By Andrea Kowalski, SVP of Products, Tebra
LinkedIn: Andrea Kowalski
Kyle Ryan, Chief Technology Officer, Tebra
LinkedIn: Kyle Ryan
X: @TebraOfficial
Broad overview statement of AI in transforming healthcare
If we are to realize the future of healthcare and address the serious challenges that plague our industry, we must embrace artificial intelligence (AI). Leveraging innovative approaches to modern AI will allow us to fundamentally address provider burnout, the staffing crisis, and other serious issues on the horizon. With AI, we can make the future of healthcare possible.
AI can transform the way providers leverage technology, which can allow them to spend more time with their patients, concentrate on care delivery, and run efficient practices. Imagine a future where providers spend 90% of their time focused on patients and have the space to provide preventative care; with their intelligent, AI-powered digital physician assistant at their fingertips, helping them to streamline their patient interactions, reduce operating costs, and save time, while providing insightful recommendations based on a wealth of healthcare data.
GAI
Within the healthcare industry, a growing body of use cases now experiment with ChatGPT and GPT4. We believe there are a number of use cases where we can leverage ChatGPT to improve our overall business operations, streamline costs, and improve the well-being of our providers and clinical staff. We also believe there is a tremendous opportunity to transform care delivery. There is still a great deal to learn about the opportunities, challenges, and dangers of using AI in healthcare settings, particularly around care decisions. Just like a medical student needs to be supervised, any use of AI needs to be supervised for bias and accuracy. AI can help to accelerate activities and take work off provider’s hands, but ultimately providers are responsible for the end results of their work. Still, AI is an area with tremendous potential and is an area of focus about which we will continue to learn.
Though the long-term applications of AI in healthcare are still evolving, in the near term, Tebra is focusing on supporting providers and their practices with patient management and patient communications through AI technology.
Recall/Appt Mgmt
Patient management takes a great deal of operational work from practice staff, and a big part of that includes communicating back and forth with patients. This includes reaching out to existing patients and interacting with them on a regular basis to ensure their care needs are met when they’re not in the office. The coordination of incoming requests and outgoing communications can be time consuming and even impersonal, especially at scale and on a regular basis. With AI, this work can be not just automated, but personalized to facilitate a stronger connection between providers and patients. Possible use cases include automating and personalizing messages that aim to get patients who need care back into the office, respond to specific actionable messages from patients, educate patients, and communicate test results.
Tebra is starting with this area first to help reduce the administrative burden on practices and streamline operations. Our focus here will allow providers and their staff to focus more on care delivery and creating that connection with patients, ultimately to drive better outcomes. We believe that AI has the potential to truly transform healthcare and we intend to stay at the forefront of technological advancements to deliver maximum value to our independent practices as they provide quality healthcare.
Claims submission/claim correction automation/claim rejection
Independent healthcare practices operate in survival mode more often than not. Creating cash flow to keep their employees paid and their business thriving is paramount to their success. Yet the process of submitting claims to both public and private payers, compounded with all of the various obscure requirements that go along with trying to get paid, is painful and often time-consuming. AI can play a key role in alleviating this challenge. It can provide relief for these businesses by helping them collect revenue for the services they perform far more efficiently and effectively. It can, in combination with machine learning, intelligently review a claim before submission to ensure that it has the correct codes or fill out a claim based on the procedures that were performed, or handle rejects to streamline the manual review and resubmit effort. It also eliminates operating expense overhead and streamlines revenue collection to ensure the success of independent healthcare practices.
Clinical notes/documentation
Provider burnout is a real thing. The note and documentation requirements due to increased regulation and payer demands continue to get more and more burdensome. Relief is required for independent healthcare providers to survive. AI can be the answer. Advancements in machine learning and natural language processing can all but eliminate the burden and time-consuming process of capturing the needed notes and documentation of a patient visit and the follow-up actions required. With intelligent automation to capture the key points of a patient visit, the necessary documentation could be prepared and ready for a quick review by the provider; even done right from their mobile device. This is not a thing of the future but something we can and must do now.