Tag: Andrew Lockhart

Great Expectations: What Health Systems Want from AI Vendors

Andrew Lockhart

By Andrew Lockhart, CEO, Fathom.

Imagine this: physicians spend more time with their patients than with their paperwork. Billing is quick and accurate, with minimal denials. Healthcare workers enjoy a positive work/life balance. Thanks to the rapid advancement of AI, this vision of healthcare is becoming increasingly possible.

Health system leaders are already investing toward this ideal state. From roundtable discussions at Healthcare Financial Management Association and Becker’s Healthcare to Zoom chats every week, I’ve connected with many C-suite executives at health systems about their expectations for AI. There is, across the board, a clear set of priorities for the next one to two years. The overarching vision is not just to integrate new technologies but to do so in a way that delivers tangible improvements in workforce experiences and satisfaction, revenues and costs, and patient care outcomes.

Here are a few resounding themes that I’ve heard.

  1. Proving ROI

Proving ROI on AI investments is crucial: put plainly, you want to ensure you’re getting more than enough bang for your buck. Applications of AI need to map back clearly to measurable cost and revenue impacts. Health system CFOs expect predictable ROI and are screening new technologies closely.

Many AI tools on the administrative side can meet this proof of hard ROI. For example, organizations like ApolloMD have experienced significant improvements in coding efficiency and revenue capture by minimizing coding errors and denials through autonomous coding.

While vendors typically report impressive ROI from their technology, any vendor worth its salt will agree to a proof of concept allowing you to test and validate impact for your organization. For example, an easy way to build confidence in autonomous coding is to compare coding results between your team and the AI system before committing to go-live.

  1. Increasing end-to-end strategies

Many AI tools have surfaced to address a single use case. However, health system leaders are more interested in comprehensive, integrated solutions across departments. Consider the case of ambient documentation and autonomous coding: ambient documentation works as a medical scribe using AI to document clinician-patient encounters, and then autonomous coding steps in as a medical coder to translate and assign the necessary codes for billing.

These types of end-to-end strategies are more compelling and impactful. Health system CEOs increasingly gravitate toward them to ease administrative burdens, speed up visit-related processes, and enhance patient outcomes. The market is supporting this expectation: Abridge, an ambient documentation platform, recently raised $150 million in funding, and Google Cloud added an autonomous medical coding solution to its marketplace earlier this year. Used in conjunction, these technologies offer more integrated – and more valuable – strategies for health systems.

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How AI Is Changing the Game for Providers: 4 Predictions for 2024

Profile photo of Andrew Lockhart
Andrew Lockhart

By Andrew Lockhart, CEO, Fathom Health.

Healthcare has a vibrant startup and innovation ecosystem, but that doesn’t mean everyone shares the perks that come with technological developments. Historically, payors have often been ahead of the game in adopting and benefiting from new tech, forcing providers to play catch up.

But artificial intelligence (AI) is changing the game. A persistent trend I’ve witnessed is the steady rise of providers prioritizing technology – especially AI – to inform strategic priorities and address chronic headwinds such as staff shortages, increasing cost pressures, and slow reimbursement times, to name a few.

As healthcare leaders catch on to the enormous potential of AI to combat thorny issues, AI will take center stage next year, reshape the larger healthcare ecosystem, and begin to even the playing field between payor and provider.

As the end of the year approaches, here’s how I see this playing out in 2024:

Autonomous medical coding will be widespread — if not the norm.

The latest health IT report from Bain & Company and KLAS Research highlights the increasing importance of software and technology. Per the report, 70% of providers think AI will have a more significant impact on their organizations this year vs. last year, and an impressive 56% of those surveyed view software and technology as one of their top three strategic priorities, with revenue cycle management (RCM) coming in at a resounding first place. With many health systems focused on reducing administrative burdens for clinicians and a continued shortage of medical coders, autonomous coding adoption will surge.

Large language models (LLMs) like ChatGPT won’t work as advertised.

There’s plenty of commotion about the capabilities of language models, but they will likely disappoint when functioning as the core of autonomous coding engines. However, they will be enormously valuable in solving smaller pieces and edge cases, pushing coding automation rates to 100% for all the high-volume outpatient specialties.

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