The global pandemic is pushing the healthcare system even harder to find ways to help hospitals efficiently address cost and streamline operations. From managing healthcare billing and the insurance process to providing a faster diagnosis of a serious disease, artificial intelligence (AI) has the potential to completely change how hospitals operate. MedTech Intelligence recently discussed some of the areas of impact with Jim McGowan, head of product at ElectrifAI.
MedTech Intelligence: How is AI helping hospitals manage healthcare bills and the insurance process?
Jim McGowan: The original areas within a hospital where AI created efficiency were in registration and insurance processing, most notably in revenue cycle management (RCM). RCM was envisioned as a seamless process across patient appointment and registration; claim coding and submission; payment reconciliation; and appeals. Over time these solutions grew so complex that parallel industries around Pay and Chase emerged, in which providers needed incremental support to capture all their revenue. With margins in the low single digits each dollar counts.
These RCM systems are rule based, which is antiquated AI technology. [Our] RevCaptureAi solution combats the limitations of these traditional revenue cycles with the dynamic intelligence of artificial intelligence (AI) and machine learning (ML) that track, analyze and generate insights about your missed charges. In a billion-dollar health system, just 1% of missed total charges adds up to $10 million in lost revenue. This is the opportunity.
Both providers and payers are implementing chatbots to more efficiently engage with patients/members by automating common support topics like confirming eligibility, getting claims/payment status, scheduling appointments and more. Machine learning is in the early stages of adoption. ElectrifAi has used machine learning to capture missed codes on hospital bills for [more than] five years, and building practical solutions to AI problems for [more than] 15 [years].
ElectrifAIs CEO Edward Scott discusses artificial intelligence and machine learning during the coronavirus crisis in Beating COVID-19 Is a Team SportMTI: How is the technology streamlining medication management? What is its role in managing procedures?
McGowan: Medication errors are still a significant issue in hospitals. EMR solutions were implemented to improve workflow and data capture for a complete patient view. These solutions have reduced adverse drug events (ADEs). Technology has been used to create many checks-and-balances within hospitals, which requires a double-check and scan of a barcode for each patient and medication to validate the drug was prescribed by a physician. There is continued work needed to capture the full patient history as these solutions are hospital system specific, do not include interoperability with the PBM data, and do not share with other hospital systems. Ultimately, a more complete patient system of record may be necessary to ensure that each system connects to each other to share data.
One of the areas where AI in healthcare has shown the most promise is in diagnostics, which can ultimately be leveraged in operating and emergency room settings. Right now, early diagnosis is one of the most important factors in the ultimate outcome of a patients care. AI deep-learning algorithms are being used to shave down the time it takes to diagnose serious illnesses. Our PulmoAi X-ray solution is an example of a tool that amplifies the work of radiologists, who leverage AI to triage cases as emergency rooms and ICUs overflow.AI is being used within healthcare for evidence-based recommendations. AI algorithms ingest collected vitals, lab results, medication orders and comorbidities and produce smarter triage tools.
We have seen growth in digital applications for mental health and virtual assistants to answer patient questions. As telehealth grows, I would not be surprised if the virtual assistants handle increasingly large volumes of questions, significantly greater than live operators. These bots are becoming much more important as the front-end to a telehealth call.
AI and Robotics for laser eye surgery and orthopedic surgeries are growing. AI-based visualizations are exploding in the market. AI is attempting to enter every facet of healthcare.
MTI: What factors should technology developers consider when designing AI solutions for hospitals?
McGowan: There are a number of important factors: Regulatory concerns, community demographics, fitting into existing workflows, technical proficiency of both the hospital personnel and consumers.
Healthcare is a highly regulated industry. HIPAA balances portability with privacy. This is for a very good reason, but has a lot of side effects, like complicating marketing efforts. You cant send an email to a patient telling her its okay to get the hip surgery she canceled when COVID-19 struck, because you cant guarantee someone else wont read it. If you send someone a reminder about their diabetes medication and are too specific in the email, what happens when that email is opened by someone other than the specific patient? Solutions that require you to log into a website to view the information was the evolution during the 2010s and continued to evolve with the growth in depth and sophistication of the mobile app solutions. Inappropriate sharing of data, even within a family, can create legal liability that hampers more specific and appropriate messaging.
When building solutions, AI can enable a very quick solution to the above concerns. Tools like robotic process automation (RPA) and chat bots have allowed providers to quickly create solutions that gather patient information and respond with an appropriate response, even in the patients preferred language. These more natural language conversations guide the patient to a choice without being overly and overtly intrusive.Most importantly, AI and ML people really have to deeply understand their craft if they want to influence medical decisions of any kind. Data science is not just technology development. It requires deep understanding of the problem domain being addressed, as well as statistics, inference, and logic. And data science without exceptional data engineering is useless. There is no magic inside the algorithms. If the data is bad, the results will be bad. Weve seen data systems where almost half the data is inaccurate. Let that sink in. Would you go to a doctor if half the facts in their medical books were wrong? AI solutions start with great data engineering.
Id like to talk directly to the C-Suite in the hospitals for a moment.
Lets discuss the elephant in the room: many hospitals are poorly run businesses, with razor thin margins and inadequate spending controls. These are not financially healthy organizations.
This year we saw 42 hospitals file for bankruptcyso far. All have two things in common: They all had revenue capture solutions, and they all couldnt pay their bills.
First, revenue capture doesnt address your problem: you need elective surgeries. Revenue Capture fixes leaks in your billing process. Hospitals dont go bankrupt because their billing process is too leaky. The revenue isnt coming in. The elective surgeries arent there.
Second, the revenue capture programs you do have use rules-based systems, and those dont work when the rules change. COVID-19 changed the rules. You needed a machine-learning based solution. Rules-based systems have been around since the 1950s. The world has moved on. We have a machine learning based revenue capture solution, and not one hospital using it has gone bankrupt. And still, that should not be your priority right nowthats just a part of getting healthy.
You need to restart elective surgeries. You need to manage your finances.
Customer engagement isnt optional for any other business, and it isnt optional for yours. Machine learning can help.
You also need to get control of your spending. Spend analytics is critical. Again, this is not optional for any business, hospital or not. Machine learning can help.
AIespecially machine learninghelps improve the health of the patient, the financial health of the hospital, and ultimately the health of the community. The pandemic should not be a reason to push off these technologiesits the reason you should embrace them today.
Artificial intelligence and machine learning are proving to be meaningful weapons in our arsenal during the coronavirus crisis.
Change is constant, and we continue to evolve.
A recent paper released by Duke University cites the promise of AI, but urges policy changes in order to bring AI-enabled clinical decision software to fruition.
Expanded designs that enable clinicians to leverage data in making healthcare decisions, but privacy challenges remain.
- The Next Generation Of Artificial Intelligence - Forbes - October 16th, 2020
- St. Louis Is Grappling With Artificial Intelligence's Promise And Potential Peril - St. Louis Public Radio - October 16th, 2020
- Looper column: Artificial intelligence, humanity and the future - SouthCoastToday.com - October 16th, 2020
- For artificial intelligence to flourish, governments need to think ahead about its responsible use - Firstpost - October 16th, 2020
- MediFind Selected as Finalist for Best in Artificial Intelligence in the Shorty Social Good Awards - The Wellsboro Gazette - October 16th, 2020
- The relentless threat of artificial intelligence taking our jobs away - Mint - October 16th, 2020
- Will artificial intelligence technology change the dairy industry - positivelyosceola.com - October 16th, 2020
- Penn Medicine researchers use artificial intelligence to identify early signs of Alzheimer's Disease - Express Computer - October 16th, 2020
- Futurism Reinforces Its Next-Gen Business Commerce Platform With Advanced Machine Learning and Artificial Intelligence Capabilities - Yahoo Finance - October 16th, 2020
- SparkCognition Advances the Science of Artificial Intelligence with 85 Patents - PRNewswire - October 16th, 2020
- Dont Be Afraid, BMW Promises To Keep Artificial Intelligence (AI) On A Tight Leash With These 7 Principles - CarScoops - October 16th, 2020
- Artificial Intelligence in Government: Global Markets 2020-2025 - ResearchAndMarkets.com - Business Wire - August 31st, 2020
- Import Screening Pilot Unleashes the Power of Data - FDA.gov - August 31st, 2020
- Supercharge vegetation management and outage prediction with artificial intelligence - Utility Dive - August 31st, 2020
- Automation, artificial intelligence to be central in the post-Covid world - Economic Times - August 31st, 2020
- Artificial Intelligence Is the Next Top Gun - Bloomberg - August 31st, 2020
- Defense Innovation Unit Teaching Artificial Intelligence to Detect Cancer - Department of Defense - August 31st, 2020
- Toward a machine learning model that can reason about everyday actions - MIT News - August 31st, 2020
- How Artificial Intelligence is changing the way we search and find online - ITProPortal - August 31st, 2020
- TikTok Assets Cant Be Sold Without Chinas Approval - Bloomberg - August 31st, 2020
- Artificial Intelligence in Oil and Gas Market Global Size, Growth and Demand 2020 to 2030 - The News Brok - August 31st, 2020
- Rage Against the Algorithm: the Risks of Overestimating Military Artificial Intelligence - Chatham House - August 31st, 2020
- U of I to lead two of seven new national artificial intelligence institutes - University of Illinois News - August 31st, 2020
- Holocaust survivors will be able to share their stories after death thanks to a new project - 60 Minutes - CBS News - August 31st, 2020
- Funding boost for artificial intelligence in NHS to speed up diagnosis of deadly diseases - GOV.UK - August 31st, 2020
- Artificial Intelligence Identifies 80,000 Spiral Galaxies Promises More Astronomical Discoveries in the Future - SciTechDaily - August 31st, 2020
- Is Artificial intelligence the Future of IT Help Desk? - Analytics Insight - August 10th, 2020
- Experts Are Divided Over Future Of Artificial Intelligence But Agree On Its Growing Impact - Outlook India - August 10th, 2020
- "Artificial Intelligence Will Make Medicine Better in the Long Run" - Biophotonics.World - August 10th, 2020
- How machine learning and artificial intelligence can drive clinical innovation - PharmaLive - August 10th, 2020
- Top Artificial Intelligence and Robotics Investments in July 2020 - Analytics Insight - August 10th, 2020
- Job interviews: Recruiters are using artificial intelligence to analyse what you say to find the right hire - TechRepublic - August 10th, 2020
- The next frontier of human-robot relationships is building trust - Scroll.in - August 8th, 2020
- Game-Changing Artificial Intelligence Solution by PhotoShelter to Revolutionize Social Media Workflow as Premier Lacrosse League Returns to the Field... - August 8th, 2020
- How Artificial Intelligence is Helping to Fight against Coronavirus in India? - Analytics Insight - August 8th, 2020
- BLOG: How to capitalise on the Artificial Intelligence theme - Your Money - Your Money - August 8th, 2020
- Artificial Intelligence and Its Partners - Modern Diplomacy - August 8th, 2020
- Artificial intelligence isnt destroying jobs, its making them more inclusive - The Globe and Mail - August 8th, 2020
- RadNet and Hologic Announce Collaboration to Advance the Development of Artificial Intelligence Tools in Breast Health - GlobeNewswire - August 7th, 2020
- COVID-19 Impacts: Artificial Intelligence-as-a-Service (AIaaS) Market Will Accelerate at a CAGR of Over 48% Through 2020-2024|Growing Adoption of... - August 7th, 2020
- Artificial Intelligence in Business: The New Normal in Testing Times - Analytics Insight - August 7th, 2020
- VIEW: Digitisation in pathology and the promise of artificial intelligence - CNBCTV18 - August 7th, 2020
- What It Means to Be Human in the Age of Artificial Intelligence - Medium - August 7th, 2020
- Not so Artificial Intelligence When is AI really AI? - EFTM - August 3rd, 2020
- IMD to explore artificial intelligence to improve forecasting, predict extreme weather events - Firstpost - August 3rd, 2020
- Examples of Failure in Artificial Intelligence - ReadWrite - August 3rd, 2020
- IMD plans to use artificial intelligence in weather forecasting - The Financial Express - August 3rd, 2020
- MLOps: What You Need To Know - Forbes - August 3rd, 2020
- Postdoctoral Research Associate in Artificial Intelligence job with DURHAM UNIVERSITY | 215559 - Times Higher Education (THE) - August 3rd, 2020
- How do CEO's Succeed with Artificial Intelligence at their Workplace? - Analytics Insight - August 3rd, 2020
- The future of Artificial Intelligence and what it means to the Enterprise? - Analytics Insight - August 3rd, 2020
- Artificial intelligence helps lead decisions over Intelligent automation and - 401kTV - August 3rd, 2020
- Artificial Intelligence and civil liability. Who pays the damages? - Lexology - August 3rd, 2020
- The AI-boost: Using more artificial intelligence will boost GDP growth - The Financial Express - August 3rd, 2020
- $19.9B Artificial Intelligence in Retail Industry, 2027 - Rising Focus on Blockchain and Adoption of 5G Technology - Yahoo Finance - August 3rd, 2020
- Artificial Intelligence Loses Some Of Its Edginess, But Is Poised To Take Off - Forbes - July 31st, 2020
- How artificial intelligence is transforming the world in the current pandemic situation? - Geospatial World - July 31st, 2020
- The NBA will use artificial intelligence and a tap-to-cheer app feature to help fans stuck at home get in the game - CNN - July 31st, 2020
- Different Scopes Of Artificial Intelligence To Dive In With! - Inventiva - July 31st, 2020
- Gatling Exploration to use artificial intelligence to identify possible gold targets at the Larder project in Ontario - Proactive Investors USA &... - July 31st, 2020
- Elon Musk Thinks that Artificial Intelligence Will Be 'Vastly Smarter' Than Humans in 5 Years - News18 - July 31st, 2020
- Church body recommends restrictions on Artificial Intelligence - The Tablet - July 31st, 2020
- How the Coronavirus Pandemic Is Breaking Artificial Intelligence and How to Fix It - Gizmodo - July 31st, 2020
- Using artificial intelligence to smell the roses - UC Riverside - July 30th, 2020
- Shield AI Recognized As One of the Most Promising Artificial Intelligence Companies - PR Web - July 30th, 2020
- Artificial intelligence needs an update on ethics to be able to help humanity in times of crisis - Economic Times - July 30th, 2020
- Reshaping Artificial Intelligence with the Help of Affordances - Analytics Insight - July 29th, 2020
- WISeKey to Showcase its Cybersecurity Solutions for Artificial Intelligence Used in Drones and Robots at SIDO 2020 - GlobeNewswire - July 28th, 2020
- GPT-3: The Next Revolution in Artificial Intelligence - Analytics Insight - July 28th, 2020
- FLY AI: the role of artificial intelligence in aviation - Airport Technology - July 28th, 2020
- Four university experts use Artificial Intelligence to discover that children don't like going to school on Mondays in Milton Keynes - Milton Keynes... - July 28th, 2020
- UF Announces $70 Million Artificial Intelligence Partnership with NVIDIA - University of Florida - July 28th, 2020
- People are using artificial intelligence to help sort out their divorce. Would you? - The Conversation AU - July 28th, 2020
- Artificial Intelligence Is the Hope 2020 Needs - Bloomberg - July 28th, 2020
- Top Five Data Privacy Issues that Artificial Intelligence and Machine Learning Startups Need to Know - insideBIGDATA - July 28th, 2020
- I Am a Model and I Know That Artificial Intelligence Will Eventually Take My Job - Vogue.com - July 28th, 2020
- Artificial Intelligence in Manufacturing Market Worth $16.7 Billion by 2026 - Exclusive Report by MarketsandMarkets - PRNewswire - July 28th, 2020
- The Global Artificial Intelligence in Accounting Market is expected to grow from USD 884.99 Million in 2019 to USD 4,779.11 Million by the end of 2025... - July 28th, 2020
- Imint is the Swedish firm that gives Chinese smartphones an edge in video production - TechCrunch - July 26th, 2020
- UF students, get used to this topic: artificial intelligence - Tampa Bay Times - July 26th, 2020