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Editor's Note
Welcome to the intersection of human-centered care and artificial intelligence in occupational therapy!
This is the second issue of The OT Algorithm, and if you missed last week’s launch, you can read it here to learn more about the what and why of this newsletter.
Thanks for being here!
Table of Contents
🔥 Hot Take of the Week
Stop saying please and thank you to your generative AI platforms.
They’re not human.
And no, you’re not being rude.
Everyone did a 2025 rewind this year, including our AI tools.
One of mine scored me at a 1/10 for politeness - because I don’t use please and thank you.
That wasn’t accidental.
Generative AI doesn’t respond to politeness.
Well, it might. But it responds better to clarity, structure, and direction.
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📰 AI News of the Week
One curated update from technology, healthcare, or regulation, translated into what it actually means for your daily practice or studies.
This week’s headline:
Why this matters:
Historically, the need for prior authorization (Medicare Advantage plans, commercial insurance payers) has shown delays in care, leading to delays in intervention and ultimately, decreased outcomes or quality of life for those impacted. This addition to traditional Medicare can specifically lead to older adults having to wait longer and navigate even more paperwork just to get the care they need. Alarm bells: Will this lead to decreased access, delayed care, and increased burdens on all involved?
Adding in AI: Six tech companies were selected to conduct the AI-driven prior authorizations, with humans making the final decisions. Concern: What if the AI rejects something by accident? They say a human will review all denied pre-auths.
Checks & Balances: Questionable - however, CMS states that these companies will be penalized for inappropriate denials, reviewed by humans, while financially motivated to reduce costs.
What to pay attention to:
This is a six-year, six-state pilot program.
Name of Program: Wasteful & Inappropriate Service Reduction (WISeR)
States enrolled: New Jersey, Ohio, Oklahoma, Texas, Arizona, & Washington
Impact: 6.4 million traditional Medicare enrollees
Focus for the first year (of six): 17 specific outpatient-only medical services
Examples:
skin and tissue substitutes
electrical nerve stimulator implants
knee arthroscopy for osteoarthritis
This program will EXCLUDE inpatient-only and emergency services, as well as “services that would pose a substantial risk to patients if significantly delayed,” per CMS. How do they plan to assess that?
The tech companies:
Six states = six tech companies
Some of them are backed by insurance companies (namely, Oklahoma’s and Ohio’s programs are connected to BCBS & Kaiser Permanente, respectively).
Why this matters to OT:
Occupational Therapy is downstream from these decisions. Even if therapy/rehab isn’t on the list, delays or denials of care (e.g., ortho, neuro, spine, pelvic health) can directly impact OT start times, care plans, and long-term outcomes.
Pre-auth delays = care delays. A 72-hour turnaround only applies if enrolled providers are using the WISeR portal. Billing through the local MAC as usual? We don’t know how long that could take because the MAC becomes your middleman, impacting scheduling, discharge planning, and patient expectations.
OT at large often absorbs systemic fallouts—adapting plans, educating patients, and troubleshooting gaps in care.
AI isn’t acting alone, but timing still matters. CMS is requiring human review with audit-based safeguards, but even “appropriate” delays can still reduce access or compress therapy timelines.
Advocacy & literacy matter more than ever. As AI moves earlier into authorization pathways, OTPs need to understand how these systems work so they can advocate effectively for patients and protect care continuity.
My goal is to keep these article reviews as non-biased as possible. If you find something to be biased, please feel free to write a comment or send me a message. I’m always willing to learn and improve.
🧰 Tool of the Month: ChatGPT
A beginner-friendly look at one AI tool: what it’s good for, where it falls short, and when not to use it.
I’m starting with ChatGPT because it’s widely accessible and versatile for us as OTPs, and because it’s largely representative of how generative AI works and behaves.
What it is:
A generative AI tool that can analyze text, summarize information, draft content, and support structured thinking through prompts.
What it’s good for:
Streamlining communication tone and style
ChatGPT is particularly effective at:
translating complex language into plain language
adjusting tone for different audiences (e.g., patient, family, student, admin)
generating drafts that you refine, not finalize
Where it falls short:
It does not understand perspective, unless you establish it first.
ChatGPT doesn’t inherently know:
your role
your scope
your authority
your professional responsibility
And if you don’t define those, it fills in the gaps—often incorrectly.
⚡ A Use Case Example
A real OT-relevant example of the tool in action (e.g., summarizing a complex neuro-rehab study or drafting a patient-friendly home program).
Scenario:
An OT practitioner wants help translating a discharge summary into clearer patient-facing language after completing their own assessment, without changing clinical decisions or recommendations.
Example Prompt:
“You are a clinical documentation assistant. I am an occupational therapist. Rewrite the following discharge instructions in plain language for a patient with mild cognitive impairment. Keep clinical decisions unchanged and flag any areas that may need clinician review.”
Why this works:
The OTP retains clinical judgment
The AI supports clarity and accessibility
Responsibility stays with the practitioner
This is AI as a communication aid, not a decision-maker.
💬 Prompting 101
One simple strategy to talk to AI so you get better, more tailored results.
This week’s tip:
Establish ROLE: Always tell the AI who it is and who you are.
This single step will dramatically improve output quality.
Try this instead of that:
❌ “Rewrite these instructions.”
✅ “You are a healthcare communication assistant. I am an OT practitioner. Rewrite these instructions using plain language appropriate for a patient with mild cognitive impairment.”
This month, we’ll build on this framework:
Issue 01: Role
Issue 02: Task
Issue 03: Context
⚖️ Ethics Corner
A brief reflection on privacy, bias, and professional responsibility. Because in OT, literacy without ethics is just risk.
This week’s ethical consideration:
When roles aren’t clearly established, responsibility becomes unclear.
And unclear responsibility is where ethical risk begins.
🔁 Looking Ahead
Next week, we’ll build on this foundation by focusing on task assignment—how to ask AI to do specific work without outsourcing your thinking skills.
One tool.
One skill at a time.
No overwhelm.
a note from me:
If this was your first article, thank you so much for being here! As I build this, I want to make sure it’s helpful to you. Please comment or email with any feedback or suggestions!
— Pooja
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