The Top 7 Questions to Ask Your AI Vendor

There is a lot of buzz about the potential of artificial intelligence (AI) to streamline administrative processes while ensuring timely care delivery, resource allocation, and patient satisfaction. This, combined with market drivers, increased competition, and the popularity of generative AI, have created a perfect storm of interest. This leads to a myriad of companies offering solutions to fill the demand. However, not all solutions are created equal. In an industry as unique as healthcare, where errors can have dire consequences, the stakes are especially high. It is critical for both providers and payers to have a firm understanding of the various types of AI technology available to best assess potential solutions.

This blog breaks down the fundamentals. Below is an overview of the most common technologies and questions to ask vendors when evaluating AI solutions.

AI 101: Breaking Down the Different Types of Artificial Intelligence

AI technologies fit into three groups: analytical AI, reactive AI, and generative AI. Solutions leveraging analytical AI analyze and interpret complex data sets, uncover insights, and make data-driven predictions or decisions. Reactive AI technologies operate based on predefined rules and perform specific tasks without the ability to learn or adapt.

Generative AI technologies generate new content including images and text by drawing from learned patterns in existing data using Large Language Models (LLMs). LLMs use complex statistical methodologies to process natural language inputs to predict the next best word to respond to a prompt based on the training data. While the ability of LLMs is remarkable, there are many limitations, including a propensity for “hallucinations,” which can result in factually incorrect responses. Since these systems make determinations based on training data that may reflect human biases, generative AI has the potential to perpetuate societal biases as well. Furthermore, some systems create growing concerns due to the inability to see how decisions are made.

Questions to Ask Your Vendor

Given the inherent biases of AI and risk of inaccuracies, healthcare organizations need to be cautious when evaluating partners. Below are the top questions to ask your AI vendor during the exploration process.

Have they done it before – cradle to grave – with AI? AI systems are not like other IT systems; they change over time. Ensure the vendor you are working with has at least five years of experience maintaining their artificial intelligence solution. Ask how they will monitor learning systems. If the vendor doesn’t provide clear answers, walk away to avoid being a test case that could deliver a negative outcome.
Can they explain the system to your clinical staff? The solution should use terminology in a way your clinical staff understands. Ask if the system will leverage language that is commonly used within your healthcare environment.
Is the technology observable? Transparency is an important quality to consider. Ask your vendor what data the solution uses to make decisions and what is the source of that data. Also understand what happens when the system doesn’t know or is unsure how to answer a question.
Does the technology provide the right analytics? To ensure confidence in the AI solution’s decisions, avoid “black box” approaches. Ask the vendor if it’s possible to assess the data. It’s also important to confirm that the solution delivers the right level of analytical information to enhance business insights.
Does the technology keep you in the loop? While automation technologies can be an integral tool for success, they must always have human oversight. Ask your vendor if the solution keeps humans in the loop. It’s also important to ask if your team will have control and visibility to all the information being used.
Is the data accessible? If data is not easily accessible or integrated into clinical workflows, it can lead to frustration for providers and patients. Ask if you will have immediate access to your data. Avoid vendors that only make data accessible behind a paywall or require payment to access data at a later date.
Did they say yes to everything? Despite its promise, AI has limitations. If a vendor says their system doesn’t make mistakes and answers “yes” to every problem you present, that’s a red flag. The vendor’s offering may be too good to be true.

For a full breakdown, download our Questions to Ask Your AI Vendor Cheat Sheet . Also visit Availity.com/AuthAI to learn how Availity is leveraging analytical AI to streamline prior authorization reviews.

References

Availity provides the information in this blog for education and awareness use only. The information provided here is for reference purposes only, and does not constitute the rendering of legal, financial, or other professional advice or recommendations by Availity.

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The Top 7 Questions to Ask Your AI Vendor

AI 101: Breaking Down the Different Types of Artificial Intelligence

Questions to Ask Your Vendor

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