Can AI Help Prevent Hospitalizations?

By Marianne Chrisos - Last Updated on May 2, 2019
Marianne Chrisos

Marianne Chrisos | Born in Salem, Massachusetts, growing up outside of Chicago, Illinois, and currently living near Dallas, Texas, Marianne is a content writer at a company near Dallas and contributing writer around the internet. She earned her master's degree in Writing and Publishing from DePaul University in Chicago and has worked in publishing, advertising, di...

Artificial Intelligence

Technology and healthcare go hand in hand. It’s advanced in technology that has made many medical procedures possible and live-saving, from organ transplants to prosthetics to researching and developing medications that can prevent and cure diseases. While medicine is certainly more than just an application of technology, technology is a solid foundation for much of modern medicine. Artificial intelligence might lead to quality improvement in healthcare sector.

Can artificial intelligence reduce preventable hospitalizations?

One way that technology is growing to help the medical field is through working to minimize preventable hospitalizations. Being admitted to a hospital is often a medical necessity and certainly needs to be an option in preventing or treating an emergency. But some hospital admissions turn out to be problems that could be treated in other facilities like a doctor’s office or urgent care, and hospitalizations are expensive for patients and hospitals. Not only does minimizing the healthcare costs for individuals help to ensure that overall insurance rates can stay low for everyone, but many hospitals also offset the cost of uninsured patients by using earmarked tax dollars, which can impact neighborhoods at large. Not to mention, being in a hospital can e stressful and traumatic for patients and providing them with less stressful options is helpful for their mental and physical states. AI technology has the potential to prevent unnecessary hospitalizations while still assuring high-quality care.

One tech company, Clover Health, has been making strides in this area. Forbes took note of this and explained Clover Health’s contributing in reducing preventable hospitalizations by saying, “Machine learning may help identify where things are getting rocky for patients well before they get knocked over and have to go to the hospital. That’s what Clover Health, which was founded in 2014, has been trying to do. Clover Health is a rather unique combination of an insurance-health care services-tech company…Clover Health has been developing and using data and machine learning approaches to proactively figure out where to intervene long before things get so bad that a patient has to go to the hospital. Guided in part by what the data and computers say, they then deploy teams of health care professionals such as doctors, nurses, and behavior health specialists to check on and even visit the homes of Medicare Advantage beneficiaries.”

Why is Clover Health able to do this more effectively than another tech company? Because of their access to patient data as an insurer. Clover Health AI makes it possible for patients to better understand and connect with the massive amount of data that indicates changes in health that need to be addressed before they develop further, such as mental status changes, breathing difficulties, blood pressures, and blood sugar measurements and other neurological or lifestyle changes that may require medical intervention before it becomes severe. There is also the added benefit that patients can access this information in the comfort of their own homes and have a more private, discrete experience as opposed to needing to go to a doctor’s office to even know if there should be an evaluation, assessment, test, or treatment.

AI, as used by Clover Health, is helping patients better understand their health risks before hospitalization becomes necessary and also helps patients understand what symptoms are cause for concern and need emergency treatment versus what can be handled by a visit to a primary care physician. While artificial intelligence is not the same as experienced medical providers, it is a promising technology that can help both medical professionals and patients alike. The right doctors and the right medical training are always needed to make decisions on and execute treatment, but artificial intelligence is looking more and more like a tool that can help to increase the quality of information and potentially the quality of care.

Marianne Chrisos

Marianne Chrisos | Born in Salem, Massachusetts, growing up outside of Chicago, Illinois, and currently living near Dallas, Texas, Marianne is a content writer at a c...

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