Future of Healthcare and Artificial Intelligence (AI):
Practical Insights and Diverse Perspectives on AI in Healthcare Project Management
SERIES ARTICLE
By Dr. Deepa Bhide, MBBS, DCH, PMP
Hyderabad, India
Introduction
Chronic diseases account for most illnesses, disabilities, and deaths worldwide and are the leading drivers of the increase in healthcare spending. A staggering $4.1 trillion in annual healthcare expenditures highlights the significant economic burden of healthcare in the United States [1]. Healthcare organizations at all levels are working toward reducing these numbers and providing a better quality of life for these patients. Along with healthcare provider organizations, healthcare insurance companies are making concerted efforts toward achieving these goals.
The intersection of healthcare and technology birthed a new era of innovation, and the health insurance industry is at its forefront. Artificial intelligence (AI) rapidly transforms how insurers operate, from streamlining claims processing to personalizing customer experiences. This article delves into the profound impact of AI on the healthcare insurance landscape, helping the industry provide simplified, tailor-made health insurance plans and services to reshape business models, improve efficiency, and, ultimately, enhance the lives of policyholders. The following trends highlight the transformative impact of AI in the medical and health insurance sectors, paving the way for more efficient, personalized, and cost-effective insurance services.
Chatbots for customer service – Conversational AI will transform customer service models and empower businesses to provide a personalized, efficient, and scalable support experience. Since most people can access the Internet and smartphones, using chat apps to interact with doctors or healthcare insurance companies is easier. AI-powered chatbots will improve customer service by handling inquiries and claims efficiently. One of my patients mentioned to me, “Doc, my chatbot is so helpful in answering my queries, and it seems like I feel half cured!”. That was an exciting and reassuring comment.
Claims processing automation—Turnaround time to settle health insurance claims is one of the biggest bottlenecks for policyholders and healthcare insurance companies. This could result from manual processing needs to identify many potentially fraudulent claims. AI is streamlining claims processing to expedite reimbursements and reduce errors. For example, “Accelerating Automation for Insurance [2],” a study by Accenture, highlights that AI-powered automation has been able to speed up control by 70%, with the time saved being used for more accurate claims checks.
Personalized premiums—Healthcare insurance companies are realizing that insurance policies are no longer about one-size-fits-all and need to be tailored to the specific healthcare needs of clients. These organizations are leveraging AI to personalize premiums based on individual health data (both historical and current). With time, AI algorithms will continue to develop and grow, allowing healthcare insurance companies to better serve their client needs. Thanks to AI’s ability to collect data from nearly any electronic platform and device, including wearable technology and social media interactions, to mention a few, a deeper and more detailed understanding of client demands and risk profiles will become possible.
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Editor’s note: This series is by Dr. Deepa Bhide, a practicing pediatrician with additional experience in information technology and project management. Her 2023 series of articles introduced readers to a range of important issues related to programs, projects and PM in healthcare. In this new series, Dr. Bhide will interview experienced healthcare, IT and project professionals around the world to reflect on the impact of artificial intelligence on global healthcare. Learn more about Dr. Bhide in her author profile at the end of this article. To read previous works by Dr. Bhide, visit https://pmworldlibrary.net/authors/dr-deepa-bhide/
How to cite this paper: Bhide, D. (2024). AI for Healthcare and Healthcare Insurance; Future of Healthcare and Artificial Intelligence (AI): Practical Insights and Diverse Perspectives on AI in Healthcare Project Management, series article, PM World Journal, Vol. XIII, Issue IX, September. Available online at https://pmworldlibrary.net/wp-content/uploads/2024/09/pmwj145-Sep2024-Bhide-AI-for-Healthcare-and-Healthcare-Insurance.pdf
About the Author
Dr. Deepa Bhide
Hyderabad, India
Dr. Deepa Bhide, MBBS, DCH, PMP, has over 20 years of professional experience where she has blended medical practice and research with IT and Project Management. She juggles consulting, training, and operations and is proficient in clinical medicine, project management, and healthcare information technology. Starting her career as a medical practitioner, she has worked with varied organizations before her current stint as director and clinical expert for Inventurus Knowledge Solutions.
Deepa’s growing interest and work in these areas, born from her day-to-day patient interactions, helped her view Project Management as a backbone of progressive healthcare. Her paper on “Patient Care – A Project Management Perspective” has received global recognition and acclaim. With a physician background as a solid foundation to leverage IT/PM skills and knowledge, Deepa has blended her broad-based experience and learnings to present a unified, holistic, and wholesome view of Project Management and Healthcare, a cross-domain confluence. Through various webinars, events, talks, and writings across platforms, Deepa has been an evangelist in championing global project management during the COVID-19 pandemic.
A Gold medalist from Osmania University for standing First in the MBBS course, she pursued her DCH in Pediatrics and Child health. Deepa has served various roles in local and global Project Management Institute (PMI) regions. She remains actively engaged with PMI and has been a participant and speaker for various national and global meetings and online events.
Deepa lives in Hyderabad, India, and loves traveling, singing, and experimenting with global cuisine. She can be contacted at deepa.bhide@gmail.com.
To view other works by Dr. Bhide, visit her author showcase in the PM World Library at https://pmworldlibrary.net/authors/dr-deepa-bhide/
