AI News Monitor

As AI continues to reshape healthcare, the debate over its ethical use and regulation intensifies.

Artificial intelligence (AI) is rapidly transforming healthcare, from streamlining patient documentation to influencing insurance claim approvals. Tampa General Hospital (TGH) is at the forefront of this shift, leveraging AI-powered software called Ambient Listening to reduce the administrative burden on doctors. The tool, described as an “intelligent human scribe,” records and transcribes patient-doctor conversations in seconds, saving physicians an average of 4.5 hours per day on paperwork.

Dr. Nishit Patel, Vice President and Chief Medical Informatics Officer at TGH, emphasized the potential of AI to improve efficiency while ensuring accurate medical documentation. However, he warned of the risks of an “AI arms race” if health systems or insurers misuse the technology. “If we use these tools ethically to do the right thing for the patient, we all win,” he said.

Meanwhile, concerns are growing over the use of AI by insurance companies to deny claims. Dr. John Licato, an Associate Professor in Computer Science and Engineering, acknowledged that the technology to auto-reject claims already exists. “The technology to do it is definitely there,” he said, adding that lawsuits are underway to determine whether insurers are using AI to deny claims en masse. Licato expressed skepticism about finding a balance between AI and human oversight, predicting a continuing “arms race” in the industry.

In response, states like Florida are taking legislative action. State Senator Jennifer Bradley introduced SB794, which mandates that all denied insurance claims be reviewed and approved by a human professional, prohibiting AI from being the sole basis for denials. However, enforcement remains a challenge. “What is to stop them from just saying, ‘Yeah, I looked it over?’” Licato questioned.

As AI continues to reshape healthcare, the debate over its ethical use and regulation intensifies. While tools like Ambient Listening promise to enhance patient care, the potential for misuse in insurance claims highlights the need for careful oversight to ensure fairness and transparency in the system.