GoKawiilIn their urgent hunt for a solution, many health-care providers are now pinning their hopes on agentic AI, with more than two-thirds (68%) having already adopted AI agents into their workforce, according to KPMG.
The technology is being deployed to automate complex back-office processes, collaborate with medical teams, and even triage patients, all in a bid to reduce the cognitive load on clinicians and improve quality of care for patients as the supply of human health-care workers dwindles.
A different type of digitalization
Until now, the benefits of digitalization within health care have been limited.
Many staff have blamed slow or outdated technology for adding to the administrative burden rather than alleviating it. For example, U.S. patient data was migrated to electronic health records (EHRs) in the early 2000s, but this data remains fragmented and reliant on manual inputs.
New telehealth services and digital care tools, like remote monitors, have had similar shortcomings, says Ashis Barad, MD, chief digital and technology officer at Hospital for Special Surgery (HSS), an academic medical center in New York that focuses on musculoskeletal health. Both technologies have helped improve access to health care by removing geographical barriers, he says, but they’ve failed to replicate the quality of in-person care or win trust from patients.
Agentic AI is different from these existing technologies, he insists.
Rather than relying on manual inputs or defaulting to human workers for any case that sits slightly outside a rigid framework, AI agents can handle nuanced, complex scenarios. They can make autonomous decisions, retrieve information from expert clinical sources, and iterate over time, freeing clinicians to focus on higher-level patient care. As Dr. Barad puts it: “Agentic AI takes your workflow and collapses it, augments it, supercharges it, and makes it more performant.”
At HSS, AI agents have already been deployed in multiple areas. They handle complex backend processes, such as insurance claims that previously took several weeks to complete and involved both HSS staff and a third-party contractor to handle the volume. Now, says Dr. Barad, AI agents complete 1,100 claims per month. They’ve reduced the appeals stage from 45 minutes to five and improved the success rate of those appeals from 65% to 100% in the nine months since implementation. HSS now handles all claims in-house.