term of 8.5 years, while U.S. Senators served an average term of 11.2 years. 

    Congressional term limits are a proposed constitutional amendment that would limit the number of terms a member of Congress can legally serve. Under Article V, the Constitution can be amended by either (1) a two-thirds vote of support in both chambers of Congress, or (2) a constitutional convention called by two-thirds of all states and ratified by three-fourths of all states. Term limits reached their highest level of political salience in the 1990s. In 1992, Arkansas voters attempted to impose term limits on their state’s federal congresspeople via an amendment to their state constitution. In U.S. Term Limits, Inc. v. Thornton, the Supreme Court decided that this amendment was unconstitutional and that states cannot impose term limits on their own federal delegation; the only way to impose congressional term limits is to amend the U.S. Constitution. 

    Current Attempts to Impose Congressional Term Limits

    In 2024, Representative Ralph Norman (R-SC) introduced a joint resolution to amend the Constitution and enact a three-term limit for Representatives and a two-term limit for Senators. The resolution died in committee. In January 2025, Senators Ted Cruz (R-TX) and Katie Britt (R-AL) introduced a resolution with the same provisions. Their proposed amendment was co-sponsored by 17 senators, all of whom are Republicans. 

    While the constitution has never been amended through a constitutional convention, some states are also taking that approach to impose congressional term limits due to limited success of prior joint resolutions in Congress. Indiana’s State Senate recently voted to approve a resolution calling for a convention to consider term limits. If the Indiana House passes the resolution, Indiana will become the tenth state to call for a constitutional convention, joining Alabama, Florida, Louisiana, Missouri, North Carolina, Oklahoma, Tennessee, West Virginia, and Wisconsin. 

    Arguments In Favor of Congressional Term Limits

    The case for congressional term limits centers on the following arguments: (1) Term limits motivate politicians to get more done while in office, (2) Congressional turnover eliminates the incumbent funding advantage, (3) Term limits reduce careerism in politics, and (4) Congressional term limits have widespread support.

    One common argument in favor of congressional term limits is that the policy will incentivize politicians to act more efficiently and effectively during their term given the knowledge that they cannot serve indefinitely. Some argue that today, legislators avoid taking immediate action on hot-button issues like immigration and healthcare because they know those issues drive voters to the polls. These proponents argue that congressional term limits would help shift lawmakers’ core objective from winning re-election to creating effective, long-term policy solutions. 

    Advocates for congressional term limits also express concern that members of Congress are unrepresentative of their constituents, especially in terms of economic status. They highlight that funding has become a barrier to becoming an elected official and that incumbency is often linked with disproportionately high campaign funds, making it difficult for newcomer candidates to win against an incumbent. Proponents of term limits say the policy would reduce this incumbent advantage, leveling the funding playing field every two or three terms so that candidates have more of an equal financial footing heading into their race. Supporters also suggest that term limits could indirectly decrease the role of corporate funders in politics by deterring companies from making major investments in lawmakers who will only hold power for a short period. 

    Other proponents of congressional term limits argue that the policy would limit careerism in Congress by making room for people with more real-world expertise to service. They highlight that the average duration of time served in Congress has been steadily increasing from 8.9 years to 11 years, arguing this demonstrates that congressional office is viewed as a career plan instead of a post of service. In the absence of indefinite congressional roles, proponents argue, everyday Americans with more recent connections to the job market would have more opportunities than career politicians who are “insulated from the communities they represent.”

    Finally, proponents of congressional term limits highlight that the majority of Americans support the policy. A 2023 Pew Research Center study found that 87% of respondents favored limiting the number of terms one person can serve in congress. A different 2023 study from the Maryland School of Public Policy found support for congressional term limits transcended political party, with 86% of Republicans, 80% of Democrats, and 84% of Independents in favor of the policy.

    Arguments Against Congressional Term Limits

    The arguments against congressional term limits are primarily built around the three subarguments: (1) Term limits fail to address political corruption, (2) Term limits ignore the value of the incumbency and institutional knowledge, and (3) Frequent congressional turnover shifts power away from the legislative branch. 

    Some opponents argue that congressional term limits fail to curtail political corruption, and may even worsen the problem. They hold that imposing term limits will cause lawmakers to work more closely with lobbyists for two reasons. First, given that term limits will cause a sharp increase in the number of “freshmen” lawmakers with limited legislative experience, critics argue that more politicians will rely more closely on lobbyists and special interest groups to write or recommend laws to “fill [lawmakers’] own informational and policy gaps.” Second, critics warn that term limits will only exacerbate the “revolving door” phenomenon in which retired legislators seek to maintain political influence by securing careers as lobbyists or private sector government affairs consultants. They cite a 2023 study that found that state governments with term limits saw an increase in the frequency of political corruption events. The study observed a “penultimate effect”, where state legislators under a term limitation devoted more of their last term to securing their personal power than to passing policy. Given that the frequency of last terms will increase significantly under term limit policy, opponents worry about an accompanying increase in political corruption. 

    Opponents of term limits also argue that the values of political incumbency in the legislative process are taken for granted. They argue that policymaking is a specialized skill that must be developed over time, highlighting examples of how bills with loopholes and contradictions – the result of unskilled policymaking – harm the American public. They hold that incumbency’s value is its ability to maintain legislative efficiency and institutional knowledge. Given that federal policymaking is a skill that can only be learned on-the-job, critics say incumbency gives lawmakers the opportunity to become the specialized professionals their constituents deserve. They also argue that bipartisan partnerships among lawmakers take years to cultivate, and that term limits would hinder cross-party collaboration. 

    The third core criticism of term limits is that the policy would shift power to the executive and the private sector at the detriment of democracy. As lawmakers are denied longer tenures, opponents argue, lobbyists and staffers become the primary voice of experience in the legislature. Additionally, critics suggest that a decrease in experienced legislators with cross-aisle relationships will further hinder Congress’ ability to efficiently pass legislation, catalyzing an increase in executive orders and other executive branch actions. This will create hurdles to the traditional system of checks and balances. 

    Conclusion 

    The debate over congressional term limits is longstanding and complex. While proponents argue that the policy will increase legislative efficacy, decrease corruption, and represent the will of the people, critics worry that it could have a counteractive effect. As the debate continues, countless questions linger. How much do we value incumbency? How are money and careerism intertwined? Is the legislature representative enough? Is legislative efficiency worth risking? After all of those questions have been asked, there is only one question left: Should Americans be for or against congressional term limits?

  • The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    The “Let Pregnancy Centers Serve Act” of 2024: Key Insights and Implications

    What are Crisis Pregnancy Centers?

    Crisis pregnancy centers (CPCs) are nonprofit, community-based organizations that aim to ensure pregnant people carry their pregnancy to term. CPCs provide services, including pregnancy tests, ultrasounds, baby formula, and diapers to achieve their mission. While they have operated in the U.S. for decades, CPCs have become more prominent in the public eye in light of the Supreme Court’s Dobbs v. Jackson decision that overturned the national right to abortion. Contention has emerged concerning whether CPCs should continue to receive federal funding and qualify as eligible healthcare centers for patients using federal healthcare assistance programs. 

    Introduction to the Let Pregnancy Centers Serve Act of 2024

    The Let Pregnancy Centers Serve Act of 2024 was introduced to the Senate Committee on Finance by Senator Cindy Hyde-Smith [R-MS] on January 18, 2024, and is currently in the introduction stage. The Act contains two central provisions:

    1. Maintaining TANF Eligibility: Temporary Assistance for Needy Families, or TANF, is a government program that provides financial assistance to pregnant people and families for the purpose of accessing food, housing, healthcare, and other necessities. States have autonomy in implementing TANF, including determining the type and amount of assistance payments, and the services that can be obtained with TANF funds. The Act would ensure that people who receive TANF can use their benefits to pay for CPC services, and that CPCs can continue to receive TANF-delegated funding from the federal government.
    2. Renewing federal funding: The Act would prevent the federal government from denying CPCs funding via grants, on the basis that doing so merits federal discrimination against grantees. 

    Arguments in Support of the Let Pregnancy Centers Serve Act of 2024

    Enhanced Access to Pregnancy Services

    Proponents of the Act argue that PCPs should be praised for the broad range of goods and services they provide at little to no cost, such as baby clothes and formula. Early pregnancy confirmation is cheaper and more accessible at a CPC than at an abortion clinic, which supporters argue increases accessibility. They cite a study that showed that patients without health insurance were significantly more likely to visit a CPC than not to visit a CPC during their pregnancy. Additionally, proponents believe that the educational programs provided by some centers, such as parenting classes and prenatal care, help equip new and expecting parents with necessary knowledge and skills. In addition, some CPCs offer different types of emotional and psychological support. Advocates of the Act believe that the counseling services provided by some centers can help individuals and families navigate the pregnancy experience and its complexities. 

    Protection from Federal Discrimination

    One of the primary objectives of the Act is to ensure that CPCs continue to receive TANF funding. The bill aims to prevent the Biden administration’s proposed rule that would reduce or cut TANF funding to CPCs. Proponents argue that these centers play a crucial role in providing support to pregnant women, and that losing TANF funding eligibility could significantly impact their ability to offer essential services. Advocates of the bill argue that protection against federal discrimination is crucial for maintaining the viability of CPCs and ensuring they can continue to provide their service without undue interference. Advocates emphasize that CPCs have been allowed to receive federal funding since 1996, and that reversing this practice signals federal discrimination on a national scale. Proponents also argue that states should have the flexibility and power to direct funds to organizations that align with their values and priorities, and that the federal government would infringe upon state’s rights by prohibiting funding to CPCs nationally. 

    Arguments Against the Let Pregnancy Centers Serve Act of 2024

    Misleading Patients 

    Opponents of the Act argue that CPCs provide misleading or incomplete information about reproduction with the goal of preventing patients from seeking abortion, which can impact patients’ ability to make informed decisions about their health. Most crisis pregnancy centers have a religious affiliation and are not medically licensed, and thus fall outside the scope of consumer protection regulations that are designed to protect patients. Opponents argue that CPCs purposefully and unethically market themselves as health clinics, which has led to the development of websites like ExposeFakeClinics.com and The Anti-Abortion Pregnancy Center Database to warn patients about CPCs in their area. 

    Critics also claim that many ethical concerns that arise when the government provides TANF funding to organizations that are unqualified to provide medical advice. In particular, critics argue that CPCs’ main goal is to discourage or delay women from seeking abortion services, and that providing them with TANF funding could lead patients to perceive them as legitimate and objective healthcare providers. Delays in medical care, whether it be prenatal checkups or appointments about different options, can lead to more complex and costly procedures later on, and potentially put pregnant people’s lives at risk. Critics believe that by prioritizing funding for un-licensed pregnancy centers, the government risks misleading pregnant people into seeking services at centers with no medical credentials and thus neglecting their healthcare needs.

    Misuse of Federal Funds

    Additionally, opponents of the Act are concerned that CPCs lack the oversight and accountability required of other TANF-eligible medical facilities, which could increase the risk of mismanaged or ineffectively-used federal funds. While states must spend TANF funding on programs that achieve one of four TANF purposes, some argue that CPCs are deceptive and lack patient-centered care. Critics of the Act believe that TANF dollars could be used in more efficient ways than funding CPCs, such as promoting job preparation and work. They believe that funding CPCs risks diminishing government funds that could be used to fund prenatal care, contraceptive counseling, and more comprehensive maternal health services. Many believe that allowing TANF funds to support CPCs could weaken the overall monetary support network for reproductive health in the nation. 

    Conclusion

    The Let Pregnancy Centers Serve Act of 2024 aims to protect crisis pregnancy centers by allowing states to allocate TANF and other federal grant funds to these centers without federal interference. Supporters argue that CPCs offer vital services that deserve protection and uphold states’ rights to manage their grant distributions. Conversely, opponents express ethical concerns about funding centers that lack medical qualifications, licensure, and oversight. Critics warn that the Act could misallocate federal funds, diverting resources from licensed maternal and contraceptive care programs to less regulated centers. The legislation’s outcome will significantly impact pregnant individuals nationwide.