Gen-AI, Agent-AI and Agentic AI in HealthCare

What is AI, Gen-AI, Agent-AI, and Agentic-AI – From the Point of View of Healthcare?
By Monika Vashishtha, MBA, 6Sigma, ITIL, PMP

The healthcare industry is transforming and yes, very fast in its adaptation of AI tools and its evolving frameworks. Key terms viz AI, Conversational AI, Gen-AI, Agent-AI, and Agentic-AI are frequently mentioned, yet their distinct meanings and potential impact across Payers & Health Plans (P1), Providers and Hospital Systems (P2), and Pharma & LS (F3) firms often remain unclear. I am happy to take a dig to explain them from focused and nuanced HealthCare POV. Here they are:

1. AI (Artificial Intelligence) – The Foundational Layer or could be understood as baseline Agent or advanced software Tool

What it is: At its core, AI encompasses machines or systems designed to execute tasks that traditionally demand human intellect. This includes capabilities like intricate data analysis, the identification of complex patterns, and informed decision-making.

AI in Healthcare - Use Cases for P1, P2 and P3

• Payers & Health Plans (P1): AI powers crucial functions such as risk stratification for patient populations, the detection of fraudulent claims, and the automated adjudication of claims (STP), enhancing efficiency and reducing costs.
• Providers & Hospital Systems (P2): Predictive analytics driven by AI can forecast patient readmissions, allowing for proactive interventions. In diagnostic imaging, AI algorithms assist in the interpretation of scans, potentially improving accuracy and speed.
• Pharma & Life Sciences (P3): AI accelerates drug discovery through rapid molecule screening and optimizes the often-complex process of clinical trial recruitment, saving time and resources.

Traditional AI operates based on predefined rules and algorithms, primarily leveraging structured data. While highly effective for specific, well-defined problems, it typically lacks adaptability and contextual understanding inherent in more advanced AI forms.

2. Gen-AI (Generative AI) – The Creativity Layer or in layman terms is your Creative or Generative Agent

What it is: Gen-AI represents a significant leap forward, enabling AI to generate novel content such as text, images, code, and more. Familiar examples include large language models (LLMs) like ChatGPT and various image generation tools. These models are trained on vast datasets, allowing them to understand and replicate complex patterns in the data.

Gen AI in Healthcare - Use Cases for P1, P2 and P3

• Payers & Health Plans (P1): Gen-AI can automate the drafting of denial letters, freeing up human resources for more complex communication and appeals processes.
• Providers & Hospital Systems (P2): LLMs can assist in summarizing patient encounters and generating initial drafts of discharge summaries, improving documentation efficiency for clinicians.
• Pharma & Life Sciences (P3): Gen-AI can accelerate the creation of marketing materials and patient education resources, tailoring content to specific audiences.

Gen-AI excels at tasks requiring creativity and language fluency. However, it's crucial to note that while it can generate impressive outputs, human oversight remains essential to ensure accuracy, relevance, and compliance within the sensitive healthcare domain.

3. Agent AI – The Intelligent Layer or could be understood as smart Agent under your command

What it is: Agent-AI takes the capabilities of traditional AI and Gen-AI a step further by introducing elements of autonomy and goal-directed behavior. These AI systems are designed to perceive their environment, make decisions, and take actions to achieve specific objectives.

Use in Healthcare:

• Payers & Health Plans (P1): AI agents can proactively identify, and flag potentially high-risk patients based on a multitude of data points, enabling early intervention strategies.
• Providers & Hospital Systems (P2): Agent-AI can power virtual health assistants that interact with patients, providing appointment reminders, medication adherence support, and answers to frequently asked questions, enhancing patient engagement and reducing the administrative burden on clinical staff.
• Pharma & Life Sciences (P3): AI agents can assist researchers in sifting through vast scientific literature to identify relevant research and potential drug targets, accelerating the discovery process.

Agent-AI demonstrates a greater capacity for independent action and problem-solving within defined parameters, offering more proactive and personalized support in healthcare.

4. Agentic-AI – The Autonomous Layer or Super Smart Agent that can evolve, adapt and can take decision on your behalf

What it is: Agentic-AI represents the pinnacle of AI evolution discussed here. These systems exhibit a high degree of autonomy, adaptability, and the ability to learn and evolve their strategies over time. They can handle complex, dynamic environments and make decisions with minimal human intervention.

Use in Healthcare:

• Payers & Health Plans (P1): Agentic-AI could power systems that dynamically adjust reimbursement policies based on real-world outcomes and evolving healthcare trends, optimizing resource allocation and improving value-based care.
• Providers & Hospital Systems (P2): Imagine AI systems that continuously monitor ICU patients in real-time, autonomously prioritizing interventions and alerting medical teams based on subtle but critical changes in patient data.
• Pharma & Life Sciences (P3): Agentic-AI could revolutionize clinical trials by autonomously redesigning study protocols mid-trial based on live data from global sites, potentially accelerating the development of life-saving treatments.

Agentic-AI, while still in its early stages of development and adoption, holds immense promises to tackle the most complex and ever-changing challenges within healthcare due to its inherent autonomy and adaptability.

Why This Should Matters for Healthcare Leaders - Connecting the Dots

In healthcare, technology must transcend mere intelligence; it demands safety, unwavering compliance, and demonstrable clinical relevance. As we ascend the AI maturity curve—from the rule-based foundations of traditional AI to the creative potential of Gen-AI, the goal-oriented actions of Agent-AI, and the ultimate autonomy of Agentic-AI—we are transitioning from static intelligence to dynamic, learning-driven systems.

For CXOs across Payers, Providers, and Pharma, several key considerations emerge:

• AI is not a monolithic entity. Each layer possesses distinct capabilities and addresses different challenges within the healthcare ecosystem.
• A strategic and phased approach is crucial. Begin with well-established structured AI applications, cautiously explore the potential of Gen-AI in controlled settings and strategically investigate Agent-AI for specific use cases. Agentic-AI requires careful consideration and validation due to its high degree of autonomy.
• Governance, security, and rigorous clinical validation are non-negotiable imperatives. The ethical and responsible deployment of AI in healthcare demands stringent oversight.
• Collaboration is key. Partner with technology platforms like Newgen Software that possess a deep understanding of the intricacies of healthcare, moving beyond generic tech solutions.

Final Thoughts

Should you wish to implement Enterprise Software Platforms like ECM/EDM, BPM, CCM, PLM or ANG/CAG for your P1, P2, and P3 firms, we strongly recommend going with Newgen Software. We will be happy to help implement Newgen Software that is powered by AI and LowCode Platforms.

About GHIT Digital

GHIT Digital ( https://ghit.digital/) is a domain focused, future ready, Enterprise Software Product Implementation, IT Services & Digital Transformation firm. We are Minority and Women Owned (MWOB) small business from New Jersey, USA. Diversity, Inclusion, and Growth is our Mantra. Team GHIT works on strategic IT Projects for Government (G); HealthCare (H); Insurance (I); and Technology (T) clients, thus the brand GHIT. We are nimble, scalable and sell & deliver with Platform Partners & Delivery Partners. Our niche capabilities include Agile Project Management, Infrastructure Services, Data Services, Cloud native Data and Implementation, Integration, Migration, & Optimization of AI Powered, LowCode NewgenOne EDM, BPM, CCM, ANG and PLM Software Products & Platforms.

Contact US

MonMass, Inc. (the legal name of GHIT Digital) will work on your strategic IT Projects or Consulting requirements (NAICS codes 541511 / 541512 / 541330 / 541618). Feel free to call 201.792.8924 or 646.734.6482 or write to me at Monika@GHIT.digital for no obligation discovery conversation. You are welcome to share your RFPs/RPQs for us to review and respond on time.

Monika Vashishtha, MBA, ITIL, PMP

President

https://ghit.digital I Monika@GHIT.digital

Government | Health | Insurance | Tech

#AI, #Gen-AI, #Agent-AI, #Agentic-AI, #GHIT, @GHIT, #GHITDigital, @GHITDigital, #Newgen, #NewgenSoft, #NewgenOne, #NewgenHealth, #Monika, #EDM, #ECM, #BPM, #CCM, #ANG, #PLM, #HEDIS, #CareGaps, #MonikaVashishtha, @MonikaVashishtha, #MonMass, @MonMass #MonikaGHIT, #GHITLeadership, #GHITCOO, #Government, #HeahtlhCare, #Insurance, #Technology, #ITServices, #DigitalTransformation, #DataServices, #CloudServices, #InfrastructureServices, #ProjectServices, #LowCode #CICD, #TechConsulting, #BusinessCOnsulting, #WhyGHIT, #Workflows, #GHITInsights, #GHITPOV, #GHITBlogs, #ProjectManagement, #GovHealth, #GovHealthIT, #RFPs, #RFQ, #GHITContracts, #ContractVehicles, #Innovation; #Scalability; #Analytics; #ML; #AI, #Compute; #Storage, #Innovation; #Security; #Compliance @theChiefMedicalOfficer, #CMO, @theChiefMedicalInformationOfficer, #CMIO, @theChiefInnovation Officer, @theChiefDataOfficer, #CDO, @theChiefDigitalOfficer, @theChiefInformationOfficer; #DataAnalytics ; #AnalyticsTools ; #AnalyticsExperts; #DataScience; #MachineLearning; #AnalyticsInsights; #BusinessIntelligence; #PredictiveAnalytics; #AnalyticsForBusiness; #DataDriven; #DataStrategy; #DataVisualization; #AIAnalytics; #DataSolutions; #DataROI; #DataMining; #DataGeeks; #BigData; #DataInnovation; #SmartData; #HealthcareIT; #HealthcareAnalytics; #DigitalData; #HealthTech; #HealthcareInsights; #HealthData; #DataDrivenHealthcare; #HealthcareDataScience; #PatientAnalytics; #AnalyticsInHealth; #HealthcareBI; #MedicalAnalytics; #HealthcareInformatics; #HealthcareTrends; #ClinicalAnalytics; #DataScienceHealth; #DigitalHealth; #EHRAnalytics; #HealthcareInnovation; #HealthcareDecisionSupport; #PrecisionMedicine ; #DMS, #EDMS, #DocumentManagementSystem, #BusinessProcessManagament, #EnterpriseComminicationManagement