Difference between revisions of "Healthcare AI Use Cases"

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* Fraud:  How do new data sources allow health plans to spot fraud sooner?
 
* Fraud:  How do new data sources allow health plans to spot fraud sooner?
 
* Payment Integrity:  How can AI help ensure proper reimbursement?
 
* Payment Integrity:  How can AI help ensure proper reimbursement?
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 +
Pharma & Life Science <br>
 +
* Biomarkers:  Which patients will have an increased success rate based on biological factors?
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* Drug-Combinations:  Which drug combinations are most likely to be successful?
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* Segmentation:  Which groups of patients respond differently to treatment?
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* Strategy:  Which subpopulations should be included/excluded based off of predicted success rates?
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* Responsive:  Which patients are responding to treatment?
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* Events:  Which patients are most likely to experience adverse reactions?
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* Effectiveness:  How will clinical trial results translate into real world effectiveness?
 +
* Value:  What improvement in outcomes will a new treatment generate over existing therapies?
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* Switching:  Which factors are most relevant in understanding which patients switch drugs?
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* Marketing:  Which physicians can we market to?
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Other <br>
 
Other <br>

Revision as of 08:55, 10 July 2020

ClosedLoop AI Use Cases

Hospitals

Health Insurers


Providers & ACOs

  • Total Risk: Who will be my most expensive patients this year
  • ED Over-Utilization: Which of my patients would most benefit from establishing a relationship with a primary care provider?
  • Readmissions: Which patients are most likely to be readmitted to the hospital?
  • Transportation: Which patients are most likely to need help with transportation in order to make it to their appointments
  • Rising Risk: Which patients are likely to see large increases in their overall health risk over the next 30/60 days?
  • Chronic Disease: Which patients are most likely to develop or progress in the severity of a chronic disease
  • Medication Adherence: Which patients are most likely to be noncompliant with medications?

Payers and Health Plans

  • Trend: Which members are likely to see large increases in their overall health risk over the next three to six months?
  • Readmissions: Which members are most likely to be readmitted to the hospital?
  • Medication Adherence: Which members are most likely to be noncompliant with medication plans?
  • Palliative Care: Which members are most likely to benefit from discussions with a palliative care specialist?
  • ED Over-Utilization: Which members are most likely to benefit from establishing a relationship with a primary care provider?
  • Disenrollment: Which members will most likely to disenroll?
  • Fraud: How do new data sources allow health plans to spot fraud sooner?
  • Payment Integrity: How can AI help ensure proper reimbursement?

Pharma & Life Science

  • Biomarkers: Which patients will have an increased success rate based on biological factors?
  • Drug-Combinations: Which drug combinations are most likely to be successful?
  • Segmentation: Which groups of patients respond differently to treatment?
  • Strategy: Which subpopulations should be included/excluded based off of predicted success rates?
  • Responsive: Which patients are responding to treatment?
  • Events: Which patients are most likely to experience adverse reactions?
  • Effectiveness: How will clinical trial results translate into real world effectiveness?
  • Value: What improvement in outcomes will a new treatment generate over existing therapies?
  • Switching: Which factors are most relevant in understanding which patients switch drugs?
  • Marketing: Which physicians can we market to?


Other