14 Sep The AI Advantage: Reshaping Healthcare Practices for a New Era

Posted at 10:18h in Blog by

     

     During a presentation at the NCMGMA Fall Conference in September 2023, our team covered a multitude of artificial intelligence (AI) applications that can be implemented into current practices to facilitate operations regarding administrative, clinical, and revenue cycle management duties. We demonstrated how AI applications have the potential to replace the labor-intensive processes of manually creating clinical summaries, coding, and billing. Furthermore, we explained how these applications could minimize human errors in the revenue cycle, improve cash flow, and reduce record-keeping costs. We also expanded upon the other uses of these applications, such as eligibility verification and prior authorization. 

 

AI in Healthcare – Understanding the Relevance and Potential Misconceptions

     AI has emerged as a transformative force in healthcare, offering unprecedented opportunities for improving patient outcomes and streamlining processes. AI operates by enabling machines to simulate human intelligence, learning from data, identifying patterns, and making data-driven decisions. In healthcare, AI plays a crucial role in diagnosing diseases, analyzing medical images, predicting patient risks, and optimizing treatment plans.

     Machine Learning (ML) and Natural Language Processing (NLP) are vital components of AI in healthcare. ML algorithms, taught by professional clinicians, learn from data to recognize patterns and predict outcomes. NLP enables computers to understand and interact with human language. Together, these technologies empower AI to interpret vast volumes of medical information and facilitate more effective decision-making.

     However, AI in healthcare, just like any other technology, has its misconceptions and potential issues. One critical concern is ensuring the security and privacy of patient data, as mandated by the Health Insurance Portability and Accountability Act (HIPAA). Adhering to stringent safety measures is essential to protect sensitive medical information from unauthorized access or breaches. One widely accepted misconception is the thought that AI will overtime take jobs. In reality AI technology is no threat to the workforce as it is unable to fully carry out the tasks of workers, but is rather a new tool which improves processes and heightens efficiency. In fact, AI will contribute to the creation of new jobs such as prompt engineers, educators and integrators.

Administrative:

     “ChatGPT” and “AutoGPT” are AI tools that assist medical practices in streamlining administrative tasks. Another application, “Everlaw,” can read and summarize  the primary points of large legal documents with factual evidence. It can be used to read a wide range of contracts, specifically contracts for fee schedules with payers. “Fireflies” is an automated note-taker that can be used in meetings, allowing you to be more present in the meeting and have an abundance of automated notes. These applications provide efficient solutions for content creation, time-management, and automating routine workflows, allowing healthcare professionals to dedicate more time to patient care. 

Clinical:

     “Amazon Web Services HealthScribe” is a noteworthy example of clinical AI as it aids in medical transcription tasks. By converting voice inputs into accurate, structured text, HealthScribe enhances documentation and enables faster access to patient records ultimately improving clinical workflows. “NVIDIA: MONAI” can be used for diagnostic imaging and is trained on deep neural networks. “Nanox” is another medical imaging analytics application that offers solutions to healthcare providers in interpreting medical images. It is FDA cleared for detecting coronary artery calcium and vertebral compression fractures. These applications aid in daily tasks thus saving time and reducing the burden on clinicians.

Revenue Cycle Tools:

     “Experian Health” and “Olive” are AI applications that prove invaluable in the revenue cycle management of medical practices. They optimize billing processes, identify billing errors, and accelerate reimbursement cycles, thus ensuring financial efficiency. The “ChatGPT code interpreter” further aids in revenue cycle tasks, simplifying coding and billing procedures. “Microsoft Azure Health Bot” and “IBM Watson” are AI-powered chatbots that support practices in revenue cycle management. These chatbots interact with patients, answer queries, schedule appointments, and process payments, hence enhancing patient engagement and satisfaction.

     In conclusion, our team of interns at Prosper Beyond is excited to explore and leverage the potential of AI in healthcare. With a keen focus on administrative, clinical, and revenue cycle tools, we aim to contribute to the advancement of healthcare practices by providing better patient experiences and improving overall efficiency in the ever-evolving healthcare landscape. We are beyond excited about the possibilities of AI and its potential to revolutionize how healthcare is understood and received.

Our Team

     Our team came together as a group of interns at Prosper Beyond, a specialized healthcare consulting practice committed to guiding providers through the complexities of payer contract negotiations and revenue cycle optimization. When asked to present concrete examples of AI applications that could be implemented into current practices at this year’s NCMGMA fall conference, our team went above and beyond to research the multitude of potential applications. They put together a presentation that focuses on the most useful applications to healthcare administration that are readily available to be integrated into today’s world of healthcare. Let’s meet the members of our dedicated team:

Cayden Jacobsen is a Biology student at UNC Charlotte, passionate about artificial intelligence and its possibilities in the healthcare sector. He originally started college on a pre-med track, however, he is now pursuing a path in management consulting. After college, he plans to attend Law School or pursue his MBA. 

Paige Roberts is a dedicated healthcare management student at Appalachian State University. Paige’s journey has equipped her with valuable skills through previous roles, including a leadership position. She gained practical experience interning at Prosper Beyond, which expanded her perspective and ignited her interest in various career paths within healthcare. As she approaches anticipated graduation in December 2023, she is eager to embark on the next phase of her academic journey. Paige is considering a master’s degree in either business administration or healthcare administration, further enriching her expertise and contributing to the evolving healthcare landscape.

Richa Puranik is passionate about bettering healthcare systems and is pursuing a major in Public Health at UNC Chapel Hill, specializing in Health Policy and Management. She aims to explore minors in Business Administration and Spanish for the Business Professions. During her time with Prosper Beyond she gained valuable insight on the world of healthcare consulting, and hopes to explore more potential future careers. Upon her graduation in May 2026, Richa plans to further her education by obtaining a dual Master’s degree via the MBA/MHA track.

 

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