The agony of asymmetric A.I. benefits in Health Care

Great to reduce doctor burnout. What about patient and caregiver burnout?

Doctor burnout:

Yesterday, the New York Times published an article entitled A.I. May Someday Work Medical Miracles. For Now, It Helps Do Paperwork (sharable gift-link embedded here). This is a splendid piece of work by Steve Lohr, an author I follow who’s well-versed in advances in technology. Unlike much of what we read elsewhere on AI and healthcare, the article is pretty darned honest, even injecting a hyperbolic promise about future capabilities that some might misread:

Every doctor, enthusiasts predict, will have a superintelligent sidekick, dispensing suggestions to improve care.

Needless to say (but I’ll say it anyhow for clarity) we may be years away from anything approaching the enthusiast’s visions of superintelligent medical sidekicks.

Nonetheless, there’s value in the newest technology-based doctor assistants that do a far better job than older speech-to-text transcription machines. Sample claim:

Easing “the crushing burden of digital paperwork that physicians must produce, typing lengthy notes into electronic medical records required for treatment, billing and administrative purposes.”

The article goes on to say that

For years, doctors have used various kinds of documentation assistance, including speech recognition software and human transcribers. But the latest A.I. is doing far more: summarizing, organizing and tagging the conversation between a doctor and a patient.

The head of medical informatics at the University of Kansas Medical Center, Dr. Gregory Ator, is optimistic about the value of this technology for physicians but he also throws up a significant boundary to avoid crossing:

The Kansas health system is steering clear of using generative A.I. in diagnosis, concerned that its recommendations may be unreliable and that its reasoning is not transparent. “In medicine, we can’t tolerate hallucinations,” Dr. Ator said. “And we don’t like black boxes.”

Real benefits

In the end, some doctors are reporting that this new software has cut daily documentation and form-filling time from hours a day to minutes, improving doctor-patient communication and reducing doctor burnout.

That’s great.

Patient burnout:

Now what about automation tools for patients to manage their side of the process, particularly health insurance forms, treatment codes, claims, payments, and appeals?

Healthcare providers have a broad array of “solutions” for providers but none for patients. Look at this review, for example. Here’s a mirror image subset of the best practices checklist provided for practitioners in that review. I’ve extracted a few of the common needs for patients facing complexity and denials of coverage by insurance providers:

• Stay organized. Track the summary status and disposition of all claims. A simple spreadsheet isn’t enough.

• Prioritize bringing the highest impact transactions to closure.

• Identify trends (progress and failure) by payer (insurer), healthcare institution, practitioner, and type of claim.

• Be timely — pursue lingering and rejected claims ASAP. Honor payer deadlines.

• Identify other resources that can help you in managing claims and payments

• Collaborate with the payers, institutions, and practitioners to help them expedite positive closure.

Where’s the patient’s (and caregiver’s) intelligent assistant for managing their care?

• How can we move beyond fax, phone, and read-only web-text communication to smart agents/assistants that work across the patient-provider divide?