How AI can fill gaps caused by the health care worker shortage

Web Golinkin: ©Web Golinkin

Artificial intelligence is seeping into so many aspects of life that it’s no surprise it’s surfacing as a potential solution to the worker shortage haunting healthcare.

Maybe that idea gives you pause.

After all, the concept of AI replacing workers is generally viewed as a negative, and understandably so. Beyond that, health care is an area where the average person likely prefers a well-trained professional – an actual human being – to interact with, not a virtual substitute.

Still, despite these legitimate concerns, the use of AI in health care could be a positive development, especially in the area of care management where patients need assistance to effectively participate in the management of their chronic conditions between provider visits, as well as in post-surgical recovery.

In these instances, AI-powered coaches can help to alleviate at least some of the worker shortage while at the same time reducing costs. Early results also suggest that AI-powered care can increase patient engagement and improve care quality.

But before we venture too far into the solutions AI offers, let’s review the underlying problems in health care that could make AI not only a welcome solution but a necessary one.

Worker shortage expected to worsen

The health care worker shortage is already severe and headed in the wrong direction. The most recent projections from the Association of American Medical Colleges suggest that by 2036 the United States will be facing a physician shortage that could reach as high as 86,000. Meanwhile, hospital CEOs cited workforce challenges as their top concern in an annual survey by the American College of Healthcare Executives. The category of workforce challenges on the survey includes not only personnel shortages but also other issues, including employee burnout. Burnout and the worker shortage are intertwined since one of the causes of burnout is that healthcare workers are being called on to do so much more because of the shortage.

The U.S. isn’t the only country facing a paucity of health workers. The World Health Organization estimates a global shortfall of 10 million health workers by 2030. WHO anticipates the bulk of the shortage will be mostly in low- and lower-middle-income countries. But WHO also says that “countries at all levels of socioeconomic development face, to varying degrees, difficulties in the education, employment, deployment, retention, and performance of their workforce.”

Between the worker shortage and rising health care costs, it’s incumbent on the industry to find alternative ways of providing needed care to patients, and one of the strategies for improving outcomes and controlling costs is care management. This type of care is primarily aimed at patients who have chronic conditions or are at risk of developing them, as well as at patients who are recovering from surgical procedures. Even if they are faithful about their provider appointments, these patients still must be carefully monitored and supported between visits. Are they taking their medications as prescribed? Are they adhering to a healthy diet? Are there any new warning signs? How is their emotional health?

Sometimes patients have more than one chronic condition – requiring more care at greater expense. They are often referred to as the 5/50s. Essentially, they represent 5% of all patients who generate 50% of healthcare costs.

AI care coaches will help

Because it’s so important for chronically ill patients’ health to be supported on an ongoing basis, care management programs funded by health insurers and risk-bearing providers arose as a way to provide this support between provider visits. Typically, the care coach is a registered nurse who interacts with a panel of high-risk patients, empowering them to be actively involved in their own care and coordinating with other members of the care team when necessary.

This monitoring generally doesn’t happen in person. Care coaches typically communicate with patients telephonically and may supply condition-related print and video materials. More recently, asynchronous email and text messages have become the primary communications channels.

Traditional care management has worked well in terms of outcomes and ROI, but it has had its drawbacks. The upfront expenses can be significant and check-ins by telephone have become less effective because many people ignore calls from numbers they don’t recognize. Additionally, the growing nursing shortage that affects other areas of healthcare has also had a negative impact on care management.

This is where AI comes in.

Imagine if patients with chronic conditions or who are recovering from surgeries had an AI-powered care coach who was available to them 24/7 via text or interactive video. Unlike a human coach, the AI-powered coach would be available on demand and at a fraction of the cost of a human coach. The AI-powered coach also could interact with others on the patient’s care team – including their primary care physician, specialists, and pharmacists – keeping them up to date and soliciting their direct involvement as necessary.

This is not just a pipe dream. AI-powered health coaches already exist – mainly in pilot programs and always in non-diagnostic capacities – in some cases supplementing the work of live nurse coaches and in other cases working independently. They function by ingesting and analyzing large amounts of health data, including clinical care plans, regulatory documents, medical manuals, and drug databases, and use AI algorithms to support each patient’s individual health needs.

The results so far are promising in terms of medical accuracy and both patient and provider satisfaction, and at a significantly lower cost than previous care management models.

It will take time for AI-powered care coaches to become fully “trained,” and for patients to become accustomed to them and trust them, but they have the potential to help save healthcare by filling gaps caused by growing workforce shortages while improving care and reducing costs.

Web Golinkin (webgolinkin.com/), author of the Amazon bestseller Here Be Dragons: One Man’s Quest to Make Healthcare More Accessible and Affordable, has been CEO of six companies over the last 35 years, including FastMed, RediClinic, and Health Dialog. He also co-founded and chaired the Convenient Care Association, a national trade association of organizations that provide consumers with high-quality, convenient and affordable healthcare in retail-based locations. Golinkin has been widely covered in the national media and has spoken at numerous healthcare conferences.