How artificial intelligence is transforming healthcare

by David Pare

Pulse Series: This is the third of my monthly blogs on news, start-ups and developments in the healthcare industry, part of the 21st Century Series on Australian Healthcare.

What better place to start the digital health journey than with the often poorly understood subject of artificial intelligence (AI). Analysts at International Data Corporation (IDC) define AI as technology that uses “natural language processing (NLP) and understanding to answer questions and provide recommendations and direction.” This is a far cry from the concept of robots running rampant and taking over jobs. On the contrary, a new report from IDC forecasts AI actually creating jobs.

There are many reasons why these capabilities are invaluable to the healthcare industry. Consider the amount of unstructured content that exists across the healthcare ecosystem: doctors’ notes, lab reports, discharge notes, as well as patient-specific data such as lifestyle, risk factors, age and so on. We all know about the move towards personalised medicine, but without AI, providers and health insurers are forced to manually process all this data to manage the patient’s health.

Gaining acceptance

Nevertheless, AI is not widely accepted by doctors. If I were to posit a reason for this, it’s likely because doctors are trained to be figures of authority. In reality, AI is simply a tool that removes time-consuming activities that detract from engaging with patients. Doctors might use AI to assess why a patient’s health is deteriorating based on data from wearables, or to provide valuable insights on the best medication to use based on the patient’s history.

I do see doctors’ thinking towards digital starting to change. When I visit doctors, they typically have Google open on their desk because they know they don’t have all the answers. AI is just another, deeper and more comprehensive tool to assist them.

There are areas of healthcare where AI is being put to good use. For example, some research labs have been using predictive analytics to assist radiologists in better tracking of disease progression, augmenting the radiologists’ expertise to assess changes that the human eye would struggle to see.

Insuring for the gaps

From the point of view of insurers, one area where AI has huge potential is in fraud detection and analysis. Take an example of a patient sent for knee surgery. The specialist might note that the patient is undergoing simple surgery, but the hospital could put in a claim for complex surgery. The difference between the two could be up to $5,000. At some point, the insurer will discover the discrepancy and realise it has been overcharged. It has been estimated that claim leakage (or fraud, depending on your perspective) results in losses of about 1 to 3 percent a year for insurers. Consider a small health insurer with one million members that would pay back around $1.5 billion per year in claims to its members. In this simple scenario, claims leakage would equate to losses of $15 to $45 million per year.

The beauty of AI is that it can quickly look at gaps and discrepancies and, using algorithms, can learn why gaps might make sense in one scenario but not in another. This helps to significantly reduce time-consuming and costly manual processes.

AI into the future

The various stakeholders in the healthcare ecosystem are starting to explore many exciting new areas in which AI will play a central role. One of these is predictive analytics. Drawing on data about patients from a variety of sources, it could be possible to predict those at risk and take steps to help them improve their health outcomes before they develop more serious issues. For example, AI algorithms can be used to identify patients who are likely to develop diabetes or chronic heart failure problems. Rather than wait until the patient’s health spirals downwards, the healthcare provider, hospital or even insurer can propose an intervention program and provide clinical support to help that person change his or her behaviour. The challenge here is that the Australian health system is focused on the volume of activity, meaning that doctors are paid for treating sick patients, rather than a value-based system where clinicians are incentivised to keep patients healthy by focusing on prevention.

IDC has stressed the importance of harnessing the unstructured content that exists across healthcare to achieve improvements in quality of care, remove unnecessary cost and accelerate innovation.

Payers, providers, the pharmaceutical industry and patients will have many opportunities to tap into the power of AI to transform the health ecosystem, whether for regulatory intelligence, diagnosis and treatment, ensuring the best use of key resources such as doctors and nurses, driving innovation, or to enhance personalised care and the patient experience.


David Paré is the chief technology officer for DXC Healthcare and Life Sciences in Australia and New Zealand. He is an innovative thinker with 20 years of experience in business and technology management consulting, helping organisations through their digital transformation.

 

 

RELATED LINKS

How IoT paves the way to value-based care

A practical guide to digital health innovation in Australia

 

Comments

  1. Great Blog!
    I loved your blog post and here you shared informative information about how AI easily transform healthcare sector.

    Thanks for sharing!!!

    Like

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