Artificial Intelligence in Healthcare: Compliance, Risk, and Responsible Use

“Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence”

On December 4, 2024, Title 42 of the Medicare Advantage plan was amended by CMS and the goal was to implement reforms that will ultimately improve healthcare access, quality, and equity for Medicare beneficiaries. This change is related to executive order 14110 by the Biden-Harris Administration, “Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence” which ensures that the development of AI does not jeopardize the advancement of equity and civil rights especially in health organizations. Institutions that do not comply with this amendment will be subjected to possible prosecution.

Artificial Intelligence (AI) is rapidly becoming a prominent force in our society, and its application in healthcare is viewed with both hope and caution. Health information professionals must understand what AI entails, its capabilities, and how to employ it responsibly and ethically. With increased use of AI in healthcare, questions arise about maintaining patient trust and safeguarding data integrity, especially given the discrepancies and accuracy rate of AI-driven data collection and analysis. Additionally, with the increasing automation of revenue cycle operations in healthcare systems, ensuring coding accuracy, billing, and documentation in this evolving landscape becomes even more crucial.

Global Perspectives on AI and Digital Health in Healthcare: AHIMA and GDHP Partner for First Health Information Summit

In November AHIMA and IFHIMA joined forces and conducted the first global policy summit of health information professionals and presented on public issues related to the health information profession in collaboration with GDHP (Global Digital Health Partnership), a collection of national digital health authorities and the World Health Organization (WHO).

In short, digital health is the “systematic application of information and communications technologies, computer science, and data to support informed decision-making by individuals, the health workforce, and health institutions, for strengthened resilience and improved health and wellness for all.” Digital health includes digital technology-based data fields e.g., data analytics, artificial intelligence, eHealth, and telemedicine, to name a few.

A central concern of the summit was the evolving impact of digital health technologies, in particular the implementation of AI, and the priorities and needs of professionals within the health information sector as they relate to digital health. During the summit, key policies were discussed that are currently impacting the health information profession.

Federal Guidance and Recommended Practices for Digital Health: UASAID Recommended Practices

In addition to the global policy health summit, the United States Agency for International Development (USAID) recently released a position paper titled Digital Health which outlined four priorities for programmatic digital health investments. These focal areas underscore the federal government’s strategic emphasis on advancing digital health technologies. These priorities range from strengthening a country’s digital health environment to aligning digital health investments with national architecture. Additional recommended practices outlined by USAID include:

• Requiring standards to enable integrated health care service delivery at scale.
• Establishing standards that equate to better coordination of care, and deepening engagement with local partners.
• Engaging with local partners including the private sector to support the ability of global health funders like USAID to be effective long-term partners to government ministries of health.
  

Preparing HIM and Revenue Cycle Teams for AI Adoption

CFO’s and Directors of HIM need to ensure compliance with CMS regulations while preparing for stricter federal-level oversight in addition to monitoring the overall performance of AI solutions. The need for education and training will continue to grow to accurately assess AI-driven data, ensuring that decision-making remains informed and aligned with regulatory standards.

UASI collaborates with healthcare systems to enhance workforce capabilities in exchanging and using relevant healthcare data by reviewing and identify coding and documentation errors that impact revenue integrity and patient care, ensuring the accuracy and integrity of patient information. UASI is committed to supporting the digital transformation of health systems with long-term vision of achieving data interoperability, ensuring equity in the use of AI, and creating globally sustainable health systems.

Works Cited:

World Health Organization. (2021). Ethics and governance of artificial intelligence for health. Available at: who.int/publications/i/item/9789240029200

Executive Office of the President. (2023). Executive Order 14110—Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. Available at: govinfo.gov/content/pkg/DCPD-202300949/html/DCPD-202300949.htm

Office of the Federal Register. (2023). Safe, Secure, and Trustworthy Development and Use of Artificial Intelligence. Available at: federalregister.gov/documents/2023/11/01/2023-24283/safe-secure-and-trustworthy-development-and-use-of-artificial-intelligence