How AI can be used to cut a $1 trillion healthcare problem. see Fast Company

How AI can be used to cut a $1 trillion healthcare problem

The adoption of electronic health records (EHRs) was supposed to expedite these administrative tasks. In reality, it’s just created more roadblocks.

[Photo: Nikada/Getty Images]



The feasibility of AI and machine learning (ML) tools in healthcare settings is up for debate. ChatGPT made headlines after a recent experiment proved it could pass all three parts of the United States Medical Licensing Exam (USMLE). At the same time, experts continue to raise concerns about the tool’s limitations in real-life healthcare situations, as well as its proclivity for inaccuracies and bias.

While clinicians and other medical experts continue to debate ML’s effectiveness for treating patients, they’re neglecting a much more dependable and equally impactful use case: administrative work. ML has tremendous potential to streamline tedious administrative tasks and free up valuable time for clinicians, which ultimately leads to better patient outcomes. However, the effectiveness of AI in reducing administrative workloads hinges on providers’ ability to properly incorporate these tools into their work routines. 


The U.S. spends nearly $4 trillion on healthcare annually, and administrative costs account for a quarter of this figure. For those not in the medical field, it can be difficult to grasp how much time clinicians spend each day on administrative work. Patient record-keeping, insurance billing, prescription management, and countless other tasks pile up, reducing the amount of time providers can dedicate to their patients. 

The adoption of electronic health records (EHRs) was supposed to expedite these administrative tasks. In reality, it’s just created more roadblocks. Fifty-seven percent of providers say that excessive EHR documentation is contributing to burnout. And while a majority of providers say exchanging data within their EHR network is easy, far fewer (24%) say the same for out-of-network EHRs.

Administrative restraints also affect patients. Think back to your most recent doctor’s visit. How much of the visit was spent filling out paperwork or waiting patiently while a physician or nurse practitioner typed away at their computer? This time would be better spent having a more substantive discussion about new health issues and treatment options. These administrative burdens don’t just come at the expense of providers and staff—they take time away from the quality of care patients receive. 


ML has significant potential for helping providers streamline their administrative responsibilities and, as a result, foster better and more fulfilling patient experiences. 

One potential use case involves AI-powered scribing solutions, which a number of startups are beginning to roll out. These solutions take detailed notes of a patient and provider’s conversation, which helps streamline and better capture the visit, allowing for a more productive appointment. 


Another trending use case is prior authorizations, or PAs. PAs occur when a healthcare payor requires a provider to secure approval to carry out a specific procedure or prescribe a medication. Physicians and their staff spend almost two full business days each week on PAs, and they can be a major source of contention between payors and providers. ML can quickly compile relevant patient information from EHRs and provide data-backed recommendations about the benefits of various treatment options. While providers still review the information and make the final call, ML can help reduce the time it takes to complete each PA.

In this example, ML acts as a supplemental tool for providers rather than the primary source of truth. This distinction is crucial. When using ML tools, providers will still have to use their best judgment for decision-making. But a reduced focus on administrative work coupled with a more comprehensive picture of a patient’s health history will make these judgments easier. 


Concerns about bias and the feasibility of using ML and AI solutions are not without merit. Obviously, tools like ChatGPT have limitations, and it’s important to fully consider all the factors that could impact patient outcomes.

But using these tools for administrative purposes offers providers a much lower-stakes path to realize their benefits. Ultimately, by streamlining administrative tasks, providers become better equipped to offer their patients more comprehensive care.

 Chris Riopelle is the CEO and cofounder of Strive Health.

About michelleclarke2015

Life event that changes all: Horse riding accident in Zimbabwe in 1993, a fractured skull et al including bipolar anxiety, chronic fatigue …. co-morbidities (Nietzche 'He who has the reason why can deal with any how' details my health history from 1993 to date). 17th 2017 August operation for breast cancer (no indications just an appointment came from BreastCheck through the Post). Trinity College Dublin Business Economics and Social Studies (but no degree) 1997-2003; UCD 1997/1998 night classes) essays, projects, writings. Trinity Horizon Programme 1997/98 (Centre for Women Studies Trinity College Dublin/St. Patrick's Foundation (Professor McKeon) EU Horizon funded: research study of 15 women (I was one of this group and it became the cornerstone of my journey to now 2017) over 9 mth period diagnosed with depression and their reintegration into society, with special emphasis on work, arts, further education; Notes from time at Trinity Horizon Project 1997/98; Articles written for 2003/2004; St Patricks Foundation monthly lecture notes for a specific period in time; Selection of Poetry including poems written by people I know; Quotations 1998-2017; other writings mainly with theme of social justice under the heading Citizen Journalism Ireland. Letters written to friends about life in Zimbabwe; Family history including Michael Comyn KC, my grandfather, my grandmother's family, the O'Donnellan ffrench Blake-Forsters; Moral wrong: An acrimonious divorce but the real injustice was the Catholic Church granting an annulment – you can read it and make your own judgment, I have mine. Topics I have written about include annual Brain Awareness week, Mashonaland Irish Associataion in Zimbabwe, Suicide (a life sentence to those left behind); Nostalgia: Tara Hill, Co. Meath.
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