Artificial intelligence (AI) is creating new opportunities to improve healthcare delivery, streamline administrative workflows, and support better patient care. From identifying potential health risks to organizing patient information, AI tools can help healthcare professionals make more informed decisions and spend more time interacting with patients.
However, responsible AI use in healthcare requires human oversight, transparency, and a continued focus on clinical judgment. Artificial intelligence should support healthcare professionals, not replace them or serve as a substitute for professional medical advice.
In this episode of Ask a Clinician, Kathryn Anderton, BSN, RN, BC-RN, CCM, VP of Clinical Services at ThoroughCare, explores how AI can support care management, how healthcare providers can maintain patient trust when using AI-informed tools, and how patients can use AI responsibly to become more informed participants in their care.
What Is the Role of AI in Healthcare and Care Management?
AI can support healthcare professionals by helping them identify relevant patient information, recognize patterns in clinical data, flag potential concerns, and streamline administrative tasks.
For care management teams, these capabilities can help organize information across patients and populations, highlight opportunities for intervention, and reduce the time spent on routine documentation.
When used appropriately, AI can support several areas of healthcare delivery:
- Clinical information management: Organizing relevant patient information to help clinicians understand a patient's health status.
- Risk identification: Highlighting patterns or potential concerns that may warrant further clinical evaluation.
- Care coordination: Supporting care teams as they manage patient needs, follow-up activities, and ongoing interventions.
- Administrative efficiency: Helping streamline documentation and other repetitive tasks.
- Patient engagement: Supporting educational conversations that help patients better understand their health and care plans.
These capabilities can be especially valuable in care management programs, where healthcare professionals coordinate ongoing support for patients with chronic conditions.
AI-generated insights must still be evaluated by qualified healthcare professionals. The technology can help surface information, but clinicians remain responsible for determining how that information should influence patient care.
How Can Healthcare Providers Use AI Responsibly?
Responsible AI adoption in healthcare begins with a clear understanding of the technology's role. AI should function as a supplemental resource that supports clinical expertise rather than independently directing patient care.
Healthcare organizations can promote responsible AI use by emphasizing three principles: human oversight, transparency, and patient education.
1. Keep Clinicians in Control of Clinical Decisions
AI tools can help clinicians organize information, identify trends, and flag potential risks. However, these outputs should inform clinical review rather than replace it.
A healthcare professional must evaluate AI-generated information in the context of the patient's medical history, current symptoms, individual needs, and overall care plan.
For example, an AI tool may identify a pattern in a patient's health information that suggests a potential concern. A clinician can then review the relevant data, determine whether additional assessment is appropriate, and decide on the next steps.
This approach allows healthcare organizations to benefit from AI-assisted insights while preserving professional accountability and individualized care.
2. Be Transparent About How AI Is Used
Patient trust is essential when introducing AI into healthcare workflows. Providers should explain when AI tools are used and describe how the technology supports the care team.
Patients should understand that AI may help organize information, identify patterns, or flag potential concerns, but that healthcare professionals remain responsible for clinical decisions.
Clear communication can reduce confusion about the role of technology and reinforce the importance of the relationship between patients and their care teams.
Healthcare organizations should also consider applicable privacy, security, consent, and organizational policies when implementing AI tools that process patient information.
3. Use AI to Support Personalized Care
Every patient has unique health needs, preferences, and circumstances. AI-generated insights should be considered alongside clinical expertise and the patient's individual situation.
Care management teams can use technology to support more informed conversations and identify opportunities for follow-up. Clinicians can then use their knowledge of the patient to determine which interventions are appropriate.
The goal is not to replace the human element of healthcare. It is to give healthcare professionals additional tools that help them deliver coordinated, patient-centered care.
How Can AI Help Healthcare Professionals Spend More Time With Patients?
Administrative work and documentation can consume a significant portion of a healthcare professional's day. AI may help reduce some of this burden by organizing information, identifying relevant details, and streamlining routine tasks.
When these processes become more efficient, clinicians may have more time available for patient conversations, care planning, and follow-up.
In care management, this distinction matters. Successful programs depend on tracking clinical information and also on maintaining meaningful communication with patients and coordinating care between office visits.
AI can support these activities, but the value comes from how healthcare professionals use the information it provides.
The objective of AI-assisted care management is to improve workflow efficiency while preserving the clinical relationships and judgment that quality patient care requires.
How Should Healthcare Providers Educate Patients About AI?
Patients are increasingly encountering AI tools when searching for health information, researching diagnoses, or exploring lifestyle changes. Healthcare professionals can help patients understand both the potential benefits and the limitations of these tools.
Patient education is particularly important for individuals who may have complex health needs or difficulty evaluating the reliability of online information.
Healthcare providers can encourage patients to use AI as a supplementary educational resource while continuing to rely on their care team for medical guidance.
Appropriate Uses of AI for Patient Education
When used cautiously and alongside professional guidance, AI may help patients:
- Understand unfamiliar medical terminology.
- Learn general information about a diagnosis.
- Prepare questions for an upcoming medical appointment.
- Explore general lifestyle topics, such as healthy eating or physical activity.
- Better understand educational materials provided by their healthcare team.
These uses can help patients become more informed and engaged in conversations about their health.
However, AI-generated information can be inaccurate, incomplete, or inappropriate for an individual's specific medical circumstances. Patients should be encouraged to verify important information with qualified healthcare professionals.
What Should Patients Avoid Using AI For?
AI should not replace professional medical evaluation or serve as the sole basis for important healthcare decisions.
Patients should not rely on AI to:
- Diagnose a medical condition.
- Determine or change medication dosages.
- Decide whether to start, stop, or change prescribed treatment without professional guidance.
- Replace medical advice from a qualified healthcare professional.
- Make urgent medical decisions without contacting appropriate healthcare services.
Healthcare providers can help patients understand these limitations and explain when to contact their care team for reliable, individualized guidance.
How Does Responsible AI Use Apply to Chronic Care Management and Remote Patient Monitoring?
Chronic Care Management (CCM) and Remote Patient Monitoring (RPM) require ongoing communication, coordination, and attention to patients' changing health needs. AI tools may offer opportunities to support these workflows, provided that implementation aligns with clinical, operational, privacy, and applicable program requirements.
AI and Chronic Care Management (CCM)
Chronic Care Management supports eligible patients living with multiple chronic conditions through ongoing care coordination and management between office visits.
AI-assisted tools may help care teams organize patient information, identify trends, streamline documentation, and highlight potential opportunities for follow-up.
These capabilities can support care managers as they coordinate services, monitor progress toward care plan goals, and communicate with patients and other members of the care team.
AI should not independently determine patient eligibility, establish medical necessity, or replace the clinical assessment and oversight required for appropriate care.
AI and Remote Patient Monitoring (RPM)
Remote Patient Monitoring uses connected devices to collect health data, such as blood pressure, blood glucose, or oxygen saturation, depending on the patient's clinical needs and prescribed monitoring plan.
AI may help healthcare teams organize incoming data, identify patterns, or flag readings that warrant review. These functions can support clinical workflows by helping staff prioritize information for evaluation.
However, AI-generated alerts and interpretations must be reviewed within the appropriate clinical workflow. Healthcare professionals remain responsible for determining whether a reading requires follow-up or a change in care.
Organizations should establish clear procedures for reviewing alerts, escalating concerns, documenting actions, and maintaining appropriate clinical oversight.
Using AI to Optimize Care Management Workflows
For healthcare organizations implementing AI-assisted workflows, the focus should be on using technology to support and not bypass the processes that make care management effective.
Important considerations include:
- Establishing clear responsibilities for clinical review and decision-making.
- Evaluating AI outputs for accuracy and relevance.
- Protecting patient information and following applicable privacy and security requirements.
- Educating clinicians and patients about the technology's capabilities and limitations.
- Maintaining appropriate documentation and oversight.
- Evaluating whether AI tools improve workflow efficiency and support program goals.
AI adoption should complement established care management processes and applicable CMS program requirements rather than create shortcuts around them.
How ThoroughCare Helps Healthcare Organizations Optimize Care Management
ThoroughCare provides leading care coordination software designed to help healthcare organizations manage and streamline care management programs, including Chronic Care Management and Remote Patient Monitoring.
ThoroughCare's Clinical Advisory Team helps organizations understand the requirements associated with CMS programs and identify opportunities to improve workflows, optimize program operations, and support sustainable growth.
As healthcare organizations evaluate AI tools and new approaches to care coordination, clinical expertise remains essential. Technology should be implemented in ways that support care teams, reinforce appropriate oversight, and help organizations deliver coordinated care to the patients they serve.
Frequently Asked Questions About AI in Healthcare
What is responsible AI use in healthcare?
Responsible AI use in healthcare means applying artificial intelligence in ways that support patient care while maintaining clinical oversight, transparency, privacy, and professional accountability. AI can assist with information management and workflow efficiency, but qualified healthcare professionals remain responsible for clinical decisions.
Can AI replace healthcare professionals?
No. AI should support healthcare professionals rather than replace them. Although AI can help organize patient information, identify patterns, and flag potential concerns, clinicians must evaluate the information and determine appropriate care based on their professional judgment and the patient's individual needs.
How can AI improve care management?
AI may help care management teams streamline documentation, organize clinical information, recognize trends, identify potential risks, and support care coordination. These capabilities can help clinicians prioritize their work and focus more time on patient engagement and care planning.
How can healthcare providers build patient trust when using AI?
Providers can build trust by explaining how AI is used, communicating its limitations, protecting patient information, and emphasizing that clinicians remain responsible for clinical decisions. Patients should understand that AI is a supplemental tool, not a replacement for professional medical advice.
Can patients use AI to understand their health conditions?
Patients may use AI to learn general information about diagnoses, understand medical terminology, and prepare questions for healthcare appointments. However, AI can provide inaccurate or incomplete information and should not be used to diagnose conditions, determine medication dosages, or replace professional medical guidance.
How can AI support Chronic Care Management?
AI may support Chronic Care Management by helping teams organize patient information, identify trends, streamline documentation, and flag potential follow-up needs. These functions can complement care managers' work, but clinical assessments, individualized care decisions, and applicable program requirements still require appropriate human oversight.
How can AI support Remote Patient Monitoring?
AI may help care teams organize remote monitoring data, recognize patterns, and flag readings that may require clinical review. Healthcare professionals must evaluate these findings and determine appropriate follow-up within established clinical workflows.
Final Thoughts: Keep People at the Center of AI in Healthcare
Artificial intelligence offers meaningful opportunities to support care coordination, improve administrative efficiency, and help healthcare professionals identify information that may be relevant to patient care.
But successful AI adoption depends on more than technology. It requires transparency, patient education, responsible implementation, and qualified professionals who can evaluate AI-generated insights within the context of each patient's needs.
Whether AI is supporting a clinician's workflow or helping a patient learn more about a health condition, the guiding principle remains the same: AI should complement healthcare professionals, not replace them.