“Of all the forms of inequality, injustice in health is the most shocking and inhumane.”

Martin Luther King, Jr.

With increasing adoption of AI tools in health systems, this is a timely paper from the New England Journal of Medicine section on artificial intelligence on how AI devices are used after regulatory approval. (Note. The list of authors includes ones from Stanford and University of Illinois Urbana-Champaign as well as the company IQVIA, but somehow does not include any clinicians.)

The study systematically quantify the adoption and usage of the over 500 medical AI devices that have been approved by the U.S. Food and Drug Administration. The methodology was done by tracking the Current Procedural Terminology (CPT) codes that are explicitly created for medical AI tools. This methodology may not be entirely accurate as there may be other means that these AI tools are receiving compensation, such as the Novel Technology Add-On Payment or NTAP mechanism for inpatient use of AI for Medicare, that are not reflected by CPT codes alone.

The authors tracked 11 billion CPT claims between 1/1/18 to 6/1/23 and found that a few medical AI tools (16 total but only 4 have more than 1,000 claims) accounted for most of the AI tools being utilized. The only AI tools, according to the authors, are ones used for coronary artery disease (0501T-0504T) and for diabetic retinopathy (92229); these tools accumulated over 10,000 claims (or a scant 0.0001% of total claims). The authors also noted that certain zip codes with higher income levels, metropolitan in location, and proximity to academic medical centers had higher medical AI usage. This is interesting in that prior study showed a few states have disproportionately higher numbers of AI in health algorithms (California, New York, and Massachusetts). The authors concluded that this study showed the need for equitable access to AI technologies in healthcare as there is evidence that there are socioeconomic and geographic disparities. Ultimately, these AI tools will need to demonstrate not only equity of access, but improvement in outcome.

Read the full article here.

This fascinating topic of the adoption of AI tools, along with others will be discussed at the annual Ai-Med Global Summit, scheduled for May 29-31 2024 in Orlando. Book your place now!