How Artificial Intelligence Will Influence Healthcare Policy

A prominent part of healthcare’s future rides the still-cresting wave of innovation in artificial intelligence (AI). Half a decade ago, AI hardly made a ripple in the realm of healthcare applications. But by the end of 2018, equity funding for healthcare AI startups had reached $4.3 billion, with deal activity (576 transactions) surging past all other industries since 2013, according to research firm CB Insights.

A separate analysis from faculty experts at Boston-based health system Partners HealthCare concludes that AI will deliver a wide range of tangible benefits in care delivery by 2020. Radiology leads the way, with emerging applications for rapid disease detection, complex image assessment, and cost-effective clinical testing. Partners also expects AI breakthroughs in:

  • identifying patients at high risk for self-harm;
  • automation of high-volume tasks for triaging patients;
  • monitoring brain health to predict seizures and onset of dementia;
  • facilitating health information exchange;
  • streamlining coding and billing processes;
  • enabling voice-command technology through natural language processing and smart appliances; and
  • smartphone-based therapies for mental health conditions such as depression and substance abuse.

Real-Time Activity

Impending opportunities appear close to reaching fruition. Big-name vendors already have their hands in the AI market, with the recent HIMSS19 conference giving glimpses of new product pathways.

For instance, IBM Watson Health projects that medical data will double every 73 days by 2020, while physicians will spend twice as much time on administrative tasks than on interactions with patients. Working with partners, the company offers AI solutions aimed at identifying claims fraud and waste, decision-support tools that provide evidence-based drug information within a hospital’s workflow, and a mobile personal-assistant app that provides diabetes patients with actionable glucose insights.

Elsewhere, EHR provider Cerner is using AI within its suite of systems to identify gaps and inconsistencies in patient records. The firm believes AI-powered workflows will bring improvements to patient safety and leverage technology to counteract physician fatigue and frustration with EHR complexity.

These types of initiatives “can get us to what we’ve been missing for decades now, which is the true care in healthcare,” says futurist and practicing cardiologist Eric Topol, MD, author of Deep Medicine: How Artificial Intelligence Can Make Healthcare Human Again. Topol explains that AI will not only reduce errors made by doctors but also help them make better care decisions as a matter of course.

Policies for AI Progress

Still, industry observers recognize that AI’s progress will depend in part on careful stewardship in its implementation. At Cleveland Clinic, Susannah Rose, associate chief experience officer, emphasizesthat AI applications need to be closely monitored and rigorously tested. The policy is shaping up to “keep what needs to be human, human — and then come back in and automate those things that don’t need the human touch,” Rose notes.

Additionally, the American Medical Association (AMA) has gone on record in support of “thoughtfully designed, high-quality, clinically validated healthcare AI.” The development process should integrate the perspectives of practicing physicians, according to an AMA policy statement. Specifically, AMA backs AI developed under best practices in user-centered design, where users are physicians and other members of the care team. The technology should also conform to standards for reproducibility and safeguard the privacy and security of individuals’ personal information.

NetDirector stays certified and up-to-date on common policy and compliance needs in healthcare — such as those currently taking shape with AI. The company structures its HealthData Exchange platform so that providers can focus on delivering care, instead of managing technology.

For more information on how AI may interact with current technologies and future developments, please contact us or request a free demo.

HIEs Vie with Other Innovators to Make Interoperability Gains

In late March, the health information exchange (HIE) spanning Kansas and Missouri announced a new capability that will enable participating providers to monitor acute and post-acute patient care events in real time. The not-for-profit Lewis and Clark Information Exchange (LACIE) said its notification platform also supplies contextual information, including patients’ utilization patterns, to providers at the point of care to help coordinate transitions.

“Improving our region’s overall health and economic status rests on a foundation of delivering common capabilities for every type of provider, no matter the EHR they use, and no matter where in the region they are,” commented Jeffrey Hackman, MD, chief medical information officer at Truman Medical Centers, a LACIE participant.

Across the country, not all HIE efforts are going so smoothly. For example, Connecticut is on its fourth attempt to create a statewide HIE, mired in a decade-long implementation process at a cost of more than $20 million. Similarly, Vermont’s HIE has struggled to gain traction after a 2017 analysis found the exchange to be largely unpopulated with patient records, despite having received over $44 million in state and local funding.

The Drive to Share Data

While state and regional HIEs battle inconsistency, the entire landscape for data-sharing and information exchange is rapidly changing. A proposed policy rule released in February by the Centers for Medicare and Medicaid Services (CMS) calls for clinical and administrative information to travel with patients throughout their transitions of care, and for such information to be electronically available on-demand through an application programming interface. Enrollees in Medicaid, the Children’s Health Insurance Program, Medicare Advantage plans must have immediate electronic access to claims and other health information by 2020, the proposed rule stipulates.

Meanwhile, collaboration between vendor-neutral trade association CommonWell Health Alliance and public-private interoperability framework Carequality has yielded a working model for health systems to request and retrieve medical records from out-of-network providers, regardless of the EHR they use. Two Louisiana health systems, Lafayette General Health and Our Lady of Lourdes Medical Center, launched a CommonWell-Carequality pilot project in December 2018, and have since electronically shared more than 200,000 documents.

“When data is made readily available, providers can make diagnostic and treatment decisions more quickly, and patients can recover sooner,” noted David Callecod, president of Lafayette General Health. “Better data means better communication with our patients and providers, better care and better outcomes.”

Along those lines, there’s ample opportunity for differing HIE and EHR initiatives to come together.

John Kansky, CEO of Indiana Health Information Exchange, recently remarked, “Many HIEs are still going strong and making great progress, even on the national level.” Yet, while acknowledging that efforts by the likes of Commonwell and Carequality are “assets in the equation of making the nation more interoperable,” Kansky pointed out that HIEs often “have that last mile wired and/or have data available — and in some cases have it in normalized, curated repositories, ready to be exchanged.”

As such, high-performing HIEs should be viewed by the EHR vendor community as potential resources — not necessarily competitors — in certain markets.

NetDirector offers standards-based technology designed to integrate with state and regional HIEs as necessary and dictated by providers. The company’s cloud-based HealthData Exchange platform streamlines data/document flow, avoiding the need for slow or costly individual integrations.

For more information, please contact us or request a free demo.