Generative AI in Patient Care
Generative AI in Patient Care
with ZS
Contents
Foreword 3
Executive summary 4
Conclusion 14
Contributors 15
Endnotes 16
Disclaimer
This document is published by the
World Economic Forum as a contribution
to a project, insight area or interaction.
The findings, interpretations and
conclusions expressed herein are a result
of a collaborative process facilitated and
endorsed by the World Economic Forum
but whose results do not necessarily
represent the views of the World Economic
Forum, nor the entirety of its Members,
Partners or other stakeholders.
Foreword
Shyam Bishen
Head, Centre for Health Pratap Khedkar
and Healthcare, Chief Executive Officer, ZS
World Economic Forum
In 2022-23, the World Economic Forum and ZS Given that somewhere around 80% of all medical
collaborated to create a report outlining the most data is unstructured, these models hold strong
promising use cases for artificial intelligence (AI) promise to address global healthcare challenges
in healthcare, the stiffest barriers to adoption, a for which “traditional” predictive AI techniques are
framework for building trust and adoption for AI ill-suited.
solutions, and a call to action for stakeholders across
the healthcare ecosystem and beyond. Shortly This white paper looks specifically at generative
before the paper was published, OpenAI released AI’s promise to help empower patients. It draws on
ChatGPT, unleashing generative AI into the public interviews with digital and innovation leaders across
discourse and opening fresh new possibilities for using healthcare, technology and other sectors, who
AI to tackle healthcare’s most intractable problems. have shared their views on the most promising use
cases for patient engagement, their biggest barriers
For example, large language models (LLMs) trained to adoption and key enablers for using this new
on vast troves of unstructured data can create modality to improve global health outcomes.
original, human-like text based on minimal prompts.
The COVID-19 pandemic exacerbated numerous Many healthcare companies and other stakeholders
existing global healthcare problem areas – among have struggled to keep pace with changing patient
them a severe shortage of healthcare workers,1 expectations for how they engage with the health
widening health disparities and existential strain system, as described in the 2024 ZS Future of
on health system finances. The World Health Health Report. This paper focuses on the promise
Organization estimates the global shortage of of using generative AI to advance direct patient
healthcare workers today at 15 million (including engagement, a use case with high potential to
10 million doctors),2 a figure projected to decline alleviate health system burden, reduce healthcare
to 10 million by 2030. Around 95% of the shortfall provider burnout and improve patient experiences
is in low- and middle-income countries (LMICs).3 and outcomes.
Generative After speaking with leaders responsible for vetting help create a more robust data foundation by
AI can augment and implementing generative artificial intelligence automating data management and extracting
providers by (AI) solutions across healthcare and technology, insights from unstructured data, a task that was
offering more three themes emerged. One, using AI and other extremely time-consuming, cumbersome and
emerging technologies to create value sits at inefficient using earlier AI techniques.
intuitive, human-
the top of the corporate agenda. Two, while the
like conversations healthcare field is rife with experiments, there is – Insights generators: Generative AI enables
with patients and limited agreement on which use cases are ready real-time analysis of both structured datasets
caregivers that for deployment and hold transformational potential. (such as health data) and unstructured datasets
can help inform Three, there is no consensus on how to group (such as physician notes), offering significant
care decisions generative AI use case types. promise as a “co-pilot” to help healthcare
and spur action. providers quickly analyse information and
Based on a review of the literature and qualitative interpret results. These tools also can help
interviews with digital and innovation leaders across accelerate data integration across datasets to
healthcare, technology and other sectors, use help doctors, nurses and health systems gain
cases fall into three general categories: faster, more accurate insights.
In the June 2023 report, Scaling Smart Solutions With the advent of generative AI, the question is:
with AI in Health: Unlocking Impact on High- Given what is known about the connection between
Potential Use Cases, more than 50 leaders from better patient engagement and improved health
across healthcare, government, tech, academia outcomes,5 can this technology be used to safely
and non-governmental organizations (NGOs) plug the dangerous shortage of healthcare workers
were interviewed. Many of them identified patient by communicating directly with patients across a
engagement as an area ripe for transformation range of healthcare interactions?
using AI and other frontier technologies; however,
they also pointed to the challenges, given the Traditionally, healthcare systems engage with
disconnected healthcare ecosystem, liability individual patients mainly at a few discrete points in
concerns inherent to engaging patients without a their health journey: when they see a doctor, when
“human in the loop” and the technical limitations of they start on therapy and when they discontinue
traditional chatbots. treatment. What healthcare systems need are
ways to engage with, influence and gather insights
from patients across their entire health journey.
Generative AI can assist with all three.
FIGURE 1 Patient engagement and generative AI: addressing patient care gaps for better outcomes
Lifestyle support, early disease Patient care navigation in the Assist in monitoring, side
education and even prenatal first mile to help understand effect management,
care in LMICs*, with a focus where to direct patients for adherence and keeping
on consumers and caregivers diagnosis or treatment patients on treatment
Ada Health, a Germany-based medical AI updated. Its health assessments are deterministic,
company, has built a digital symptom checker meaning identical inputs will yield identical
based on natural language processing (NLP) outputs. In tests, Ada’s app has proven to be safe
enhanced by generative AI. Unlike when checking and accurate, correctly recognizing inflammatory
systems through a LLM like ChatGPT or Google’s rheumatic diseases more often than physicians
Bard, which are trained on the entire corpus of and besting competing apps in diagnosing a
the World Wide Web, Ada’s knowledge base range of conditions.
is curated, clinically vetted and continuously
US-based healthcare innovator K Health partnered within the system. The virtual care platform uses
with Cedars-Sinai, a leading academic health AI technology developed by K Health, which
system in the US, to offer patients 24/7 virtual automates most aspects of patient intake and
access to Cedars-Sinai doctors through a data entry, reducing administrative burden and
new mobile app called Cedars-Sinai Connect. allowing providers to focus more on patient care.
Patients can access Cedars-Sinai healthcare Patients can share symptoms, health details and
professionals 24/7 for personalized acute, concerns through the app, which summarizes and
chronic and preventive care, including same-day presents them directly to clinicians, who then use
visits and evaluation for referrals to specialists their clinical expertise to treat each patient.
Doctors report spending as long as two hours natural language processing (NLP) techniques.
per day reading and responding to messages Powered by ChatGPT-4 and working in a secure
sent through patient portals, a number that Microsoft Azure environment, URMC has built a
continues to climb as patients increasingly use model to appropriately triage messages to either
these platforms. Leaders at the University of a doctor, nurse or staff member. The tool was
Rochester Medical Center (URMC) in Rochester, still being tested at publication time, but testing
New York, have been building and testing models showed reliability (repeating the same action when
for years to support clinical operations – with presented with an identical input) in the high-90s
limited success, thanks to the messiness of and accuracy (selecting the most appropriate
available data and the limitations of traditional recipient) in the mid-80s.22
Rheumatoid arthritis (RA) is a difficult disease generative AI models to quickly and accurately
to manage, with only about 15% of patients predict treatment effectiveness. This innovative
experiencing quick relief from its painful approach is akin to translating a patient’s unique
symptoms. RA’s complexity lies in a patient’s genetic code into a language these models
genetics, which play a big role in both the can understand. The result is a more tailored
disease’s progression and how well treatments and efficient way of finding the right treatment,
work. Mayo Clinic is pioneering the use of a potentially speeding up the process of symptom
patient’s genetic profile and developing multimodal relief for RA patients.
High-income countries earn the lion’s share of oncologists. Patients can track symptoms and
investment in cancer prevention, screening and side effects throughout treatment and remission,
diagnosis, yet cancer remains a major health with generative AI recommending personalized
problem in LMICs. Take Nigeria, where four out responses and interventions for doctors to send
of five cancer diagnoses is fatal.25 The problem to patients. The generative AI tools also provide
is one of resources: Rwanda, for instance, has doctors with personalized recommendations
a population of 14 million people but only 15 based on side effects, tolerability and efficacy.
oncologists.26 Amazon and Hurone AI, a US- A beta test saved doctors 75% of time spent
based healthtech start-up, have partnered with on specific care tasks – a potentially lifesaving
the governments of Rwanda, Nigeria and Kenya efficiency boost in regions where resources are
to develop a generative AI-powered patient- so limited.
facing application to communicate with local
The annual volume of messages flowing to patient inquiries. Generative AI, which at
through electronic patient portals doubled least one study has found to provide answers
between 2019 and 2022 to more than 1 billion. displaying higher levels of empathy than those
On average, physicians spend more than 15 drafted by human clinicians, drafts responses
hours per week on administrative tasks, with based on the patient’s inquiry and medical
almost two-thirds of that time taken up by history. A doctor then has the choice to accept
electronic health record documentation – work the responses unedited, to revise as they see
that can be largely done by generative AI. fit or to draft their own response from scratch.
This use case holds significant potential both
Microsoft and Epic Systems, the US’s largest to reduce provider burden and improve patient
provider of electronic health records, are partnering experience, which studies have consistently
to pilot the use of Azure OpenAI to respond linked with improved patient outcomes.
In the previous joint briefing paper on AI in healthcare, Using generative AI to engage patients faces many
technology and healthcare leaders identified of the same challenges, plus some new ones. These
numerous barriers slowing the widespread adoption have been ranked from highest to lowest priority.
of AI in healthcare, including holes in the data
foundation, insufficient trust in algorithms, inadequate
technological infrastructure and scalability issues.
Data and trust remain the two foundational barriers for adopting generative
AI in healthcare.
Mustaqhusain Kazi, Global Head, Informatics Strategy and Digital Innovation, Roche
Mistrust H
oles in the
data foundation
Interviewees singled out trust as the While many organizations have made progress
most formidable barrier to widespread adoption in building their own data management
of generative AI for patients, with one blanket infrastructure and augmenting it with data
issue rising above all others: inaccuracy. consortia and even federated learning, additional
work is needed to ensure models are trained on
sufficiently robust data to produce outputs that
Inaccuracy: For reasons that are often unclear are fit enough for safe and reliable patient use.
to users, LLMs occasionally generate incorrect or Two data issues predominate:
misleading answers or responses in the absence of
sufficient data. These hallucinations can be hard to
discern, leading to confusion and misinformation. Biased outputs: As with predictive AI techniques,
Since the risk of faulty health information is so high, generative AI outputs reflect underlying bias in the
it is paramount that providers integrate generative data on which they’ve been trained. This creates
AI into workflows such that AI augments, rather than intense urgency to implement governance that
automates, clinical decision-making. In addition, enhances transparency across these models’ entire
careful prompt engineering by developers in initial life cycle – especially for those models, such as
releases, and continued refinement on new and those from OpenAI, Google and others, that have
domain-specific datasets for future releases, is been trained on the broad corpus of the internet.
needed to ensure LLMs avoid misinformation and can
explain why a model responded in a specific way. Patient privacy: Patient health data is
incredibly sensitive, so organizations must build
Companies like Perplexity AI are seeking to increase security, privacy and ongoing data management
trust in outputs through greater transparency by protection into governance models. Organizations
building in functionality that explains how a model like Johnson & Johnson and Syntegra use
arrived at a given output. This can help users generative AI to create “synthetic data”, allowing
evaluate the degree of trust they should place in it. them to use the technology while bypassing
security and privacy issues altogether.
As with many novel technologies, there is a risk that generative AI exacerbates existing disparities.
Multilateral, cross-border partnerships will be key to accelerating generative AI’s impact outside high-
income countries. Two barriers stand out:
Data without action is useless, and generative AI has vast potential to empower
decisions, especially in middle- and low-income countries, where healthcare
resources are extremely scarce.
John Sargent, Founding Partner, BroadReach Group
The release of ChatGPT set off a frenzy of public interest. The barriers slowing the widespread
interest, private investment and experimentation. adoption of generative AI and the corresponding
Moving past the razzle-dazzle phase will require enablers for overcoming them mirror those for
sustained public-private engagement to create predictive AI. These are covered in depth in the
urgency, enable change and protect the common June 2023 Forum-ZS insight report.
Patients Providers
Payers Life
sciences
Connectors1 Government
Note: 1. NGOs, advocacy and patient groups, distributors, group purchasing organizations, investors and other organizations in healthcare.
A person’s health is inherently precious. Any This is true at the patient level and even more
stakeholder developing, deploying or vouching so at the population level. Global patient demand
for a generative AI-powered tool that could put for medical treatment outstrips supply by many
even one patient’s health at risk through faulty, orders of magnitude, leading to great loss of life,
confusing or ill-timed information should be reduced lifespan for millions and growing fractures
cautious. However, the risk of medical or ethical to global health and healthcare systems. Generative
malpractice stemming from the responsible use of AI, especially when paired with predictive AI
these tools pales compared with the more general techniques, offers the greatest current hope
malpractice of choosing to ignore their boundless of translating today’s golden age of scientific
capacity for patient impact. innovation into equitable improvements to global
health and healthcare.
Dan Reiss
Principal, ZS
Antonio Spina
Lead, Digital and AI Health,
World Economic Forum
Acknowledgements
ZS Mustaqhusain Kazi
Global Head, Informatics Strategy
and Digital Innovation, Roche
Alex Anokhin
Lead, Health and Healthcare Innovations Pankaj Paul
Adviser to the Chairman and Founder,
Megan Wolfe Burjeel Holdings
Senior Director
John Sargent
Nicolas Zimmerman Managing Director, Founding Partner,
Content Strategy Lead BroadReach Group
Vivian Tan
World Economic Forum Vice-President, Strategic Information Management
& Global Relationships, Kaiser Permanente
Andy Moose
Head, Health and Wellness Production
The authors would like to thank the following
interviewees for their time and input, which were Laurence Denmark
crucial to the production of this paper. Creative Director, Studio Miko