Steven Y Lin, MD, Megan R Mahoney, MD and Christine A Sinsky, MD

Author’s Summary

Artificial intelligence (AI) is poised as a transformational force in healthcare. This paper presents a current environmental scan, through the eyes of primary care physicians, of the top ten ways AI will impact primary care and its key stakeholders. We discuss ten distinct
problem spaces and the most promising AI innovations in each, estimating potential market sizes and the Quadruple aims that are most likely to be affected. These ten areas include the following: risk prediction and intervention ($100 billion yearly), population health management ($89 billion yearly), medical advice and triage ($27 billion yearly), risk-adjusted paneling and resourcing ($17 billion yearly), device integration ($52 billion yearly), digital health coaching ($6 billion yearly), chart review and documentation ($90 billion yearly), diagnostics ($100 billion yearly), clinical decision making ($1-2 billion yearly), and practice management ($10 billion yearly).

With over 500 million visits per year in the United States – 51% of all physician office visits, more than any other medical specialty – primary care is where the power, opportunity, and future of AI is most likely to be realized in the broadest and most ambitious scale. For AI to add the most value and for physicians to embrace it, these innovations should support, not supplant, the patient-physician relationship. Health care is fundamentally a social enterprise, powered by committed, caring, and collaborative connections between the humans involved. AI implemented poorly risks pushing humanity to the margins; implemented wisely, AI can free up physicians’ cognitive and emotional space for their patients, even helping them to become better at being human.

We believe that the optimal role of AI is to free up physicians’ cognitive and emotional space for their patients. Using the cockpit analogy, AI has the power to protect the pilot (the physician) from the unsafe distractions of information overload by organizing the cacophony of patient data, evidence-based practice guidelines, and compliance monitoring check boxes, into a manageable cockpit for physicians. It can also automate repetitive and cumbersome tasks, such as documentation and other administrative distractions, that contribute to a hazardous cockpit for physicians. Undivided attention with compassion is the most powerful diagnostic and therapeutic tool physicians can provide their patients. AI will be most effective when it enhances physicians’ ability to focus their full attention on the patient by shifting the physicians’ responsibilities away from transactional tasks towards personalized care that lies at the heart of human healing.

As AI becomes the next great wave of technological innovations to offer power and possibility for modern healthcare, a key question is: will AI augment, rather than subvert, relationships? Or will managing and being managed by AI add yet another technological master and burden to the lives of physicians? The human challenge will be to have the wisdom and willingness to discern AI’s optimal role, and to determine when it strengthens and when it undermines human healing. Ongoing research will be needed to determine the impact of AI in achieving the Quadruple Aim of better care, better health, lower costs, and improved well-being
of the workforce.

KEY OUTTAKES

  • Primary care is where the power, opportunity, and future of AI is most likely to be realized in the broadest and most ambitious scale.
  • The optimal role of AI is to free up physicians’ cognitive and emotional space for their patients.
  • Ongoing research will be needed to determine the impact of AI in achieving the Quadruple Aim of better care, better health, lower costs, and improved well-being of the workforce.

A view from
Anthony Chang, MD, MBA, MPH, MS

“This is one of the first, if not the first, article on use of AI for primary care medicine. The authors discuss ten distinct problems that AI with its innovations can potentially contribute to in terms of real world solutions. Even more impressive than the discussions above, the authors defined each of these domains by the area of the Quadruple Aim that it is covering as well as the estimated size of the market value. The authors astutely pointed out that the optimal role of AI is to free up physicians’ cognitive and emotional space for their patients.”