Healthcare AI Use Cases

ClosedLoop AI Use Cases

Hospitals

• Appointmnet No-Shows - Predict patients most likely to miss appointments
• Predict patients most likely to acquire infections like sepsis
• Predict patients most likely to benefit from periodic check ups
• Leakage - Network Integrity - Out of Network

Health Insurers

• Risk Adjustment - Suspect Diagnosis
• Preventable Hospitalizations
• Readmissions - Predict patient readmissions
• Chronic Disease Onset and Progression - Predict onset or progression of chronic diseases.
• Patients with highest overall risk in the next 6 months or year

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?

Other

• Identify patients' with collapsed lungs - artificial intelligence-enabled mobile X-ray system flags images of patients who need immediate intercession, ensuring that patients with collapsed lungs receive more timely care. (7/8/20)
• Predicts patients' hospitalization risk and triages them to appropriate care - uses AI tech, EHR data and a questionnaire to perform clinical intake of patients visiting ER, Urgent Care or Home (6/30/20)
• Diagnosed breast cancer at a higher rate than 11 pathologists. AI model using algorithms and deep learning (12/12/17)