Synthetic intelligence has the potential to considerably enhance medical care and help the transition to value-based care, nevertheless it additionally comes with dangers. What position ought to AI play in value-based healthcare fashions? The query was requested final week throughout a panel dialogue on CES 2024 which was moderated by Dr. Jesse Ehrenfeld, president of the American Medical Affiliation.

Chris Jagmin, vice chairman and chief medical officer of state applications and medical coverage at CVS Well being's Aetna, stated it's vital to make use of AI in areas the place there may be little danger. 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,” akin to automating name facilities or automating claims fee.

However “denying one thing primarily based on AI with out human contact is, I feel, fallacious for medical follow,” Jagmin stated.

Dr. Maria Ansari, CEO and Govt Director of The Permanente Medical Group, echoed Jagmin's feedback and emphasised the significance of a human strategy when utilizing AI.

“It’s the physician who treats the affected person, not the AI,” Ansari stated. “AI [should be used] to increase our work in medical resolution help instruments.”

She added that in a value-based care mannequin, AI must be used responsibly to foretell who wants further care, akin to who’s vulnerable to having a stroke or coronary heart assault.

That is particularly vital as a result of Covid-19 pandemic, as so many individuals weren’t coming in for preventative care, Ansari famous. For instance, she stated, The Permanente Medical Group had a two-year backlog of ladies not coming in for mammograms throughout Covid-19.

“How do you prioritize that? … As an alternative of simply utilizing conventional danger components for who could be in danger for breast most cancers, we used AI to take a look at their previous mammograms, which learn as regular however collected 1,000 knowledge factors that might really predict who would go on to have most cancers and prioritized these sufferers,” Ansari stated. “That prediction mannequin turned out to be 60% extra correct than conventional danger components.

“I feel we will use AI once we speak about value-based care to enhance well being outcomes in the fitting method, in a accountable method and with out denying care, however really bettering our care,” she continued.

The dialog got here after President Joe Biden signed a treaty govt order in October on the secure improvement and use of AI. The White Home in December introduced that 28 suppliers and payers have made commitments to the accountable use of AI in healthcare. These organizations embody CVS Well being, Mass Common Brigham, Premera Blue Cross and Sanford Well being.

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