Over time, technology has significantly contributed to health care advancements. Some of these enhancements are now considered routine components of care and include electronic health record, telemedicine, wearable health devices and robotic assisted surgery.¹˒² Today, technology that incorporates artificial intelligence (AI) has emerged as a key driver of health care innovations and provides an avenue to heighten patient care, decrease administrative burden and expand resource utilization. 

Artificial intelligence systems are generally divided into two types, machine learning and generative. Machine learning defragments and analyzes large data sets.³ It identifies trends to gain meaningful information that can be used to identify patient populations in need. Machine learning is the AI tool that is predominantly incorporated in health care today.⁴ Of note, the National Aeronautics and Space Administration (NASA) has used machine learning for decades to safely analyze satellite datasets and plan planetary rover missions.⁵ Unlike machine learning, generative AI tools create new content. For example, generative AI creates chat box responses to frequent questions. Generative AI may also be applied to streamline administrative work like scheduling and summarizing a patient visit or identifying new targets used to accelerate drug discovery in cancer and other diseases.⁶

Some of the biggest drivers of AI adoption are rising medical treatment cost and the need for increased administrative efficiencies in care delivery.²˒⁷ In one study of telemedicine, a novel AI tool was used to identify high-risk patients and provide clinical decision support to clinicians.⁸ Through the use of AI, the program achieved a savings of $554 per member per month in actual claims. According to US Department of Justice, health care fraud costs the health care industry approximately $100 billion annually. AI tools have equipped the industry with progressive monitoring capabilities to detect fraud, translating to curtailed premium increases and medical expenses.¹⁰

As concerns about AI utilization grows, many states have introduced legislation to regulate its use.¹¹ In efforts to use AI responsibly to improve people's lives, the U.S. Department of Health and Human Services (HHS) released the “Strategic Plan for the Use of Artificial Intelligence in Health, Human Services and Public Health” on Jan. 10, 2025.¹² HHS aims to identify existing best practices for the ethical use of AI.

The four goals of the strategic plan include: 

Centers for Medicare and Medicaid Services (CMS), US Federal Food and Drug Administration (FDA) and Health Resources and Services Administration (HRSA) are some of the HHS divisions that will play a role in assessing opportunities.¹¹

AI systems continuously evolve, becoming smarter and more accurate as their capabilities and overall performance advance. As health care adoption continues, it is important to ensure that AI is used equitably, responsibly and without the biases that plague our industry. Through AI technologic innovations, we can pave the way to better resource utilization and superior patient and provider experiences. ²˒⁷

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