How IA Integrates AI for Systemwide Healthcare Improvements

  • June 21, 2023

The U.S. healthcare industry is the third largest and fastest growing industry in the United States, worth $808 billion. However, the United States ranks 22nd out of 27 high-income nations when analyzed for dollars spent to lives extended. Now artificial intelligence (AI) is presenting new opportunities to increase diagnostic efficiency — however, as with all technology, AI in a silo isn't serving the entire system.

Healthcare systems that deploy intelligent automation (IA) can expand AI’s efficiency into an interconnected technology system designed to simultaneously produce better patient outcomes and better business outcomes. Let’s dive into the details.

Diagnosis error rates, by the data

Taking a patient's history, spotting the patterns and being able to make an accurate diagnosis is difficult work. It’s so difficult, in fact, that despite their years of training, one study showed that the accuracy of doctors ranged from 50–90%, with a mean score of 71.40%.

Getting the wrong diagnosis is hard on any doctor, for any reason. Doctors seem to be getting more of the mild diagnoses correct: A study on errors in primary care shows that in the United States, only 5% of outpatients receive the wrong diagnosis annually. The study also shows that among patients with severe medical conditions, 20% of those patients are misdiagnosed by a primary care physician. And of those, one-third of the misdiagnoses result in patient harm.

Doctors regularly try to stay current on the most recent research, but no single person can read all the research in a given field as it comes out. In the field of epidemiology, 341 journals have been marked as authoritative, with a combined total of 7,287 articles published every month. A doctor would have to spend 627.5 hours per month reading research to stay current. AI, on the other hand, can catalog all research as it is produced.

How AI helped with COVID-19

AI’s ability to make diagnoses from a patient's history is impressive — but that’s hardly the limit of its capacity. AI can also read X-rays and MRIs to discern fine-tuned imaging anomalies that can identify pathologies and density changes that are largely indiscernible to even the most trained eyes. That means diagnoses are caught sooner. Patients get accurate treatment faster. And the system increases profits.

During the COVID-19 pandemic, CXR equipped with AI algorithms for COVID-19 diagnosis had a sensitivity (the ability to rule OUT a pathology, saying that you don't have a certain disease) of greater than 96% (83%–100%)! The algorithm’s specificity (the ability to rule IN a pathology, or say that you have a strong likelihood of having contracted a given disease) of 92% (80% to 100%). When AI read common X-rays for COVID-19, the numbers were similarly high: 95% sensitivity and 95% specificity. AI gave doctors the ability to weed out false-positive or false-negative PCR tests, which had a sensitivity of only 60.5%.

Goodbye, paperwork

Patient paperwork can be a frustrating experience — for the patient as well as the provider. Of the patients that avoid medical care, 15.6% say that is due to time constraints. Paperwork is one of the many aspects that make a visit to the doctor so time-consuming.

When a doctor is required to obtain prior authorization before providing certain services, most are still using a paper fax machine to send authorization requests. The healthcare insurer reviews the request through several processes and then responds with approval or denial via paper fax machines. With Intelligent Automation, processes that take hours, days or even weeks are reduced to minutes … or less.

If you think that sounds good in theory, you’ll love how it sounds in practice — take a look at this case study to see how NTT DATA with ServiceNow helped a top-tier healthcare system implement the ServiceNow HR Service Delivery (HRSD) platform to modernize its service operation and create a unified knowledge and service portal across the organization.

Some healthcare systems — like this public healthcare system — are undergoing a digital transformation. They're able to compare the patient to the service plan, and immediately give an accurate approval or denial. Parts of the organization are going digital, and the rest need to be intertwined through IA.

IA vs. AI in healthcare

While AI can help improve diagnostic accuracy, it can't run an entire healthcare system. Intelligent automation brings artificial intelligence into the list of technologies that are speeding healthcare along so that patients can be treated more accurately, at a faster pace, so they can get on with their lives.

Intelligent automation in healthcare touches three spaces: clinicians, labs and healthcare insurers

Clinicians benefit from intelligent automation by having access to rapid communication. The result is obtaining authorizations, diagnoses and key patient history information (such as, prescriptions and dosages, surgeries, allergies and so on) while the patient is still in the room. The clinician can treat that person far more accurately, and the person receiving care feels truly cared for.

Labs can streamline the work of reporting information so that doctors don’t have to wait, and patients don’t have to go without care. IA allows lab results to be compared to symptoms and past medical history for a clearer window into the issues driving the need for laboratory exams.

Healthcare insurers don’t have to be at odds with providers. The back and forth between the providers charging for care and the insurance footing the bill can leave the patient in a bind and ultimately lead to the patient at the center of the care footing a bill that drives them into financial distress. With intelligent automation, the details of each patient’s contract are clear so that no expenses are unnecessary and no critical treatments are deferred for financial reasons.

Health plan and life sciences providers also face complex challenges. Regulatory compliance and investor expectations demand the most streamlined of processes. Nothing can stifle the speed of innovation quite like miscommunication and bottlenecked processes coming from all the various branches of healthcare into a biomedical and pharmaceuticals research organization. Implementing an approach that combines effective risk transfer and mitigation is essential to creating a holistic risk-management solution.

Help more — bring IA into your healthcare organization today

Healthcare systems are specific about the technology they deploy — every single tool has been chosen and deployed for highly specific purposes. The challenge still facing your system is that each piece of technology isn't reaching every aspect of the business that could benefit from its capacity. Intelligent automation is the platform that synchronizes the disparate technologies throughout your healthcare system to bring AI’s diagnostic capabilities into third-party payer systems combined with patient data and policy stipulations, and beyond. The NTT DATA ServiceNow Practice gives you intelligent automation that improves outcomes for both patients and providers.

Call us today to get an analysis and consultation for what intelligent automation can do for your healthcare system.

Make healthcare faster, more accurate and better quality for your patients download our fact sheet to learn more.

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Grant Pulver

Grant Pulver boasts 20+ years of experience in technology, consulting, and management. He leads a team walking hand in hand with Client Leadership teams to ensure their business outcomes are imbued into their technology and platform strategies. Grant previously served as Program Manager at Fruition Partners and Vice President of End User Technology at AIG, Inc.


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