Friday, November 17, 2023

Help doctors heed their calling: the urgent case for AI integration

As an executive for leading health care systems like Humana, a lot of my work entails listening to doctors. Lately what I hear is both uplifting and worrying. When doctors speak about why they entered medicine and their hopes and dreams for their work in medicine, I’m always humbled. They wholeheartedly follow a simple calling to improve the health and well-being of their patients. But I also hear doctors calling for help.

Many complain about the paperwork and administrative chores that have led to an alarming rate of burnout among physicians. Others view this stress and exhaustion as symptoms of a greater problem. They expect the very best of themselves. It’s not humanly possible, however, they say, to manage the deluge of clinical, social, and benefits data that they need to coordinate care most effectively.

Physicians today must be collaborators and communicators as well as doctors. As primary care has evolved into a team effort in recent years, they need to coordinate with teams of nurses, social workers, case managers, and specialists working together to keep patients healthy over the long term. Many have determined that integrated care, or highly personalized treatments coupled with multimodal interventions, is essential to fulfilling that goal.

As a result, doctors want access to multitudes of data points about patients' physical, mental, and social conditions, family histories, comorbidities, and other information. At the same time, they must also keep pace with local clinical developments, key public health trends, and scientific advances in medicine. The problem is that they can’t possibly process and analyze the sources of this information quickly or efficiently enough to unlock its true value for the people under their care. This dilemma is at the heart of the crisis afflicting dissatisfied doctors today.


'There is a better way to care for patients'


Dr. Jason Mitchell is the chief medical and clinical transformation officer of Presbyterian Healthcare Services, one of the nation’s largest provider-led integrated health systems. Doctors trying to follow their calling, he told me, struggle with processing significant amounts of patient data and demands across so many sources while handling their many other daily tasks. For people who have dedicated years of their lives to medicine, this reality can be incredibly discouraging.

“Health care has become so complex it can distract from what is most important, the care of the patient across from me,” said Dr. Mitchell. “Yet, I also know that actionable data from those complexities can help me better understand a patient’s history and risk factors, and lead to a more tailored treatment approach.”

Dr. Mitchell’s words illustrate the troubling questions that I regularly hear from physicians striving for excellence: How do I keep pace with it all? How can I best assemble and assess all the information and factors affecting a patient's health? What's the patient’s medical history and family background that will accelerate some of the high-risk conditions soon? What social and environmental factors affect their health? How will behavioral issues and lifestyle impact their ability to follow treatment? What are the most effective treatments for this specific patient right now?
Doctors clearly spend too much of their time searching for this kind of granular intelligence rather than using it to benefit their patients. Their quest to follow their calling has become a matter of finding and mastering the data at their disposal in the limited time that they have available.


Generative AI, predictive AI, and integrated data


To truly help doctors pursue their integrated care mission – the calling that motivated them through years of grueling studies, frantic residencies, and managing their practices – we need to pursue the latest technological approaches that are designed with our physicians’ experience and holistic health outcomes in mind, specifically generative artificial intelligence (AI) combined with predictive AI and integrated data. Experts have talked about adopting new technology to revolutionize care and doctors’ experiences for decades. Now AI has the potential to do it.

An AI-driven intelligent platform could help doctors in the same way that pilots operate through a cockpit to control their aircraft – a mediating tool, in other words, that helps reduce the many complicated aspects of flight into manageable processes, including when conditions are chaotic, and lives hang in the balance.

A streamlined cockpit in a clinical platform would give doctors the right data at the right time for the patients they serve. The readouts on this cockpit, furthermore, would focus the doctor’s attention squarely on the safe health journey of patients while minimizing time spent on the administrative demands of employers, insurers, and others.

Instead of sifting through mountains of data from disparate sources, AI could help doctors parse thousands of data points for individual patients and the latest guidelines for care as well as predict options for treatments. This technology would and could not serve as an autopilot that might replace doctors. Instead, it would reduce their busy work while they reclaim time for patients. The American Medical Association, for example, used the term “augmented intelligence” when recently formulating recommendations for AI in clinical settings.


Integrated care and AI


Successful integrated care is a team approach, a collaboration between primary care providers and specialists who consider the totality of the patient’s needs through tailored programs of disease management, mental health treatment, physical therapy, and more. The primary care doctor, as the quarterback or chief strategist in this integrated approach, needs to see the entire playing field.

It's here that technological tools built around AI become indispensable. Systems based on this technology can better connect doctors to their caregiving teams, streams of essential clinical data, social data, and patient health metrics. With AI, doctors have the necessary holistic intelligence infused into the workflow to deliver hyper-personalized interventions. The time and attention they gain help clinicians operate at the “top of the license,” delivering clinical excellence that otherwise would be humanly impossible.

Here are three ways that AI can help doctors heed their calling to deliver optimized integrated care:Easy access to longitudinal data

Health care data is currently siloed across doctors’ notes, lab test results, electronic health records, insurance claims, knowledge about social determinants of health, remote patient monitoring data, and other myriad factors. An AI-enabled co-pilot could amass this longitudinal data to help doctors grasp the full range of their patients’ needs. This approach makes life easier for doctors, and, more importantly, gives them a clear view of the intertwined causes of their patients’ health challenges.Automating routine tasks with generative AI

Generative AI synthesizes existing information to summarize or create new content or data. It uses large language models and algorithms to understand and simulate data structures and patterns to create output that is novel but still within the confines of its learned data patterns. This particular skill makes generative AI exceptionally beneficial for simplifying interactions with physicians. It can not only automate but infuse deep intelligence into repetitive tasks like scheduling routine follow-up appointments, lab tests, and prescriptions, for example, freeing up doctors’ time to focus on the personal touch the patient needs.Better prognoses through predictive AI

Foreseeing outcomes based on historical data, this AI type uses machine learning techniques to analyze data in real-time, detect patterns, and take advantage of mathematical models to gauge the chances of future events and behaviors. Longitudinal data and AI algorithms together can assist physicians in crafting hyper-individualized treatments – including variables like medications and dosages – at a broad and deep level that is almost impossible for humans to accomplish quickly and accurately alone.

Doctors, of course, would need to watch out for bias within AI, including so-called hallucinations where AI invents data, as well as protecting privacy and other concerns. Doctors must be given the opportunity to leverage the co-pilot but the challenge they face today is getting to the point where they can dispense with the busy work of finding and analyzing the longitudinal data so that they can focus on their true calling, the patient care. They need to be in the pilot’s seat assisted by an intelligent co-pilot.

AI-enabled, cockpit-like platforms, with rigorous oversight, could free doctors to answer their calling and, in the process, transform health care.


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