Posted on 11/20/2024 - 9:06 AM by Michael Barr, MD, MBA, MACP, FRCP
By Michael Barr, MD, MBA, MACP, FRCP
Senior Director of Population Health Improvement at the Population Health Alliance
Technology is transforming health care at a rapid pace – and it seems artificial (or augmented) intelligence (AI) is on every journal’s table of contents. However, one use of AI that has not received much attention is AI for case management and population health management. We aimed to change that with our recent webinar hosted by the Commission for Case Manager Certification (CCMC) and the Population Health Alliance (PHA). During this webinar, we brought together industry experts to discuss the integration of AI and data analytics in case management and population health. If you missed the session, here are the key takeaways that underscore the potential of AI to revolutionize healthcare—and why you should dive into the entire webinar for more.
AI: A Partner, Not a Replacement
A prominent theme of the discussion was the role of AI in supporting, rather than replacing, case managers. CCMC Commissioner Margaret Brown, Senior Director of Care Management at Priority Health, emphasized that AI can augment case managers’ abilities to manage clients effectively and efficiently by reducing documentation burdens, automating administrative tasks, and allowing them to focus on what truly matters—human connections and individualized care.
For those concerned that AI might replace their roles, Brown’s reassurance was emphatic: AI is there to assist, not replace case managers, much like a scribe in a physician’s office. This allows case management professionals to concentrate on their clients without getting bogged down by administrative demands.
Data Analytics: From Insight to Action
Todd Glanton, Senior VP of Technology and Analytics at Monroe Plan for Medical Care, shared how AI and data analytics can drive better decision-making by identifying high-risk populations and predicting potential health issues and avoidable costs. AI can synthesize data from multiple sources to identify population-level needs and present a more complete picture of each unique client. This information can drive better interventions for attributable populations and person-specific engagement strategies using tailored messaging and intelligent appointment scheduling based on their stated preferences and needs. Stratifying client populations helps ensure that high-need people get the care they need, and reducing the administrative burden of outreach and scheduling makes it easier for case managers to focus on providing proactive, personalized care.
Social Determinants of Health: Anticipating Needs
Rebecca Jacobson, CEO of Astrata, highlighted the importance of AI in identifying and addressing social determinants of health (SDOH), including housing, food insecurity, and transportation barriers. AI’s ability to process vast amounts of unstructured data from different sources helps case managers anticipate and address these issues, suggest targeted interventions, and intervene earlier to increase the chance of success.
Ethical Considerations: Ensuring Fair and Equitable AI Use
Using AI is not without challenges – especially concerning fairness and using AI-generated insights to guide care. The panel stressed the need for ethical AI implementation to help avoid the potential for harm. AI can be biased based on the data used to create the algorithms. For example, people who do not receive the same level of care as others may not be as well represented in the data set used to train the models. Case managers must understand the potential for algorithmic bias and ensure that AI systems are transparent and equitable. Jacobson emphasized the importance of continuously monitoring and adjusting AI models to prevent unintended consequences and ensure that care is personalized, not stereotyped.
What’s Next for Case Managers?
The discussion ended with optimism: AI is not something to fear but a tool to embrace in the same way that calculators, electronic health records, and other technology have changed how we work and manage clients. AI can help case managers work more efficiently, focus on engagement, and can result in better outcomes. The experts urge case managers to “lean in” and actively shape how AI is used in their field.
Watch the full session to learn how AI and data analytics are transforming case management and population health.