Using AI to tackle foundational problems

Los Angeles - As AI generates more attention in the healthcare industry, Dr. Nolan Chang sees plenty of reasons for legitimate enthusiasm, as well as plenty of hype.

Chang is the executive vice president of strategy, corporate development and finance, The Permanente Federation, part of Kaiser Permanente. He participated in a panel discussion at the ViVE digital health conference this week.

He also spoke with Chief Healthcare Executive® about the ways to target AI toward substantial problems in healthcare.

With AI, Chang says there’s an important question: “Is it reinforcing the existing systems, or is it actually solving for something foundational?”

It’s difficult to say at this point, but Chang says he hopes to have a more defined answer in a year.

Chang says he wants AI to be used to examine “the foundational challenges that we're facing.”

“I think it's really easy to just say, I'm going to use the tool to solve my existing problems and try to make my life easier,” Chang says. “But if we're looking at the patients as a whole, what's really driving the utilization, I think there's an opportunity to use technology to augment what we're able to do and drive better outcomes.”

He notes that some AI companies are taking ill-advised approaches in the solutions that they are offering to hospitals and health systems.

Chang recalls another recent discussion he participated in weeks ago, with one participant talking about using AI to enable a primary care doctor to have as many as 10,000 patients in their panel at one time.

While others in the discussion viewed that more hopefully, Chang assessed that scenario differently.

In that discussion, Chang responded, “You're all patients out there. How excited would you be to hear that your primary care physician has 10,000 patients on their panel? Really excited?”

Chang says he’s encouraged that more health systems have been talking about using AI tools, such as ambient documentation, to help clinicians do a better job with their patients and to reduce their administrative headaches, as opposed to simply seeing more patients.

And he says that he is excited about the opportunities AI will afford physicians and health systems to know their patients more deeply.

Chang spoke enthusiastically about AI-powered documentation tools that record and summarize patient appointments. Those tools enable doctors to have more natural conversations, looking face-to-face instead of on a monitor or keyboard.

But he says those notes also can reveal details that even as a physician, he may not normally see. He says one advantage of ambient documentation is that the technology can sometimes surface details that were especially relevant to the patient, even if the physician was focusing on other areas of concern.

For instance, a patient may come to a doctor complaining of exhaustion and low energy, and also shortness of breath. As a doctor, Chang says he’d gravitate to the patient’s shortness of breath, but he says that the AI-generated summaries may also highlight the concern of the patient and ultimately lead to better care for the patient.

“Making sure that patients are heard is where some of the tools would be really useful,” Chang says.

Kaiser Permanente has utilized a value-based care model, as opposed to being paid fees for services delivered to patients. Kaiser is focused on keeping people healthy and reducing the chances that they’ll need to be treated in hospitals.

Chang says he sees AI as a tool that can eventually accelerate value-based care.

“If we're not keeping that population healthy, then they're going to land in the clinic or the hospital more and utilize services. And so in that longitudinal value-based system, the more healthy we are able to keep them, the better off we're going to be,” he says.

Kaiser Permanente is deploying technology intended to guide patients more easily, including an “intelligent navigator,” Chang notes. Patients can type in their own words the problem they’re experiencing, rather than simply choosing a menu, and that can help direct patients to the right setting for care.

Chang says he wants to see AI utilized for “patient-centered” approaches.

“Aligning those technologies to be able to make sure we are able to understand the patients and meet them where they're at, based on the words that they're using, I think I think that's really powerful,” Chang says.

Chang also encourages health systems to have deeper conversations about the use of AI that will pay off down the road, and he says hospitals and other providers should try to think of different strategies to keep people healthy.

“Let's make sure we stay engaged at all levels,” he says. “Let's partner with people that are traditional partners and help us solve problems, but also the non-traditional people that we might not think of. Let's broaden that conversation and just try to say: ‘What are you struggling with? How can you come together to solve common problems and make a bigger impact?’”