AI in Healthcare: An Answer to Quality of Services

AI in Healthcare: An Answer to Quality of Services

Healthcare Tech Outlook | Wednesday, May 29, 2019

FREMONT, CA: Healthcare is an area where artificial intelligence (AI) guarantees to hold a genuinely life-changing impact. The revolutionary disruption of AI in the healthcare sector can be observed across clinical research, drug development, and hospital care. AI applications have pioneered the intricacies of the health sector to improve patient outcomes and significantly reduce expenditure.

According to industry estimates, the overall investment is expected to reach $6.6 billion by 2021 in healthcare alone. As history proves, investment in technology leads to huge savings. Accenture too has predicted that the top AI uses may result in annual savings of $150 billion by 2026 for the companies deploying AI solutions in healthcare.

As of now, AI holds enormous importance for the healthcare industry in bolstering accessibility, reducing cost, and improving treatment. First and foremost, AI promises to improve network information. For instance, a health plan can combine data from different variables, which includes service inquiries, and grievances, utilization management, network adequacy, and administrative survey data inform networking decisions. AI applications can be deployed to utilize, to help predict the plan's ability to serve an area before expansion, and this can help to identify gaps within the plan's network before causing any impact on members and resulting in regulatory non-compliance for the enterprise.

Many data sources feed AI, claim data, usage management data, network adequacy data, initial health screening data, admissions data, and legislative rule change data, a health plan can accurately predict adjustments in future claims, appeals, and claim volumes for providers to allocate their processing resources and expected workloads on related issues as efficiently as possible, such as capitation deduction.

AI also improves financial decision-making. Healthcare organizations can make better-informed investment decisions using machine learning (ML) algorithms. AI, while bearing in mind multiple variables, can acknowledge patterns, develop strategies, and show different scenarios. In particular, AI can also be used to detect malware and thwart attacks.

In addition, AI in healthcare also improves managerial competencies. Healthcare enterprise can utilize AI to optimize electronic health record (EHR) workflow by enhancing natural language processing tools and automation. Above all, AI contributes to fraud prevention and detection. By using AI with multiple data sources, healthcare institutions can better detect and prevent fraud.

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