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The Cleveland Clinic in Cleveland, Ohio, U.S., on Saturday, Nov. 14, 2020. On Sunday, the Ohio Department of Health reported a total of 298,096 cases in Ohio since the pandemic began, leading to 5,722 deaths and 22,265 hospitalizations. Photographer: Dustin Franz/Bloomberg via Getty Images

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Earlier this spring, the emergency department at the Cleveland Clinic told Dr. Rita Pappas it had a problem. 

The Cleveland Clinic is the largest hospital system in Ohio, but after an influx of patients came in, the emergency department did not believe it could accommodate all the people who would need care. 

Pappas, the Cleveland Clinic’s medical director for the admission and transfer center, disagreed. 

The Cleveland Clinic was in the midst of trying new AI-powered software from Palantir. The system was predicting that there would be a large number of discharges that day, meaning there would be enough space for all the incoming patients. 

Pappas and her team convinced the emergency department to give Palantir’s platform a chance, and — to her relief — the new system worked. 

“It was perfect. We were able to accommodate all the patients, and so everyone was cheering, they were so happy,” Pappas, who also practices clinically as a pediatric hospitalist, told CNBC in an interview. “Everyone got really excited. I was very excited because I do not want to have the emergency department yelling at me.”

Ordinarily, Pappas said managing patient flow in a similar scenario would require constant communication, every hour throughout the night. But by accurately predicting patient discharges, Palantir’s system saved Pappas, her team and the emergency department a lot of time and effort.

Palantir partnered with two health-care systems, Cleveland Clinic and Tampa General Hospital in Florida, during the summer of 2021 to develop software called Palantir for Hospital Operations. Now, just two years later, the company says its hospital-operations platform accounts for around 10% of its commercial revenue in the U.S.

The software translates complex data into digestible information that health-care workers can use to guide their decision-making and resource allocation. It can be used to generate real-time and predictive insights into areas like staffing, wait times and hospital-bed assignments.

Shyam Sankar, the company’s chief technology officer, said he thinks Palantir for Hospital Operations is just getting started. 

“I’m so excited that we’re at 13% of beds in the U.S., but you know, like 90% of the work is in front of us here,” Sankar told CNBC in an interview. 

A race against the clock

Palantir specializes in data analytics, and shares of the company are up around 150% so far this year as bullish AI investors are buying into its tech offerings. The company reported its first quarterly net profit for Q4 2022, and Palantir CEO Alex Karp said in a May letter to shareholders that the company expects to remain profitable “each quarter through the end of the year,” and that demand for its new Artificial Intelligence Platform (AIP) is “without precedent.”

The company is perhaps best known for its work with the U.S. government’s defense and intelligence agencies, but despite its high-profile customers in government, Sankar said Palantir works to tackle hard challenges across a variety of industries, including health care — a field that experts widely believe is in crisis. 

Hospital360 within Palantir for Hospital Operations

Palantir

Nurses and physicians are experiencing high levels of burnout, and staffing shortages across the country have made it difficult for hospital systems to keep up with patient demand. These challenges were magnified by the Covid pandemic, as nearly 63% of physicians reported symptoms of burnout in 2021, up from 38% the prior year, according to a recent study co-authored by the American Medical Association.

Companies across the medical and technology fields have been working to build solutions that could bring health-care workers some relief. But unless the new platforms, tools and services can be easily integrated into workflows, physicians and nurses often find they can be more trouble than they’re worth. 

“If you don’t build it in the workflow of the user, it actually doesn’t get used, it just sits on the shelf,” Dr. Peggy Duggan, executive vice president and chief medical officer of Tampa General, told CNBC in an interview.  

As such, in the summer of 2021, a team of four Palantir employees set out to create a meaningful solution that health-care workers at Cleveland Clinic and Tampa General could actually use. It was a daunting challenge, and there was an additional catch: They were only given a matter of weeks to build something worthwhile.

Drew Goldstein and Jeremy David, co-heads of health care at Palantir

Courtesy: Palantir

Drew Goldstein and Jeremy David led Palantir’s team of four, and they now run its fast-growing U.S. commercial health-care team. The pair said they were given around 12 weeks to build a solution for Tampa General, and their work in Florida was already underway when the Cleveland Clinic’s chief information officer called to give them an even shorter timeline: eight weeks. 

“For better or for worse, I’m quite hopeful and optimistic,” David said in an interview with CNBC. “I was like, ‘Eight weeks? We can get something live in three.'” 

David, Goldstein and their two teammates took an intense, hands-on approach to building their hospital-operations software. 

They spent their allotted time on the ground in the hospitals in both Ohio and Florida, shadowing doctors and nurses during their shifts, even overnight. They asked questions about existing workflows and tried to grasp the biggest pain points for each organization, an experience Goldstein said was both “overwhelming” and “exciting.” 

To their surprise, the Palantir team learned that hospital staff were carrying out some of their operations by manually entering data into spreadsheets and configuring information like scheduling on paper and whiteboards. 

The Palantir team also became acquainted with whiteboards, as Goldstein said much of their early efforts in Ohio were spent trying to draw out existing workflows with hospital-operations leadership. 

“It was so foundational in our understanding of what these problems could look like,” Goldstein told CNBC in an interview.

At the Cleveland Clinic, the Palantir team initially focused on addressing challenges related to patient flow, particularly around accelerating aspects of the patient-discharge process, while they trained their focus on clinical-staffing allocation at Tampa General. But before long, Goldstein said it became clear the health systems shared both of those problems.  

“So then, instead of just building these completely separately, we started to think about, like, what should the product look like to be able to solve this?” Goldstein said.

When their work was done in Florida and Ohio, Palantir’s team had what amounted to an early iteration of Palantir for Hospital Operations. David said it was the product of several 100-hour weeks where he and Goldstein, who have become good friends, often lived in adjoining hotel rooms. 

“Drew didn’t like that,” David joked. “[I’d] knock on his door, ‘Good morning, Sunshine!'” 

David said the team’s hands-on approach was essential in order to understand what support health-care workers truly needed. 

“If you treat the nurses and patients like widgets, you’re going to lose,” David said. “For about two weeks, we tried to treat them like widgets, and we lost.”

The group presented their work to hospital leadership through a series of demos and testimonials, and David said it was clear the health systems believed Palantir had created something special. 

Their next challenge, Goldstein said, was to keep building and execute on a broader, longer-term vision. 

A new tool for hospital staff: ‘They love it’

The Cleveland Clinic officially launched Palantir’s platform in March. 

Pappas said the hospital system had considered working with other companies, but that the Palantir team stood out because they truly listened to the staff’s needs. 

She said the Cleveland Clinic wanted help building a system that could optimize the number of patients staff could see, while also ensuring that they were all being cared for safely. Pappas said Palantir’s engineers not only took their concerns seriously but got psyched when they were able to build successful solutions.

“It sounds silly, but everyone had this, ‘Oh, we did it!’ moment,” she said. 

As the medical director for the admission and transfer center, Pappas works with a bed-management team to place patients throughout the hospital. Prior to using Palantir’s platform, they relied on Microsoft Teams and Excel spreadsheets to carry out their operations. 

Now, Pappas said they have easy access to both real-time and predictive insights on the number of patients coming into the hospital’s operating rooms, emergency department and as direct admissions, which are patients who receive treatments like chemotherapy. 

“The system is actually learning and taking information, and it’s very accurate,” she said. “It serves as a command center so that we can see very clearly how many patients we are going to be caring for every day.”

Since the official launch of Palantir’s software on March 1, the Cleveland Clinic main campus has been able to accept an 8% increase in patient transfers from other hospitals. 

In fact, Palantir’s system proved to be so useful that Pappas said some members of her team expressed fear that they were going to be replaced by it. Once she reassured them that the platform is just meant to serve as a tool, she said they’ve grown to love it. 

“They’ve developed a trust in the system,” Pappas said. “People in health care are kind of conservative, you know, don’t like change, and so the fact that they trusted and are using it now really just says to us that it’s a successful venture for us.”

Schedule review within Palantir for Hospital Operations

Palantir

Duggan said staff at Tampa General, particularly nurses, are also very fond of Palantir’s technology. She acknowledged that it is still the “early days” of the partnership, but the software company passed its first test by building a staffing model that nursing managers can use to find team members who are available for shifts. Duggan said this process is often conducted manually, so automating it has saved Tampa General’s staff significant time and energy. 

“The nurse leaders love it,” she said. “It’s right in their workflow; it makes their day easier and they love it. They love all that technology support.” 

Duggan said once the Palantir team managed to solve the staffing problem, it was clear the company would be able to use its software to tackle challenges across several different areas of the hospital. Palantir is now working on a series of projects at Tampa General, and Duggan said she is particularly impressed by how it is helping clinicians handle cases of sepsis, the No. 1 killer in hospitals nationwide. 

Sepsis occurs when a patient’s body has an extreme response to an infection. Once diagnosed, Duggan said patients have to stay on a pathway of treatment over the next few days in order to increase chances of survival. 

Palantir built a monitoring system for the sepsis pathway at Tampa General, which helps the clinicians ensure the patients are getting the care they need. She said it can also help provide insights as to why a patient might not have received antibiotics, for instance. 

Duggan said it is new but exciting territory, and it has allowed Tampa General to identify variability in some of its most important work.   

“Our work in sepsis definitely has decreased early mortality by about half, and so that’s real lifesaving,” she said. “I tell people that it’s people’s mothers, sisters, cousins, right? That’s real lifesaving for sure.”

Meanwhile, Palantir’s commercial health-care team has ballooned from four employees to more than 50, and Goldstein said the rapid growth has been unexpectedly challenging to learn to manage. 

But as they plan to partner with more health systems, expand their own team and continue to refine their technology in the years ahead, David said the potential for innovation makes for a truly exciting time. 

“I think we really solved this core problem, where it’s like, OK, a health system actually can deploy this really transformative platform technology to the front lines of health care,” he said. “There’s this old trope that’s like banks and hospitals don’t adopt technology — that is definitively not true anymore.”

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How Elon Musk’s plan to slash government agencies and regulation may benefit his empire

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November 22, 2024

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How Elon Musk’s plan to slash government agencies and regulation may benefit his empire

Elon Musk’s business empire is sprawling. It includes electric vehicle maker Tesla, social media company X, artificial intelligence startup xAI, computer interface company Neuralink, tunneling venture Boring Company and aerospace firm SpaceX. 

Some of his ventures already benefit tremendously from federal contracts. SpaceX has received more than $19 billion from contracts with the federal government, according to research from FedScout. Under a second Trump presidency, more lucrative contracts could come its way. SpaceX is on track to take in billions of dollars annually from prime contracts with the federal government for years to come, according to FedScout CEO Geoff Orazem.

Musk, who has frequently blamed the government for stifling innovation, could also push for less regulation of his businesses. Earlier this month, Musk and former Republican presidential candidate Vivek Ramaswamy were tapped by Trump to lead a government efficiency group called the Department of Government Efficiency, or DOGE.

In a recent commentary piece in the Wall Street Journal, Musk and Ramaswamy wrote that DOGE will “pursue three major kinds of reform: regulatory rescissions, administrative reductions and cost savings.” They went on to say that many existing federal regulations were never passed by Congress and should therefore be nullified, which President-elect Trump could accomplish through executive action. Musk and Ramaswamy also championed the large-scale auditing of agencies, calling out the Pentagon for failing its seventh consecutive audit. 

“The number one way Elon Musk and his companies would benefit from a Trump administration is through deregulation and defanging, you know, giving fewer resources to federal agencies tasked with oversight of him and his businesses,” says CNBC technology reporter Lora Kolodny.

To learn how else Elon Musk and his companies may benefit from having the ear of the president-elect watch the video.

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Why X’s new terms of service are driving some users to leave Elon Musk’s platform

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November 22, 2024

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Why X's new terms of service are driving some users to leave Elon Musk's platform

Elon Musk attends the America First Policy Institute gala at Mar-A-Lago in Palm Beach, Florida, Nov. 14, 2024.

Carlos Barria | Reuters

X’s new terms of service, which took effect Nov. 15, are driving some users off Elon Musk’s microblogging platform. 

The new terms include expansive permissions requiring users to allow the company to use their data to train X’s artificial intelligence models while also making users liable for as much as $15,000 in damages if they use the platform too much. 

The terms are prompting some longtime users of the service, both celebrities and everyday people, to post that they are taking their content to other platforms. 

“With the recent and upcoming changes to the terms of service — and the return of volatile figures — I find myself at a crossroads, facing a direction I can no longer fully support,” actress Gabrielle Union posted on X the same day the new terms took effect, while announcing she would be leaving the platform.

“I’m going to start winding down my Twitter account,” a user with the handle @mplsFietser said in a post. “The changes to the terms of service are the final nail in the coffin for me.”

It’s unclear just how many users have left X due specifically to the company’s new terms of service, but since the start of November, many social media users have flocked to Bluesky, a microblogging startup whose origins stem from Twitter, the former name for X. Some users with new Bluesky accounts have posted that they moved to the service due to Musk and his support for President-elect Donald Trump.

Bluesky’s U.S. mobile app downloads have skyrocketed 651% since the start of November, according to estimates from Sensor Tower. In the same period, X and Meta’s Threads are up 20% and 42%, respectively. 

X and Threads have much larger monthly user bases. Although Musk said in May that X has 600 million monthly users, market intelligence firm Sensor Tower estimates X had 318 million monthly users as of October. That same month, Meta said Threads had nearly 275 million monthly users. Bluesky told CNBC on Thursday it had reached 21 million total users this week.

Here are some of the noteworthy changes in X’s new service terms and how they compare with those of rivals Bluesky and Threads.

Artificial intelligence training

X has come under heightened scrutiny because of its new terms, which say that any content on the service can be used royalty-free to train the company’s artificial intelligence large language models, including its Grok chatbot.

“You agree that this license includes the right for us to (i) provide, promote, and improve the Services, including, for example, for use with and training of our machine learning and artificial intelligence models, whether generative or another type,” X’s terms say.

Additionally, any “user interactions, inputs and results” shared with Grok can be used for what it calls “training and fine-tuning purposes,” according to the Grok section of the X app and website. This specific function, though, can be turned off manually. 

X’s terms do not specify whether users’ private messages can be used to train its AI models, and the company did not respond to a request for comment.

“You should only provide Content that you are comfortable sharing with others,” read a portion of X’s terms of service agreement.

Though X’s new terms may be expansive, Meta’s policies aren’t that different. 

The maker of Threads uses “information shared on Meta’s Products and services” to get its training data, according to the company’s Privacy Center. This includes “posts or photos and their captions.” There is also no direct way for users outside of the European Union to opt out of Meta’s AI training. Meta keeps training data “for as long as we need it on a case-by-case basis to ensure an AI model is operating appropriately, safely and efficiently,” according to its Privacy Center. 

Under Meta’s policy, private messages with friends or family aren’t used to train AI unless one of the users in a chat chooses to share it with the models, which can include Meta AI and AI Studio.

Bluesky, which has seen a user growth surge since Election Day, doesn’t do any generative AI training. 

“We do not use any of your content to train generative AI, and have no intention of doing so,” Bluesky said in a post on its platform Friday, confirming the same to CNBC as well.

Liquidated damages

Another unusual aspect of X’s new terms is its “liquidated damages” clause. The terms state that if users request, view or access more than 1 million posts – including replies, videos, images and others – in any 24-hour period they are liable for damages of $15,000.

While most individual users won’t easily approach that threshold, the clause is concerning for some, including digital researchers. They rely on the analysis of larger numbers of public posts from services like X to do their work. 

X’s new terms of service are a “disturbing move that the company should reverse,” said Alex Abdo, litigation director for the Knight First Amendment Institute at Columbia University, in an October statement. 

“The public relies on journalists and researchers to understand whether and how the platforms are shaping public discourse, affecting our elections, and warping our relationships,” Abdo wrote. “One effect of X Corp.’s new terms of service will be to stifle that research when we need it most.”

Neither Threads nor Bluesky have anything similar to X’s liquidated damages clause. 

Meta and X did not respond to requests for comment.

WATCH: Bluesky CEO: Our platform is ‘radically different’ from anything else in social media

Bluesky CEO: Our platform is 'radically different' from anything else in social media

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The Pentagon’s battle inside the U.S. for control of a new Cyber Force

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November 22, 2024

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The Pentagon's battle inside the U.S. for control of a new Cyber Force

A recent Chinese cyber-espionage attack inside the nation’s major telecom networks that may have reached as high as the communications of President-elect Donald Trump and Vice President-elect J.D. Vance was designated this week by one U.S. senator as “far and away the most serious telecom hack in our history.”

The U.S. has yet to figure out the full scope of what China accomplished, and whether or not its spies are still inside U.S. communication networks.

“The barn door is still wide open, or mostly open,” Senator Mark Warner of Virginia and chairman of the Senate Intelligence Committee told the New York Times on Thursday.

The revelations highlight the rising cyberthreats tied to geopolitics and nation-state actor rivals of the U.S., but inside the federal government, there’s disagreement on how to fight back, with some advocates calling for the creation of an independent federal U.S. Cyber Force. In September, the Department of Defense formally appealed to Congress, urging lawmakers to reject that approach.

Among one of the most prominent voices advocating for the new branch is the Foundation for Defense of Democracies, a national security think tank, but the issue extends far beyond any single group. In June, defense committees in both the House and Senate approved measures calling for independent evaluations of the feasibility to create a separate cyber branch, as part of the annual defense policy deliberations.

Drawing on insights from more than 75 active-duty and retired military officers experienced in cyber operations, the FDD’s 40-page report highlights what it says are chronic structural issues within the U.S. Cyber Command (CYBERCOM), including fragmented recruitment and training practices across the Army, Navy, Air Force, and Marines.

“America’s cyber force generation system is clearly broken,” the FDD wrote, citing comments made in 2023 by then-leader of U.S. Cyber Command, Army General Paul Nakasone, who took over the role in 2018 and described current U.S. military cyber organization as unsustainable: “All options are on the table, except the status quo,” Nakasone had said.

Concern with Congress and a changing White House

The FDD analysis points to “deep concerns” that have existed within Congress for a decade — among members of both parties — about the military being able to staff up to successfully defend cyberspace. Talent shortages, inconsistent training, and misaligned missions, are undermining CYBERCOM’s capacity to respond effectively to complex cyber threats, it says. Creating a dedicated branch, proponents argue, would better position the U.S. in cyberspace. The Pentagon, however, warns that such a move could disrupt coordination, increase fragmentation, and ultimately weaken U.S. cyber readiness.

As the Pentagon doubles down on its resistance to establishment of a separate U.S. Cyber Force, the incoming Trump administration could play a significant role in shaping whether America leans toward a centralized cyber strategy or reinforces the current integrated framework that emphasizes cross-branch coordination.

Known for his assertive national security measures, Trump’s 2018 National Cyber Strategy emphasized embedding cyber capabilities across all elements of national power and focusing on cross-departmental coordination and public-private partnerships rather than creating a standalone cyber entity. At that time, the Trump’s administration emphasized centralizing civilian cybersecurity efforts under the Department of Homeland Security while tasking the Department of Defense with addressing more complex, defense-specific cyber threats. Trump’s pick for Secretary of Homeland Security, South Dakota Governor Kristi Noem, has talked up her, and her state’s, focus on cybersecurity.

Former Trump officials believe that a second Trump administration will take an aggressive stance on national security, fill gaps at the Energy Department, and reduce regulatory burdens on the private sector. They anticipate a stronger focus on offensive cyber operations, tailored threat vulnerability protection, and greater coordination between state and local governments. Changes will be coming at the top of the Cybersecurity and Infrastructure Security Agency, which was created during Trump’s first term and where current director Jen Easterly has announced she will leave once Trump is inaugurated.

Cyber Command 2.0 and the U.S. military

John Cohen, executive director of the Program for Countering Hybrid Threats at the Center for Internet Security, is among those who share the Pentagon’s concerns. “We can no longer afford to operate in stovepipes,” Cohen said, warning that a separate cyber branch could worsen existing silos and further isolate cyber operations from other critical military efforts.

Cohen emphasized that adversaries like China and Russia employ cyber tactics as part of broader, integrated strategies that include economic, physical, and psychological components. To counter such threats, he argued, the U.S. needs a cohesive approach across its military branches. “Confronting that requires our military to adapt to the changing battlespace in a consistent way,” he said.

In 2018, CYBERCOM certified its Cyber Mission Force teams as fully staffed, but concerns have been expressed by the FDD and others that personnel were shifted between teams to meet staffing goals — a move they say masked deeper structural problems. Nakasone has called for a CYBERCOM 2.0, saying in comments early this year “How do we think about training differently? How do we think about personnel differently?” and adding that a major issue has been the approach to military staffing within the command.

Austin Berglas, a former head of the FBI’s cyber program in New York who worked on consolidation efforts inside the Bureau, believes a separate cyber force could enhance U.S. capabilities by centralizing resources and priorities. “When I first took over the [FBI] cyber program … the assets were scattered,” said Berglas, who is now the global head of professional services at supply chain cyber defense company BlueVoyant. Centralization brought focus and efficiency to the FBI’s cyber efforts, he said, and it’s a model he believes would benefit the military’s cyber efforts as well. “Cyber is a different beast,” Berglas said, emphasizing the need for specialized training, advancement, and resource allocation that isn’t diluted by competing military priorities.

Berglas also pointed to the ongoing “cyber arms race” with adversaries like China, Russia, Iran, and North Korea. He warned that without a dedicated force, the U.S. risks falling behind as these nations expand their offensive cyber capabilities and exploit vulnerabilities across critical infrastructure.

Nakasone said in his comments earlier this year that a lot has changed since 2013 when U.S. Cyber Command began building out its Cyber Mission Force to combat issues like counterterrorism and financial cybercrime coming from Iran. “Completely different world in which we live in today,” he said, citing the threats from China and Russia.

Brandon Wales, a former executive director of the CISA, said there is the need to bolster U.S. cyber capabilities, but he cautions against major structural changes during a period of heightened global threats.

“A reorganization of this scale is obviously going to be disruptive and will take time,” said Wales, who is now vice president of cybersecurity strategy at SentinelOne.

He cited China’s preparations for a potential conflict over Taiwan as a reason the U.S. military needs to maintain readiness. Rather than creating a new branch, Wales supports initiatives like Cyber Command 2.0 and its aim to enhance coordination and capabilities within the existing structure. “Large reorganizations should always be the last resort because of how disruptive they are,” he said.

Wales says it’s important to ensure any structural changes do not undermine integration across military branches and recognize that coordination across existing branches is critical to addressing the complex, multidomain threats posed by U.S. adversaries. “You should not always assume that centralization solves all of your problems,” he said. “We need to enhance our capabilities, both defensively and offensively. This isn’t about one solution; it’s about ensuring we can quickly see, stop, disrupt, and prevent threats from hitting our critical infrastructure and systems,” he added.

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