Synthetic Intelligence has the potential to significantly enhance medical care and assist the transition to value-based care, but additionally comes with dangers. So what position ought to AI play in value-based care fashions? The query was posed final week throughout a panel dialogue at CES 2024 that was moderated by Dr. Jesse Ehrenfeld, president of the American Medical Affiliation.
Chris Jagmin, vp and chief medical officer of state packages and medical coverage at CVS Well being’s Aetna, stated it’s necessary to make use of AI in areas the place there may be little threat. This consists of medical decision-making and approving one thing as an insurer. He added that AI presents alternatives in areas that “drive us loopy,” similar to automating name facilities or automating claims cost.
Nonetheless, “denying one thing primarily based upon AI with out human contact I feel is unsuitable for medical,” Jagmin stated.
Dr. Maria Ansari, CEO and govt director of The Permanente Medical Group, echoed Jagmin’s feedback, stressing the significance of getting a human contact when utilizing AI.
“It’s the doctor who’s treating the affected person, not AI,” Ansari stated. “AI [should be used] to enhance our work in medical choice assist instruments.”
She added that in a value-based care mannequin, AI needs to be used responsibly to foretell who wants an extra degree of care, similar to who’s vulnerable to having a stroke or a coronary heart assault.
That is particularly necessary getting back from the Covid-19 pandemic since so many individuals weren’t coming in for preventive care, Ansari famous. For instance, she stated that The Permanente Medical Group had a two-year backlog of ladies who didn’t are available for a mammogram throughout Covid-19.
“How do you prioritize that? … As an alternative of simply utilizing conventional threat elements for who is perhaps in danger for breast most cancers, we used AI to have a look at their outdated mammograms, which had been learn as regular, however picked up 1000 knowledge factors that may truly predict who’s going to go on to have most cancers and prioritized these sufferers,” Ansari stated. “That prediction mannequin turned out to be 60% extra correct than conventional threat elements.
“I feel we are able to use AI once we discuss value-based care to enhance well being outcomes in the precise approach that’s accountable and never denying care, however truly enhancing our care,” she continued.
The dialog got here after President Joe Biden signed an govt order in October on the protected improvement and use of AI. In December, the White Home introduced that 28 suppliers and payers made commitments for accountable use of AI in healthcare. These organizations embrace CVS Well being, Mass Normal Brigham, Premera Blue Cross and Sanford Well being.
Photograph: metamorworks, Getty Pictures
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