What Healthcare Thought Leaders Are Saying About AI

“The patient must be first. It’s not about what’s cool or let’s see what we can do with it. [We need to be asking:]

• How is [AI] helping my patient?
• How does it help providers get out of the hospital faster?
• How is this helping more efficiency?

Those are the things we need to start talking about.” 

— Dr. Daniel Carnegie, Chief Resident, UNC Preventive Medicine

In June, at NASCO’s 2024 Conference, I had the wonderful opportunity to partner with Kirk Barnes to organize a panel of healthcare thought leaders to discuss the impacts and implications of artificial intelligence (AI) on our industry. Kirk was our moderator, bringing his wealth of experience and networking skills to guide our discussion. Kirk’s day job is Program Director of the Southeast MBDA Minority Business Growth Hub and CEO of TransPharMed, an organization that helps buyers vet innovative healthcare technology.

Other panel members included:

• Daniel Andrew Carnegie, MD, MPH, MBA, Chief Resident, UNC Preventive Medicine, who graduated from Howard University College of Medicine in Washington, DC, in 2008. After his general surgery residency, he completed a surgical oncology and breast research fellowship at the Johns Hopkins University. During his time at Hopkins, he also earned his MPH and MBA degrees with concentrations in health finance and management, and discovered his passion for leveraging technology to improve health outcomes.
• Karl Hightower, C-Suite Technology and Transformation Executive, Catalyst at Wellstar, who spent five years at Novant Health, most recently as the Chief Data & Analytics Officer. In his current role, he provides foundational guidance, strategic advice, governance and mentorship around utilization of next generation data, decision support, and AI technologies.
• Christopher Kunney, Healthcare Technology Strategist and Managing Partner, IOTECH Consulting, has a robust track record of developing and implementing strategic solutions. His expertise encompasses health information technology (HIT) assessment, strategic planning, system implementation, and project management. Kunney’s contributions have been pivotal in driving IT transformation efforts and optimizing healthcare business operations. He received the 2024 HIMSS Changemaker Award.
• And myself David Weeks, Chief Digital and Technology Officer of NASCO, bringing to the panel my experience across health insurance, healthcare, technology leadership and innovation.

In some ways, it’s hard to believe it’s only been 18 months since OpenAI launched ChatGPT. Consumers now have regular access to AI tools, more every day, and every industry is rapidly evaluating how to effectively use AI. At the same time, however, we are also seeing organizations realize the complexity of implementing generative AI (GenAI) while balancing the data, security and information risk concerns. In healthcare, many organizations have established AI governance processes and set standards and policies to manage the associated risk. Also, the government continues to evaluate how organizations should be best using the transformational capabilities while balancing the known and unknown risks.

AI is not a new technology, even though it has dominated the news since ChatGPT’s debut. In fact, as I reiterated during our panel, “Artificial intelligence has really been around since the beginning of computing. When Alan Turing talked about inventing computers, he had a task that really was testing the intelligence of computers.” What’s changed is the accessibility of generative AI and, as Hightower emphasized, the sophistication of AI.

GenAI, at its simplest, is a technology based on data that creates new content and is a differentiator to much of the other artificial intelligence we are using. My fellow panelists added to my basic definition of GenAI, starting with Kunney who emphasized, “AI is not going to replace us all, at least in our lifetime….GenAI is a tool we use to hopefully improve the delivery of care, make better clinical and business decisions, and ultimately, meet the mission of our healthcare organizations and improve the human condition.”

How Health Plans Are Using AI

In my role at NASCO, I know there is a clear focus on the responsible use of AI within healthcare broadly, including lessons learned around and boundaries around usage. Within those parameters, health plans are starting to consider leveraging AI in a variety of ways, from areas that support day-to-day and administrative work, through areas that are ‘game changers’ that help enhance member and consumer cost and overall experience.

Several healthcare organizations, including NASCO’s parent company, Blue Cross Blue Shield of Michigan, are already leveraging AI through partners to tackle payment integrity opportunities within payment and pricing solutions, which helps optimize both medical and administrative costs. Other areas in payment process automation include prior authorization; for example, Health Care Service Corporation (HCSC) is using augmented intelligence to process prior authorization requests “up to 1,400 times faster” by streamlining the submission process and providing “auto-approvals when critical criteria are met.”

Panelist Perspectives

At the conference, the panel explored several insightful and impactful areas of AI, information technology and healthcare data, including:

What are some actual uses of GenAI your organization is currently deploying or trying to implement?

Kunney discussed claims denial, saying, ”Many health systems do not have the resources to go back in and clean up denied claims in a timely manner, leading to significant lost revenue. We’re incorporating AI to do the foresenics, identify the issues, make corrections, and resubmit the claims. We’re learning from AI to avoid making the same mistakes with the same type of claim, resulting in higher efficacy of claims processed and revenue being generated.”

Hightower also mentioned the potential of AI to improve claims accuracy and was most excited about how AI is changing medical research. ”With AI, we can teach doctors how to read medical research and be able to logically question it. Imagine having all the papers ever written on a topic and being able to pose questions such as, ’What is the statistical analysis of this study that was done?’ and ’Is this the right risk/benefit for my patient?’ We’re leveraging real big data into something more useful and continuing that education into the physician’s practice.”

Carnegie is enthusiastic about using AI to empower patients. “You can tell the patients to go home and learn a little about what they have in addition to what we talked about during the visit. That pays dividends. When a patient has insight into their condition, there’s so much empowerment given to patients.”

Barnes concluded the panel by asking each panelist for one takeaway. Carnegie continued his emphasis on the patient, saying, “We need to have sober conversations with our patients about privacy and security.” Kunney emphasized, “AI is a journey rather than a destination and it is going to continually evolve. Embrace AI, learn it and improve it.” Hightower added, “Make sure you know how to surf so you don’t get swamped. I have been through a lot of technology disruptions. This is by far the biggest change, and it happened overnight.”

Healthcare AI is quickly iterating and NASCO is continuing to organize discussions about the risks, opportunities, and immediate use cases for AI and GenAI. Stay tuned for future events and blogs about AI, and the future state technology ecosystem.