I'm listening to all of the news and scuttlebutt from #himss2023 about the benefits and risks of #artificialintelligence in #healthcare. What's fascinating to me is how the majority of applications might be considered "minor tweaks" to what may be a a failing system when one considers close to 20% of GDP is spent on healthcare, and our systemic outcomes are far below average.
That's not to suggest that, for example, helping a physician with documentation or referral won't be beneficial. Or that leveraging AI to determine where the next pandemic outbreak might occur won't save lives. I'm sure it will eventually even help us to optimize both diagnosis and treatment for patients, something I'm completely in favor of for selfish reasons. I believe AI has a real future in healthcare.
However when I used #ChatGPT to inquire as to how to improve the US healthcare system, the response was interesting. To be clear, I specifically asked "How should we fix the us healthcare system to be more effective?"
Fixing the U.S. healthcare system to be more effective is a complex issue that requires careful consideration of multiple factors. Here are some potential strategies that could be considered:
- Universal Access: Implementing a universal access system that ensures that all Americans have access to affordable healthcare regardless of their income, employment status, or pre-existing conditions. This could be achieved through a single-payer system, where the government acts as the sole insurer, or through other models that ensure broad access to healthcare services.
- Cost Transparency: Implementing measures to increase transparency in healthcare costs, including requiring hospitals, clinics, and providers to disclose the cost of medical procedures and services upfront, so that patients can make informed decisions about their healthcare and shop for the best value.
- Prevention and Wellness: Shifting the focus of the healthcare system from primarily treating diseases to a greater emphasis on preventive care and wellness initiatives. This could include promoting healthy lifestyles, providing incentives for preventive screenings and vaccinations, and investing in community-based health programs.
- Prescription Drug Prices: Addressing the high cost of prescription drugs by implementing measures to increase transparency, promote competition, and allow the government to negotiate drug prices with pharmaceutical companies. This could include allowing importation of cheaper drugs from other countries and encouraging the use of generic medications.
- Health Information Technology: Expanding the use of health information technology to improve patient care coordination, reduce administrative costs, and enhance communication among healthcare providers. This could include promoting the use of electronic health records (EHRs) and telemedicine to improve access to care, especially in rural and underserved areas.
- Addressing Health Disparities: Implementing strategies to address health disparities and inequalities, including racial and ethnic disparities in healthcare access, outcomes, and quality of care. This could include investing in programs that improve access to healthcare in underserved communities, increasing diversity in the healthcare workforce, and promoting cultural competency training for healthcare providers.
- Payment and Delivery System Reforms: Implementing payment and delivery system reforms that incentivize high-quality care, promote care coordination, and reduce unnecessary healthcare utilization. This could include alternative payment models, such as value-based care, bundled payments, and accountable care organizations (ACOs), that reward providers for delivering high-quality care and achieving positive patient outcomes.
- Patient Empowerment: Empowering patients to be active participants in their own healthcare, including providing them with the tools and resources to make informed decisions about their care, promoting shared decision-making between patients and providers, and improving health literacy.
- Medical Malpractice Reform: Exploring ways to reform medical malpractice laws to reduce defensive medicine practices, which can drive up healthcare costs, while still ensuring that patients who are harmed by medical errors have access to appropriate compensation.
- Interdisciplinary Collaboration: Encouraging interdisciplinary collaboration among healthcare providers, including physicians, nurses, pharmacists, social workers, and other healthcare professionals, to improve patient care coordination and outcomes.
It's important to note that fixing the U.S. healthcare system is a complex issue with many stakeholders and competing interests, and any proposed changes would need to be carefully considered, thoroughly researched, and balanced to ensure that they are effective and sustainable.
As I read this response what I see if a wholesale redesign of the system. Universal coverage, preventative care vs. reactionary / acute care, and things like malpractice reform. No where does ChatGPT list the many applications of AI I keep hearing about as a way to truly improve things.
Am I to interpret this to mean that the greatest risk in healthcare's use of AI might be to the system itself, and the stakeholders who have a vested interest in continuing on the path we're on?
Reminds me of the (before my time) famous Groucho Marx line when resigning from the Friar's club "I don’t want to belong to any club that would accept me as one of its members."
While I'm not giving up on healthcare's promise of the future and technology's role in that, I do wonder if AI is going to be the one to tell us to "bite the bullet" and fix what really needs fixing. Is that the real risk of AI?
