Healthcare administration technology has lagged behind advancements in other industries. However, artificial intelligence (AI) is now stepping in to bridge that gap, transforming how healthcare providers and pharmacy benefit managers operate.
AI tools can streamline administrative processes, improve digital experiences, and enhance efficiency in pharmacy benefits. For example, providers are using AI-driven tools to dictate work orders and simplify administrative workflows. Additionally, AI is integrated into member-facing digital tools, making healthcare more accessible and user-friendly.
In pharmacy benefits management, AI enables critical tasks, such as handling prior authorizations and Fraud, Waste, and Abuse (FWA) detection, to operate more effectively. But implementing AI isn’t effortless; it demands the right teams, significant investment, and committed leadership.
At Abarca Forward, two keynote speakers outlined the essentials for successfully deploying AI in healthcare:
- User-Centric Digital Experiences: Successful AI tools must prioritize the end-user experience, especially as younger professionals enter the healthcare field with high expectations for seamless digital interfaces.
- Data Quality and Reliability: AI is only as effective as the data it relies on. Clean, up-to-date, secure data is essential, requiring healthcare organizations to invest in data infrastructure and maintenance.
- Continuous Improvement: AI applications should evolve. Healthcare organizations must embrace ongoing enhancements, recognizing the constant influx of data and opportunities for refinement.
AI has the potential to be bigger than the cloud and the internet: It’s fundamentally changing the way that businesses work.
For pharmacy benefit managers specifically, AI presents opportunities to connect disparate medical and pharmacy data indices, generating real-time, fact-based clinical insights. This enables more timely, personalized, and seamless interventions, paving the way for innovation and improved client experiences.
With the right structure in place, the opportunities that AI can create for partners, employees, providers, and consumers are boundless. Now is the time for healthcare to invest in the groundwork necessary to realize AI’s full potential.