A healthcare algorithm started cutting care, and no one knew why
This is an absurd hellscape:
Legal Aid filed a federal lawsuit in 2016, arguing that the state had instituted a new [healthcare] policy without properly notifying the people affected about the change. There was also no way to effectively challenge the system, as they couldn’t understand what information factored into the changes, De Liban argued. No one seemed able to answer basic questions about the process. “The nurses said, ‘It’s not me; it’s the computer,’” De Liban says. When they dug into the system, they discovered more about how it works. Out of the lengthy list of items that assessors asked about, only about 60 factored into the home care algorithm. The algorithm scores the answers to those questions, and then sorts people into categories through a flowchart-like system. It turned out that a small number of variables could matter enormously: for some people, a difference between a score of a three instead of a four on any of a handful of items meant a cut of dozens of care hours a month. (Fries didn’t say this was wrong, but said, when dealing with these systems, “there are always people at the margin who are going to be problematic.”) […] From the state’s perspective, the most embarrassing moment in the dispute happened during questioning in court. Fries was called in to answer questions about the algorithm and patiently explained to De Liban how the system works. After some back-and-forth, De Liban offered a suggestion: “Would you be able to take somebody’s assessment report and then sort them into a category?” […] Fries said he could, although it would take a little time. He looked over the numbers for Ethel Jacobs. After a break, a lawyer for the state came back and sheepishly admitted to the court: there was a mistake. Somehow, the wrong calculation was being used. They said they would restore Jacobs’ hours. “Of course we’re gratified that DHS has reported the error and certainly happy that it’s been found, but that almost proves the point of the case,” De Liban said in court. “There’s this immensely complex system around which no standards have been published, so that no one in their agency caught it until we initiated federal litigation and spent hundreds of hours and thousands of dollars to get here today. That’s the problem.”
(tags: algorithms government health healthcare automation grim-meathook-future future)