2023: An A.I. Healthcare Year-in-Review by Dylan Reid and Robert Horne

A Note of Thanks

I launched this newsletter last year to provide readers with the latest developments in the A.I. space for health policy and healthcare business audiences. The timing could not have been better.

Twelve months later, it is clear to everyone that a technological revolution is going on in healthcare. One forcing the nation to reconsider everything we know about labor and markets and regulation. A national realization too: we are not prepared to take full advantage.

I am revamping the newsletter for 2024 to give you more A.I. because many of my readers also recognize the growing importance of A.I. in healthcare, a new contributor bringing more content and insight to you is my friend Robert Horne of Forest Hill Labs.My subscribers in 2024 will have access to a wealth of new content and help for those interested in A.I. and Digital Health markets, policy, or the technology itself. More to come next week. Thank you to all my readers for a great year.

 2023: An A.I. Healthcare Year-in-Review 

Key Takeaways (By: Robert Horne of Forest Hill Labs)

• A.I. in healthcare is here to stay because the cost savings and other benefits were quantified in 2023 - something that has been lacking in past years.
• Congressional healthcare committees are now exploring modernizing key regulatory regimes for A.I. and digital health. Key issues being explored include pre-market approval of digital health and A.I. products by the FDA, and coverage and reimbursement modernization for products intended for use in the care of patients.
• The FDA created a task force last month to advise the agency on modernizing the regulatory regime for digital health and A.I., and CMS has indicated a willingness to explore new avenues for coverage and reimbursement.
• Changes to the dominant service delivery business model in health care, the physician practice, has been changing in 2023 which has historically been a barrier for digital medical services and A.I. healthcare companies:
• A shift away from physician-owned businesses dominating the labor market and the introduction of retail-centered business models by Amazon and CVS Health is fueling a resurgence in interest in A.I healthcare companies.
• Ethical, human rights, and safety concerns related to A.I. as a medical workforce were ever-present in 2023 and will continue into 2024.
• The South is the next hotbed of AI Healthcare innovation because of its lower cost of living and access to world-class institutions.

2023 Overview

AI has officially entered the healthcare field and there is no turning back. Technology is helping address many healthcare problems that plague the United States, while also improving patient outcomes and decreasing federal spending.

There now exists broad recognition within Congress and the greater Washington ecosystem that artificial intelligence is not just a fad, but an opportunity to redesign economic markets and labor policy. However, elected officials are still uncertain of what policy ideas will succeed in ensuring the safety of AI.

Artificial intelligence in the American healthcare system can benefit all key stakeholders in the healthcare space, supporting patients following the treatment plans, medical professionals, and their care teams working more frequently with patients to improve care planning, pharmaceutical companies being able to discover more molecules for potential drugs for diseases, and insurance companies offering patients more access and care delivery options.

In contrast to the increased polarization on Capitol Hill, Republicans and Democrats must not look at artificial intelligence as a political issue. It is an opportunity to fix American problems. To get there, artificial intelligence should be looked at as something that both parties desire to accomplish because it can benefit all constituencies. Americans are still stuck with limited healthcare choices that have contributed to rising healthcare costs. Instead, we should look at AI as a method to improve health outcomes and create new incentives in the marketplace for patients. The integration of artificial intelligence in the healthcare sector is an area that we believe can bring the country together. While federal oversight is a positive attribute of the AI healthcare conversation and is a helpful resource, it should be the states that drive the conversation since states are closer to the health outcomes of their populations. 

With these thoughts in mind, I wanted to provide my  “2023 Year of Review’ to announce the partnership of Robert Horne of Forest Hill Labs and Dylan Reid, who will be providing you with analyses that define and provide rational solutions when implementing artificial intelligence technologies in the healthcare sector. 

We have bolded and underlined the three key things that must happen for Americans to embrace digital technologies. 

The Need To Train Federal Employees on Artificial Intelligence Technologies

Earlier this year, Senator Gary Peters [D-MI] introduced (and cosponsored by Senator Mike Braun [R-IN]  S. 1654 “AI Leadership Training Act”.  The objective of the bill is to ensure that federal officials are properly trained on the technology. While many bills attempt to answer the question of how to best regulate AI, the legislation introduced by Peters and cosponsored by Braun, answers the problem of the knowledge of AI among federal employees. How are you supposed to regulate or aid in a particular field, when you do not even know how it works in the first place? While the legislation has been placed on the Senate Legislative Calendar under General orders (which is just a fancy way of saying pending vote), we believe that educating is the proper step for determining how to best handle these case scenarios.  

From an earlier AI Healthcare Report issue, I examined the Congressional Budget Office Score of this bill.  The bill is expected to cost $10 million over FY 2023-2028. 

An example of the seriousness and the need to trade federal employees in artificial intelligence technologies can be found in this survey compiled by the National Skills Coalition in conjunction with the Federal Reserve Bank of Atlanta.  The executive summary of the study revealed that 92% of jobs across industries require digital skills. To expand upon this statistic even further, 33% of U.S. workers do not have “foundational digital skills”. To provide even more context to the conversation, a table constructed by the FRB and NSC showcases and confirms the need to train federal employees to be trained in artificial intelligence technologies below:

Source: FRB/NSC analysis of Lightcast Data

 The New Normal of AI 

This summer, the U.S. Senate Judiciary Subcommittee on Human Rights and the Law held a hearing entitled: Artificial Intelligence and Human Rights . The senatorial hearing aimed to answer three important questions, which are also pertinent to the integration of AI in Healthcare:

1. What is the new "normal" in a world where AI is becoming more prevalent?
2. Who is responsible for determining reality vs. fiction in the credibility of information from the use of AI?
3. What AI policy proposals can preserve innovation AND human rights?

As one can observe, we are still in the early stages in the determination of who is responsible for the collection and the implementation of artificial intelligence. We would go as far as to argue that we need to redefine the term “artificial intelligence”. 

Hearings, such as those in the U.S. Senate only begin to scratch the surface of whether AI policy should be a state or federal-led policy. Given that healthcare is allocated at the state level, Congress and other elected officials should strongly consider. The implementation of AI in healthcare at a quicker rate than Congress has held hearings or even passed legislation showcases that very few people truly understand artificial intelligence and what it could mean for current and future consumers.

Let me give you an example to showcase why AI in healthcare should be a state and not a federally-led issue. Person A, who happens to live in State B has been diagnosed with lung cancer and needs immediate medical treatment. However, Person A discovers that State B does not have the necessary medical equipment, knowledge, or skills needed to complete the operation. Person A can do two things:

1. Travel to another state for the lung cancer operation.
2. Meet with his local/state/federal representatives and showcase that people with their condition are a big enough condition in their respective areas and if nothing is done, then it can weaken their re-election chances for office moving forward. 

The new normal for AI is state-led with federal support if needed, but is focused on the specialization and localization of disease.

The South is the Next Area of AI Healthcare Innovation

Earlier this year, I wrote a short analysis on why the next wave of AI Healthcare Innovation will be in the South.  A few points that were made in the post were the following:

1. Low cost of living
2. Access to world-class hospitals 
3. Business-friendly environment.
4. Health Outcomes with the Greatest Opportunities 

Furthermore, in this graph by the Commonwealth Fund, one can decipher that  most of the health outcomes are from the Southern States. Universities, such as Texas Tech University Health Science Center of Telehealth and Digital Innovation in Lubbock established an institute to improve digital health access delivery to patients.   In conjunction, H.B. 617 passed by Governor Abbott showcases the need for those in rural areas to receive the proper healthcare that they need and deserve. 

Additionally, the Mayo Clinic in Arizona recently named Dr. Bhavik Patel, M.D. the new Chief AI officer,  whose role would include finding new ways to incorporate generative AI for patient needs and treatment plans. 

Recently, students at Louisiana State University in Baton Rouge demonstrated their AI solutions, in areas that included healthcare. The talent that these students showcase demonstrates the need for the state to take a more active approach in investing in AI talent to help boost the economies of states, such as Louisiana.

All these initiatives in the South (while not exhaustive) illustrate that the South is the next hotbed for innovation. Its talent pool, its health needs, and its desire to improve outcomes while decreasing costs for patients. 

As thought leaders, we understand the legislative process and appreciate the engineering elements of AI. We can also clearly explain what the buzzwords “bias” and “transparency” mean and how they will impact healthcare. While the federal government must have input into AI healthcare policy, the states must take the lead in implementing AI in their constituencies to ensure the best possible health outcomes for their residents.  Be on the website for our publishing schedule and stay tuned for the 2024 predictions of Forest Hills Labs!

Ready to challenge the conventional coverage and access arguments in healthcare, then visit us here .

Happy Holidays and New Year!

Dylan Reid and Robert Horne