Healthcare is quickly integrating artificial intelligence into many administrative and clinical care functions. Early results at academic medical centers and large innovative health systems are showing areas where the technology (if deployed thoughtfully) can create a huge boon to hospitals and patient care.
But what about rural healthcare? There are both positives and negatives to the rapidly expanding technology.
The (possible) good
Sioux Falls, S.D.-based Avera has always focused on innovation, with AI and virtual care playing a big role in expanding access to care.
"Our virtual monitoring and nursing programs, our virtual specialty visits and our use of AI tools are helping us to provide exceptional care across our very vast and largely rural footprint in new and cutting-edge ways," said Ronald Place, MD, president and CEO of Avera McKennan Hospital and University Health Center. "And as we look at critical workforce needs, the aforementioned approaches also help us to look at how we can use tools and technology to align our sometimes-limited clinical staff to the needs of our patients in a way that also optimizes quality of life for that same clinical team."
Stephen DelRossi, CFO and interim CEO of Northern Inyo Healthcare District in Bishop, Calif., also sees clear benefits to implementing robust AI solutions for automating administrative tasks and improving remote monitoring. The hospital is implementing AI-driven tools for diagnostics and medical imaging support as well to improve accuracy and reduce time-to-diagnosis.
"We are investigating predictive analytics platforms that leverage predictive analytics for patient outcomes and personalized medicine so we can target customized treatment plans and improve patient care," Mr. DelRossi said.
The hospital is also working on an AI-powered billing and automation system as well as intelligent claims processing and AI-driven financial reconciliation.
"We are building an integrated neural network that takes all routine, tedious, and monotonous tasks, as well as those designed to improve patient care and blending them together to ensure our patients’ care is of the highest quality from the front of the house, through clinical work, and final billing," said Mr. DelRossi.
Wayne Gillis, CEO of Great Falls Hospital, sees AI as a solution to revolutionize operations and address big revenue cycle and financial challenges for rural healthcare. He sees AI and large language models as essential to countering the challenging payer environment with increased denials.
"By integrating AI-driven solutions into our RCM processes, we can enhance our ability to analyze claim denials, predict outcomes, and automate appeals with a level of precision and efficiency that human teams alone cannot achieve," Mr. Gillis said. "LLMs, with their advanced natural language processing capabilities, can be instrumental in interpreting complex payer contracts, identifying patterns in denials, and even preemptively addressing issues before they escalate. This innovation could drastically reduce the time and resources spent on managing denials and ultimately improve our financial outcomes."
The (possible) bad
Sheri Strobel, CIO at Chapters Health System in Tampa, Fal., said the velocity of technical disruption is the biggest threat to health IT and revenue cycle management today.
"AI, machine learning and automation are all transforming the health IT landscape," she told Becker's. "However, the challenge lies in integrating these recent technologies with legacy systems which can be costly and complex. Organizations that fail to adopt these technologies risk falling behind in efficiency, revenue optimization and staff burnout."
Healthcare is still a top target for cyberattacks as well, and rural hospitals are especially vulnerable without the sophisticated protection large organizations have. Hackers are deploying AI and automation to more efficiently and effectively execute their attacks, exacerbating the risk.
"Any breach can result in significant financial, operational and reputational damage," said Ms. Strobel. "Increased costs for cybersecurity, business continuity solutions and automation impacts funds available for patient care, creating financial challenges."
Adding new technologies can worsen the problem as well, said Michael Archuleta, CIO and HIPAA and information security officer at Mt. San Rafael Hospital.
"As healthcare organizations increasingly adopt digital technologies and interconnected systems, they inadvertently expand their attack surface, making them prime targets for sophisticated cybercriminals," he said. "A successful breach can have devastating consequences from compromising sensitive patient data to disrupting critical care services, ultimately undermining the trust patients place in our institutions."
He recommends leaders view cybersecurity as a strategic imperative embedded in the fabric of their digital transformation efforts, which means investing in security frameworks and culture changes for continuous cybersecurity awareness to mitigate threats.
J. Brett Tracey, vice president of revenue cycle at the Arkansas Heart Hospital, sees big challenges for rural healthcare in maintaining business agility to keep pace with payers deploying automation and AI technologies.
"The influx of automation, generative AI and RPA is rapidly accelerating the gap between high and low performing organizations," he said. "High performing organizations are prioritizing efficiency through automation and increasing levels of output and analytics to advance financial performance."
Even after acquiring the technology, rural hospitals typically don't have the skill sets and expertise to fully optimize it on their leadership team.