AI could plug hospitals' money leaks, if boards measure it (opens the source in a new tab)
- Rajendra Pratap Gupta argues AI must become a balance-sheet strategy for hospitals, starting with claims and billing. IRDAI data for FY2024-25 show Rs 1,32,488 crore in health claims, of which Rs 94,248 crore was paid.
- Evidence is mixed: in a UCLA trial of 238 physicians, one AI scribe cut note-writing time by 9.5% while another showed no significant benefit. Bigger gains may come from predicting discharges and using beds and theatres better.
- Apollo Hospitals reports 20 clinical AI algorithms. Gupta urges boards to set baselines, test three use cases and tie vendor pay to independently measured results.
- 9.5%
- less note-writing time, one AI scribe
- 20
- clinical AI algorithms at Apollo
Why it matters With nearly a quarter of claim value going unpaid in India, small gains in coding and documentation move hospital finances. The column also warns that better collections must not mean inappropriate billing.
Other side Expectations are running ahead of evidence: forecast savings are not realised savings, and integration, cybersecurity and model upkeep eat into returns. If insurers deploy AI too, claims could become a costly bot-versus-bot contest.