What to know about AI in health care

By: Robert Groves, MD

Robert Groves, MD, has been innovating health care for 40+ years across diverse roles, from private practice to delivery and payer systems. He helped launch one of the first Electronic Intensive Care Unit (eICU) models, which uses tele-technology and computer algorithms to optimize intensive care unit patient management. As executive vice president and chief medical officer at Banner|Aetna, he is known for implementing revolutionary health care technology and programs that simplify care, reduce costs, and boost accessibility. He is widely regarded as an industry thought leader and is regularly invited to speak on emerging topics, including AI in health care.

Artificial intelligence (AI) in health care has the potential to transform the industry, and in many ways, it already has. From more accurate clinical diagnostics to streamlined knowledge management, there is much to be gained through the adoption of innovative tech. We are likely at the forefront of the AI revolution and technology is rapidly evolving, which makes it difficult to cut through the hype and get a clear picture of the landscape. From my vantage point as a health care leader and physician, here are some ways I think the future will be reshaped by the continued application of AI in health care.

AI in health care drives clinical advancements

Amazing clinical progress has been made through the implementation of AI technology. More accurate and faster diagnostics have been made possible by advanced algorithms that interpret medical images, like X-rays and MRIs, with a precision that matches or surpasses human experts. In drug discovery and the understanding of disease, the ability to predict the folding of proteins based on the sequence of the amino acids is another huge step forward, all thanks to using AI in health care. According to the American Hospital Association, “…although many questions remain regarding its safety, regulation and impact, the use of AI in clinical care is no longer in its infancy and is expected to experience exponential growth in the coming years.” Even today, we're starting to reap the rewards of investments in this area.

Health knowledge management supported by AI

Fifty years ago, it used to take 50 years for medical knowledge to double. Today it's measured in weeks or months. No physician can keep up with all the medical knowledge and expected practices—even in their area of expertise, much less across medicine—without some sort of knowledge management support. This exponential growth has made utilizing technology like AI essential to managing an increasingly complex body of knowledge.

AI in health care streamlines prior authorizations

Technology systems have already become adept at cutting through complexity and facilitating good knowledge management practices for common health care pain points. For example, prior authorization, a labor-intensive process by which a member’s doctor orders a test or procedure that is submitted along with clinical documentation to the insurance company for approval. This manual process typically takes days, sometimes even weeks, and leads to delays in necessary care which frustrates providers and members alike.

This is where AI comes in. Large language models can effectively review a patient’s entire medical record, and in 80% of cases, provide an accurate approval decision instantly. Even in the remaining 20% of cases not approved, the instantaneous decision allows the physician to address it before their patient even leaves the office.

The future of AI in health care

As we move forward, my experiences over the past four decades have shown me the transformative power of technology that can enhance diagnostics, tailor treatments, and streamline health care processes. Though there is much work to be done as we navigate ethical dilemmas, ensure data privacy, and establish comprehensive regulatory standards, the promise of AI in health care is profound.