Healthcare Gets Personal with AI in 2020


By Kelli Bravo

How do you define excellent care? At its core, healthcare is about listening to people and understanding their unique situation to develop a patient-centric care plan that addresses their needs. But the healthcare system that exists today still lacks the ability to anticipate needs at the rate patients expect. These new healthcare consumers expect similar health experiences to the level of personalization they have in other industries. Artificial intelligence (AI) can be the missing element that can dramatically change how providers and payers provide care and services to patients and members through more personalized experiences. 


Providers are putting more emphasis on evolving their care plans to consider social determinants of health (SDOH) including home life issues, medication affordability, and even means of transportation to and from appointments. This is necessary to treat the whole patient and to ensure the medical care being delivered is able to be received. AI can effectively distill down large amounts of patient SDOH and other information to better inform providers about their patients, anticipate their needs, and develop coordinated, personalized plans that offer support throughout their health journey.

AI has already been deployed across healthcare organizations and has had a positive impact on a payers’ and providers’ workdays as well as the patient experience – but how can this be amplified over the next year? In 2020, we’ll see healthcare evolve even further by:

  • Bringing empathy into AI: Artificial intelligence needs to evolve to deliver the personalization consumers expect from both payers and providers. AI can be seen as cold and unemotional for highly personal health situations that can require more empathy. However, with emerging advancements, more healthcare organizations will leverage AI to analyze patient data beyond clinical information, so they can gain deeper insights to better understand a patient’s unique care factors, such as travel requirements, affordability, and more. AI will more closely mirror emotional intelligence to provide a more human approach and to coordinate more personalized care plans. Organizations can use it to assess the data provided through digital doctor-patient conversations to help patients navigate what they need to know when they need to know it. AI will also provide a necessary aid for healthcare practitioners to deliver more personalized care to patients 
  • Trust in enterprise AI is on the rise. Thanks to pockets of early success across many other industries, AI is gaining more trust with the healthcare industry as it becomes more commonplace. AI has progressed to become more predictable, and the quality of the output is reaching new highs. For example, chatbots in patient portals are allowing physicians to spend more time engaging with patients and less time behind computer screens answering questions over email. Providers can also use AI solutions with predictive analytics to follow patients post-discharge to anticipate issues and drive effective and efficient follow up. In 2020, we’ll see providers and payers better understand AI best practices, and as a result, they will incorporate AI more broadly across their workflows as they begin to scratch the surface of the value it can bring them. 
  • Investing in an internal champion to derive value from AI: As AI grows as a resource to personalize care, providers and payers will become even more reliant on it. Patient champion roles may begin to also include more of a technological aspect – helping to ensure technology is operating at its best and providing value to those using it. It will be the patient champion’s job to not only advocate for consumers, but to also have a deep understanding of how patients want to use their data and balance that against provider’s and payer’s main objectives for AI. With the right champion, healthcare organizations will start to see AI bringing more value to the millions of interactions patients have across different healthcare channels.  
  • Focusing deeper on AI transparency for customer engagement: Legislative bodies are starting to take more interest in how data is collected and stored, mostly through HIPAA, which is consistently revised to keep patient data safe. It still remains to be seen how organizations will use the data generated by AI as we see more data privacy regulations go into effect. In 2020 and beyond, organizations will need to be more transparent with how they leverage AI and exactly the kind of data they get from using AI-enabled services. This can strengthen a patient’s relationship with a provider or payer and allow them to exercise more control over what information they will or won’t share. 

The expectations consumers set for healthcare providers and payers have been consistently increasing, and providers will need to keep up. Using AI provide a more holistic picture of the patient and where they are on their health journey. With all of the information AI can provide, it will be interesting to see what payers and providers do next and the new uses for AI that will emerge in the year ahead.

Kelli Bravo is Vice President of Healthcare and Life Sciences at Pegasystems.

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