This past year was a pivotal one for artificial intelligence in healthcare, of course, with healthcare provider organizations participating in significant new developments that promise to transform healthcare delivery in the years to come.

The coming year promises to introduce new layers of technological and regulatory nuance as policymakers and healthcare organizations grow more sophisticated in their understanding and use of AI, and as they acclimate to the "new normal," says Ronen Lavi, CEO and cofounder of Navina, a developer of AI technology that works with primary care data.

Healthcare IT News interviewed Lavi, who offered three trends healthcare leaders should be aware of going into 2024: one on "meaningful use" of AI, one on explainable AI and another on greater adoption of tech-enabled, advanced payment models.

Q. You have said that this year there will be early steps toward what you call "meaningful use" for AI. Please explain.

A. 2023 saw the emergence of AI into mainstream workflows across industries with the launch of OpenAI's ChatGPT. With it, analysts predicted paradigm shifts in labor, with particular emphasis on the middle class "knowledge worker." In medicine, we saw countless releases of AI-enabled functionalities, ranging from ambient dictation, task management and clinical decision support.

When electronic health records came to the scene, regulators responded with incentive programs to help accelerate the transition from paper to digital records, with the objective to increase interoperability, quality and safety of patient care.

With every exam room now equipped with a computer or tablet containing troves of patient information across a variety of platforms, clinicians are increasingly turning to AI-powered systems for summarization and insights.

Today, AI-powered data summarization and exploration has become increasingly accessible to clinicians. We anticipate regulators will see an opportunity to incentivize the usage of these solutions that enable "a complete view of the patient" to increase safety and quality of care.

Q. There certainly is a wariness in healthcare toward so-called "black box" systems. You suggest that in 2024 responsible, explainable AI will be king. Please elaborate.

A. During 2023, clinical and healthcare IT leaders witnessed an unprecedented number of creative examples for how to incorporate AI into clinical and administrative workflows. However, a year in, these leaders have grown more sophisticated and have developed a deeper understanding of what AI can – and cannot – do for their organizations.

While software developers continue to push the boundaries of what AI can do, when it comes to healthcare, nothing can replace the clinician-patient experience. Despite overhyped promises of systems that can overcome staffing challenges, the reality is that in a clinical setting, AI will augment rather than replace human interaction in the exam room.

A year into the hype cycle, we are well aware of the dangers associated with large language model-based AI "hallucinations." These risks are especially profound in a healthcare environment, and clinicians are seeking ways to "de-risk" their interaction with information coming in from multiple sources and AI engines, both for patient safety and from regulatory liability perspectives.

With President Biden shining a light on regulatory responsibility in AI, we expect the AI systems that will emerge victorious in the contentious battle for clinician adoption will be those that explain AI-driven insights and enable the final verdict to be that of the clinician.

Q. On a different front, you predict the inflationary environment will lead to greater acceleration and adoption in 2024 of tech-enabled, advanced payment models. How so?

A. Amid the technological and pharmaceutical advances we saw during 2023, the third salient theme of the year was rapid inflation. The result is costs rising across labor, procedures and drugs.

2023 saw significant movement in the value-based care investment space, with Aledade securing significant financing, and Walmart allegedly in talks to acquire ChenMed as two examples. We anticipate the current trends across providers and health plans toward value-based care will only increase in an environment where every stakeholder is feeling the pressure of rising costs.

Health plans will react by further investing in programs designed to reign in total cost of care. With many health plans already involved in care delivery as "payviders," these organizations are well positioned to continue making the push away from fee-for-service.

We anticipate hospitals and health systems faced with labor shortages and rising costs, historically lagging when it comes to value-based payment arrangements, will feel the pressure from health plans – as well as their own balance sheets – to consider accelerating the move.

To make this transition successful, healthcare leaders will seek out advanced technologies to support clinical staff tasked with new workflows and documentation requirements.

2023 saw a rapid acceleration in technology ranging from software to pharmaceuticals. 2024 promises to be a year where we witness further advancement and new dilemmas that arise from maturity and widespread adoption of these early developments. With a foggy macroenvironmental future, we anticipate healthcare will double down on total cost of care initiatives, with emphasis on tech-enabled, value-based care strategies.

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