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The next time you’re due for a medical exam you may get a call from someone like Ana: a friendly voice that can help you prepare for your appointment and answer any pressing questions you might have.With her calm, warm demeanor, Ana has been trained to put patients at easelike many nurses across the U.S. But unlike them, she is also available to chat 24-7, in multiple languages, from Hindi to Haitian Creole.That’s because Ana isn’t human, but an artificial intelligence program created by Hippocratic AI, one of a number of new companies offering ways to automate time-consuming tasks usually performed by nurses and medical assistants. This March 2025 image from the website of artificial intelligence company Xoltar shows a demonstration of one of their avatars for conducting video calls with patients. [Photo: Xoltar via AP] It’s the most visible sign of AI’s inroads into health care, where hundreds of hospitals are using increasingly sophisticated computer programs to monitor patients’ vital signs, flag emergency situations and trigger step-by-step action plans for carejobs that were all previously handled by nurses and other health professionals.Hospitals say AI is helping their nurses work more efficiently while addressing burnout and understaffing. But nursing unions argue that this poorly understood technology is overriding nurses’ expertise and degrading the quality of care patients receive.“Hospitals have been waiting for the moment when they have something that appears to have enough legitimacy to replace nurses,” said Michelle Mahon of National Nurses United. “The entire ecosystem is designed to automate, de-skill, and ultimately replace caregivers.” This March 2025 image from the website of artificial intelligence company Xoltar, shows two of of their demonstration avatars for conducting video calls with patients. [Photo: Xoltar via AP] Mahon’s group, the largest nursing union in the U.S., has helped organize more than 20 demonstrations at hospitals across the country, pushing for the right to have say in how AI can be usedand protection from discipline if nurses decide to disregard automated advice. The group raised new alarms in January when Robert F. Kennedy Jr., the incoming health secretary, suggested AI nurses “as good as any doctor” could help deliver care in rural areas. On Friday, Dr. Mehmet Oz, who’s been nominated to oversee Medicare and Medicaid, said he believes AI can “liberate doctors and nurses from all the paperwork.”Hippocratic AI initially promoted a rate of $9 an hour for its AI assistants, compared with about $40 an hour for a registered nurse. It has since dropped that language, instead touting its services and seeking to assure customers that they have been carefully tested. The company did not grant requests for an interview.AI in the hospital can generate false alarms and dangerous adviceHospitals have been experimenting for years with technology designed to improve care and streamline costs, including sensors, microphones and motion-sensing cameras. Now that data is being linked with electronic medical records and analyzed in an effort to predict medical problems and direct nurses’ care sometimes before they’ve evaluated the patient themselves. In this photo provided by National Nurses United, nurses hold a rally in San Francisco on April 22, 2024, to highlight safety concerns about using artificial intelligence in healthcare. [Photo: National Nurses United via AP] Adam Hart was working in the emergency room at Dignity Health in Henderson, Nevada, when the hospital’s computer system flagged a newly arrived patient for sepsis, a life-threatening reaction to infection. Under the hospital’s protocol, he was supposed to immediately administer a large dose of IV fluids. But after further examination, Hart determined that he was treating a dialysis patient, or someone with kidney failure. Such patients have to be carefully managed to avoid overloading their kidneys with fluid.Hart raised his concern with the supervising nurse but was told to just follow the standard protocol. Only after a nearby physician intervened did the patient instead begin to receive a slow infusion of IV fluids.“You need to keep your thinking cap onthat’s why you’re being paid as a nurse,” Hart said. “Turning over our thought processes to these devices is reckless and dangerous.”Hart and other nurses say they understand the goal of AI: to make it easier for nurses to monitor multiple patients and quickly respond to problems. But the reality is often a barrage of false alarms, sometimes erroneouly flagging basic bodily functionssuch as a patient having a bowel movementas an emergency.“You’re trying to focus on your work but then you’re getting all these distracting alerts that may or may not mean something,” said Melissa Beebe, a cancer nurse at UC Davis Medical Center in Sacramento. “It’s hard to even tell when it’s accurate and when it’s not because there are so many false alarms.”Can AI help in the hospital?Even the most sophisticated technology will miss signs that nurses routinely pick up on, such as facial expressions and odors, notes Michelle Collins, dean of Loyola University’s College of Nursing. But people aren’t perfect either.“It would be foolish to turn our back on this completely,” Collins said. “We should embrace what it can do to augment our care, but we should also be careful it doesn’t replace the human element.”More than 100,000 nurses left the workforce during the COVID-19 pandemic, according to one estimate, the biggest staffing drop in 40 years. As the U.S. population ages and nurses retire, the U.S. government estimates there will be more than 190,000 new openings for nurses every year through 2032.Faced with this trend, hospital administrators see AI filling a vital role: not taking over care, but helping nurses and doctors gather information and communicate with patients.‘Sometimes they are talking to a human and sometimes they’re not’At the University of Arkansas Medical Sciences in Little Rock, staffers need to make hundreds of calls every week to prepare patients for surgery. Nurses confirm information about prescriptions, heart conditions and other issueslike sleep apneathat must be carefully reviewed before anesthesia.The problem: many patients only answer their phones in the evening, usually between dinner and their children’s bedtime.“So what we need to do is find a way to call several hundred people in a 120-minute windowbut I really don’t want to pay my staff overtime to do so,” said Dr. Joseph Sanford, who oversees the center’s health IT.Since January, the hospital has used an AI assistant from Qventus to contact patients and health providers, send and receive medical records and summarize their contents for human staffers. Qventus says 115 hospitals are using its technology, which aims to boost hospital earnings through quicker surgical turnarounds, fewer cancellations and reduced burnout.Each call begins with the program identifying itself as an AI assistant.“We always want to be fully transparent with our patients that sometimes they are talking to a human and sometimes they’re not,” Sanford said.While companies like Qventus are providing an administrative service, other AI developers see a bigger role for their technology.Israeli startup Xoltar specializes in humanlike avatars that conduct video calls with patients. The company is working with the Mayo Clinic on an AI assistant that teaches patients cognitive techniques for managing chronic pain. The company is also developing an avatar to help smokers quit. In early testing, patients spend about 14 minutes talking to the program, which can pickup on facial expressions, body language and other cues, according to Xoltar.Nursing experts who study AI say such programs may work for people who are relatively healthy and proactive about their care. But that’s not most people in the health system.“It’s the very sick who are taking up the bulk of health care in the U.S. and whether or not chatbots are positioned for those folks is something we really have to consider,” said Roschelle Fritz of the University of California Davis School of Nursing. The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content. Matthew Perrone, AP Health Writer
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The videos roll through TikTok in 30-second flashes.Migrants trek in camouflage through dry desert terrain. Dune buggies roar up to the United States-Mexico border barrier. Families with young children pass through gaps in the wall. Helicopters, planes, yachts, tunnels, and Jet Skis stand by for potential customers.Laced with emojis, the videos posted by smugglers offer a simple promise: If you don’t have a visa in the U.S., trust us. We’ll get you over safely. Illustration of migrants climbing over a border barrier with emojis overlayed on the scene, based on hundreds of TikTok videos reviewed by the AP. [Art: Peter Hamlin/AP Illustration] At a time when legal pathways to the U.S. have been slashed and criminal groups are raking in money from migrant smuggling, social media apps like TikTok have become an essential tool for smugglers and migrants alike. The videostaken to cartoonish extremesoffer a rare look inside a long elusive industry and the narratives used by trafficking networks to fuel migration north.“With God’s help, we’re going to continue working to fulfill the dreams of foreigners. Safe travels without robbing our people,” wrote one enterprising smuggler.As President Donald Trump begins to ramp up a crackdown at the border and migration levels to the U.S. dip, smugglers say new technologies allow networks to be more agile in the face of challenges, and expand their reach to new customersa far cry from the old days when each village had its trusted smuggler.“In this line of work, you have to switch tactics,” said a woman named Soary, part of a smuggling network bringing migrants from Ciudad Juarez to El Paso, Texas, who spoke to the Associated Press on the condition that her last name would not be shared out of concern that authorities would track her down. “TikTok goes all over the world.”Soary, 24, began working in smuggling when she was 19, living in El Paso, where she was approached by a friend about a job. She would use her truck to pick up migrants who had recently jumped the border. Despite the risks involved with working with trafficking organizations, she said it earned her more as a single mother than her previous job putting in hair extensions. Depiction of migrants with faces covered by emojis giving testimony that they arrived safely to the U.S. as part of the smugglers social media campaign to build their brand of trust, based on hundreds of TikTok videos reviewed by the AP. [Art: Peter Hamlin/AP Illustration] As she gained more contacts on both sides of the border, she began connecting people from across the Americas with a network of smugglers to sneak them across borders and eventually into the U.S.Like many smugglers, she would take videos of migrants speaking to the camera after crossing the border to send over WhatsApp as evidence to loved ones that her clients had gotten to their destination safely. Now she posts those clips to TikTok.TikTok says the platform strictly prohibits human smuggling and reports such content to law enforcement.The use of social media to facilitate migration took off around 2017 and 2018, when activists built massive WhatsApp groups to coordinate the first major migrant caravans traveling from Central America to the U.S., according to Guadalupe Correa-Cabrera, a professor at George Mason University focused on the migrant smuggling industry.Later, smugglers began to infiltrate those chats and use the choice social media app of the day, expanding to Facebook and Instagram.Migrants, too, began to document their often perilous voyages north, posting videos trekking through the jungles of the Darien Gap dividing Colombia and Panama, and after being released by extorting cartels.A 2023 study by the United Nations reported that 64% of the migrants they interviewed had access to a smart phone and the internet during their migration to the U.S.Around the time of the study’s release, as use of the app began to soar, that Correa-Cabrera said she began to see smuggling ads skyrocket on TikTok.“It’s a marketing strategy,” Correa-Cabrera said. “Everyone was on TikTok, particularly after the pandemic, and then it began to multiply.”Last year, Soary, the smuggler, said she began to publish videos of migrants and families in the U.S. with their faces covered and photos of the U.S.-Mexico border with messages like: “We’ll pass you through Ciudad Juárez, no matter where you are. Fence jumping, treks, and by tunnel. Adults, children, and the elderly.”Hundreds of videos examined by the AP feature thick wads of cash, people crossing through the border fence by night, helicopters and airplanes supposedly used by coyotes, smugglers cutting open cacti in the desert for migrants to drink from and even crops of lettuce with text reading “The American fields are ready!”The videos are often layered over heavy northern Mexican music with lyrics waxing romantically about being traffickers. Videos are published by accounts with names alluding to “safe crossing,” “USA destinations,” “fulfilling dreams,” or “polleros,” as smugglers are often called.Narratives shift based on the political environment and immigration policies in the U.S. During theBiden administration, posts would advertise getting migrants access to asylum applications through the administration’s CBP One app, which Trump ended.Amid Trump’s crackdown, posts have shifted to dispelling fears that migrants will be captured, promising American authorities have been paid off. Smugglers openly taunt U.S. authorities: one shows himself smoking what appears to be marijuana right in front of the border wall; another even takes a jab at Trump, referring to the president as a “high-strung gringo.”Comments are dotted with emojis of flags and baby chickens, a symbol meaning migrant among smugglers, and other users asking for prices and more information.Cristina, who migrated because she struggled make ends meet in the Mexican state of Zacatecas, was among those scrolling in December after the person she had hired to smuggle her to the U.S. abandoned her and her partner in Ciudad Juárez.“In a moment of desperation, I started searching on TikTok and, well, with the algorithm videos began to pop up,” she said. “It took me a half an hour” to find a smuggler.After connecting, smugglers and migrants often negotiate on encrypted apps like WhatsApp and Telegram, doing a careful dance to gain each other’s trust. Cristina, now living in Phoenix, said she decided to trust Soary because she was a woman and posted videos of families, something the smuggler admitted was a tactic to gain migrants’ trust.Smugglers, migrants and authorities warn that such videos have been used to scam migrants or lure them into traps at a time when cartels are increasingly using kidnapping and extortion as a means to rake in more money.One smuggler, who asked to only be identified by his TikTok name “The Corporation” due to fear of authorities tracking him down, said other accounts would steal his migrant smuggling network’s videos of customers saying to camera they arrived safely in the U.S.“And there’s not much we can do legally. I mean, it’s not like we can report them,” he said with a laugh.In other cases, migrants say that they were forced by traffickers to take the videos even if they haven’t arrived safely to their destinations.The illicit advertisements have fueled concern among international authorities like the U.N.’s International Organization for Migration, which warned in a report about the use of the technology that “networks are becoming increasingly sophisticated and evasive, thus challenging government authorities to address new, non-traditional forms of this crime.”In February, a Mexican prosecutor also confirmed to the AP that they were investigating a network of accounts advertising crossings through a tunnel running under the border fence between Ciudad Juarez and El Paso. But investigators would not provide more details.In the meantime, hundreds of accounts post videos of trucks crossing border, of stacks of cash and migrants, faces covered with emojis, promising they made it safely across the border.“We’re continuing to cross and we’re not scared,” one wrote. Illustrations are based on hundreds of videos posted on TikTok examined by the AP that advertise travel to the U.S. to migrants. Videos are often laced with emojis, make bold promises of success and promise safe travel. Megan Janetsky, Associated Press
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E-Commerce
When Federal Reserve officials last met in late January, things looked pretty good: Hiring was solid. The economy had just grown at a solid pace in last year’s final quarter. And inflation, while stubborn, had fallen sharply from its peak more than two years ago.What a difference seven weeks makes.As the Fed prepares to meet Tuesday and Wednesday, the central bank and its chair, Jerome Powell, are potentially headed to a much tougher spot. Inflation improved last month but is still high and tariffs could push it higher. At the same time, ongoing tariff threats as well as sharp cuts to government spending and jobs have tanked consumer and business confidence, which could weigh on the economy and even push up unemployment.The toxic combination of still-high inflation and a weak or stagnant economy is often referred to as “stagflation,” a term that haunts central bankers. It is what bedeviled the United States in the 1970s, when even deep recessions didn’t kill inflation.Stagflation, should it emerge, is hard for the Fed because typically policymakers would lift ratesor keep them highto combat inflation. Yet if unemployment also rises, the Fed would usually cut rates to reduce borrowing costs and lift growth.It’s not yet clear the economy will sink into stagflation. For now, like businesses and consumers, the Fed is grappling with a huge amount of uncertainty surrounding the economic outlook. But even a mild versionwith the unemployment rising from its current low level of 4.1%, while inflation stayed stuck above the Fed’s 2% targetwould pose a challenge for the central bank.“That’s the tangled web they’re in,” said Esther George, former president of the Federal Reserve’s Kansas City branch. “You have inflation stickiness on the one hand. At the same time, you’re trying to look at what impact could this have on the job market, if growth begins to pull back. So it is a tough scenario for them for sure.”Fed officials will almost certainly keep their key rate unchanged at their meeting this week. Once the meeting concludes Wednesday, they will release their latest quarterly economic projections, which will likely show they expect to cut their rate twice this yearthe same as they projected in December.The Fed implemented three cuts last year and then signaled at the January meeting that they were largely on pause until the economic outlook becomes clearer.Wall Street investors expect three rate reductions this year, in June, September, and December, according to futures prices tracked by CME Fedwatch, in part because they worry an economic slowdown will force more reductions.One development likely to unnerve Fed officials is the sharp jump in inflation expectations this month in the University of Michigan’s consumer sentiment survey. It showed the biggest increase in long-term inflation expectations since 1993.Such expectationswhich basically measure whether Americans are worried inflation will get worseare important because they can become self-fulfilling. If businesses and consumers expect higher costs, they may take steps that push up inflation, like demanding higher wages, which in turn can force companies to raise prices to offset higher labor costs.Some economists caution that the University of Michigan’s survey is preliminary and for now based on only about 400 responses. (The final version to be released later this month typically includes about 800.) And financial market measures of inflation expectations, based on bond prices, have actually declined in recent weeks.The most recent inflation readings have been mixed. The consumer price index dropped last week for the first time in five months to 2.8% from 3%, an encouraging change. But the Fed’s preferred price gauge, to be released later this month, is likely to be unchanged.The jump in inflation expectations is also a problem for the Fed because officials, including Powell, have said they are willing to let inflation gradually return to their 2% target in 2027, because expectations have generally been low. If other measures show inflation worries rising, the Fed could come under more pressure to get inflation down more quickly.“I do worry when I see consumer expectations moving in the opposite direction,” George said. “I think you just have to keep an eye on that.”The last time President Donald Trump imposed tariffsin 2018 and 2019overall inflation didn’t rise by much, in part because they weren’t nearly as broad as what he is currently proposing and some duties, such as those on steel and aluminum, were watered down with loopholes. Now that Americans have lived through a painful inflationary episode, they are likely to be more skittish about rising prices.Powell referred such concerns in remarks earlier this month. He said tariffs could just have a one-time impact on prices without causing ongoing inflation. But that could change “if it turns into a series” of tariff hikes, he said March 7, or “if the increases are larger, that would matter.”“What really does matter is what is happening with long-term inflation expectations,” Powell added.A week after his comments, those expectations shot higher in the University of Michigan survey.Christopher Rugaber, AP Economics Writer
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