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困境中的医疗健康必须演进的三种方式

Three Ways Distressed Healthcare Must Evolve

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译文2,457 字

每一天,医疗团队都被迫在从未设计为协同工作的系统之间完成工作。他们追逐下一步、纠正错误、弥合缺口,并在支离破碎的工作流程迷宫中维持护理的推进。医疗健康面临着一场未完成工作的危机,这场危机正在推动临床倦怠,并每年给美国造成近1万亿美元的行政开销。

麦肯锡的研究和《美国医学会杂志》上的分析证实,其中约2650亿美元的浪费源于完全冗余的流程。我们花了二十年时间将数十亿资金投入到数字化转型和AI的各种迭代中,但临床医生和后台团队的行政负担仍处于历史最高水平。

对于困境中的医疗健康组织,前进之路并非再添一个孤立的工具。它需要三个转变:

由以下方呈现赞助帖缩小职场心理健康中的质量与可负担性差距在一次采访中,Kyan Health联合创始人兼首席商务官Konstantin Struck讨论了Kyan如何以可负担的价格点,让中端市场和企业雇主获得优质的心理健康劳动力护理。

作者:Stephanie Baum

构建一个深度集成的行动系统来完成任务。

利用可解释的玻璃盒AI使行动可信、可审计且可问责。

与交付成果而非仅仅软件的负责任合作伙伴合作。

记录系统与行动系统之间的关系

随着医疗技术的整合,对新基础设施的需求已经明确:一个构建在行动系统之上的AI驱动编排层。医疗IT栈依赖于电子健康记录(EHR),而EHR是为计费和合规而设计的。虽然EHR支持患者护理,但它们通常缺乏先进的AI能力,难以跟上创新步伐,在AI模型与临床实践之间造成差距。AI需要强大的基础设施和工作流程才能安全有效地运行。如果没有来自记录系统的可信集成,即使是先进的AI模型也可能变得无关紧要或危及患者安全。

构建这一关键层并不需要拆除当前的EHR或遗留基础设施。行动系统可以包裹现有系统,将断开的数据库转化为活跃的运营引擎。然而,更强大的未来状态是一个连接模型,其中记录系统和行动系统共存,持续交换数据、上下文和结果。在这个模型中,系统从数据到行动再到结果,然后持续改进,并在问责最为重要时引入可解释AI和人工干预。

由以下方呈现赞助帖2026年面向全球劳动力的前7大现代AI驱动EAP提供商发现2026年顶级AI驱动的EAP提供商。比较Kyan Health和Spring Health等平台的分诊速度、全球覆盖范围和临床质量,以改变员工福祉。

作者:Tiffany Cabasso,Kyan Health运营总监 | 心理学家,FSP这个深度集成的行动系统意味着将运营、技术、临床和财务任务统一为一个智能层,改变行政和运营工作在企业中的分配方式。这是一种结构性的委托,将当前淹没临床医生和员工的行政摩擦进行转移。虽然这种架构让团队终于能够在其许可范围内充分发挥作用,但其真正的价值更为深远。它引入了系统性的问责制,由技术本身负责执行工作直到完成。

AI ROI悖论以及为什么可解释AI能带来改变

我们通过Gen AI和复杂的分析获得了前所未有的临床洞察途径。然而,奥纬咨询的一项新研究报告指出,虽然63%的受访提供者在某种程度上使用了高级AI/自动化,但只有20%到40%的企业级使用这些工具。AI可以总结、预测、推荐和标记,但人们仍然必须验证输出、路由任务、纠正记录,并确保工作完成。

这正是可解释AI(XAI)能够发挥作用的地方。与产生输出但没有清晰推理路径的黑盒系统不同,XAI使推荐透明、可追溯且可审计。在医疗健康领域,领导者和护理团队理解答案是如何得出的、哪些数据提供了信息、哪些地方仍存在不确定性,以及何时应进行人工评估,这一点非常重要。这使得连接的AI驱动工作流程能够被信任、监控、改进和扩展。

当可解释AI嵌入到一个连接的行动系统中时,智能可以以更高的信心和问责性在患者旅程中移动,并完成工作。其价值在于确保行动能够被理解、执行、监控,并随时间改进。

例如:

连接的系统首先从外部文档中提取数据以创建患者病史,同时验证保险和财务清算。

在就诊期间,环境监听文档直接输入部分自主编码代理,并在风险、模糊性或合规要求需要时进行适当的验证、可审计性和监督。

就诊后,系统对收件箱进行分诊,管理处方续药,并确保清洁的索赔发送给付款方。所有这些都在保持对推理和所采取行动的可见性的同时发生。

让合作伙伴对结果负责

向集成行动系统的转变可能具有高度变革性。当一个组织将整个患者旅程(包括增加摩擦的行政任务)连接到单一编排层时,可以实现复合价值。但医疗健康组织不能盲目采用承诺价值却未将问责制纳入计划的创新模式。

在以价值为基础的护理和与结果挂钩的绩效世界中,太多的医疗技术和服务模型仍然奖励供应商活动而非客户成果。这种冲突在当前环境下毫无意义。当供应商薪酬与收入表现和运营改善挂钩时,激励开始与医疗健康组织最需要的结果对齐。这就是使转型可持续的原因。连接的工作流程创建了运营模式。可解释AI使该模式可信且可扩展。负责任的合作伙伴关系确保工作带来可衡量的价值。

我们行业的智能层已经成熟,但很明显,医疗健康不能仅仅通过向问题投入技术来超越系统性压力。如果没有连接的运营环境和为结果负责的合作伙伴,即使最先进的AI模型也难以带来可衡量的收益。医疗健康现在需要的是一个连接的、深度集成的行动系统,与记录系统配合,在整个企业中完成任务,并由愿意为其创造结果背书的负责任合作伙伴支持。然后,医疗健康才能从零散的活动转向可持续的绩效,减少可避免的负担,增强财务韧性,并为每个人创造更好的医疗健康体验。

图片来源:CifoTart,Getty Images Sachin K. Gupta Sachin K. Gupta是IKS Health的创始人兼首席执行官,IKS Health是护理赋能解决方案的全球领导者。Gupta于2007年创立IKS Health,并开创了其成为美国领先护理赋能平台的道路。凭借Gupta的创业精神、高管敏锐度和战略愿景,IKS Health已发展到12,000多名员工,服务超过600家医疗健康组织。Gupta继续引领组织走向快速增长和成功,包括于2024年12月在印度国家证券交易所将IKS Health上市。

原文6,826 字符

​Every day, healthcare teams are left to complete work across systems that were never designed to work together. They chase the next step, correct errors, close gaps, and keep care moving through a maze of disconnected workflows. Healthcare has an unfinished work crisis, one that is driving clinical burnout and costing the United States nearly $1 trillion a year in administrative overhead.

Research from McKinsey and analysis in the

Journal of the American Medical Association confirm that approximately $265 billion of this waste stems from entirely redundant processes. We’ve spent two decades allocating billions to digital transformation and various iterations of AI, but the administrative burden on clinicians and back-office teams remains at an all-time high.

For distressed healthcare organizations, the way forward is not another disconnected tool. It requires three shifts:

Build a deeply integrated system of action to complete the work.

Utilize explainable glass-box AI to make action trusted, auditable, and accountable.

Work with accountable partners who deliver outcomes, not just software.

The relationship between the system of record and the system of action

As health technology consolidates, the need for a new infrastructure is clear: an AI-driven orchestration layer built on a system of action. The healthcare IT stack relies on electronic health records (EHRs), which were designed for billing and compliance. While EHRs support patient care, they commonly lack advanced AI capabilities and struggle to keep pace with innovation, creating a gap between AI models and clinical practice. AI needs a robust infrastructure and workflows to operate safely and effectively. Without trusted integration from the system of record, even advanced AI models risk becoming irrelevant or compromising patient safety.

Building this key layer doesn’t require dismantling current EHRs or legacy infrastructure. A system of action can wrap around existing systems and turn disconnected databases into active operational engines. The more powerful future state, though, is a connected model where the system of record and the system of action coexist, continuously exchanging data, context, and outcomes. In this model, the system moves from data to action to outcome, then to continuous improvement, with explainable AI and human intervention when accountability matters most.

This deeply integrated system of action means uniting operational, technological, clinical, and financial tasks as an intelligence layer that changes how administrative and operational work gets distributed across the enterprise. It is a structural delegation of the friction that currently buries clinicians and staff in administrative tasks. While this architecture lets teams finally operate at the top of their license, its true value is deeper. It introduces systemic accountability, with the technology itself responsible for carrying out the work until it is completed.

The AI ROI paradox and why explainable AI makes a difference

We have achieved unprecedented access to clinical insights using Gen AI and sophisticated analytics. However, a new study from Oliver Wyman reports that while 63% of providers surveyed use advanced AI/automation in some capacity, only 20% to 40% use these tools enterprise-wide. AI can summarize, predict, recommend, and flag, but people still have to validate the output, route the task, correct the record, and make sure the work is completed.

This is where explainable AI (XAI) can make a difference. Unlike black-box systems that produce outputs without a clear reasoning path, XAI makes recommendations transparent, traceable, and auditable. In healthcare, it’s important that leaders and care teams understand how an answer was derived, what data informed it, where uncertainty remains, and when human assessment should be applied. This allows connected AI-driven workflows to be trusted, monitored, improved, and scaled.

When explainable AI is embedded into a connected system of action, intelligence can move across the patient journey with increased confidence and accountability, and complete the work. The value lies in making sure the action can be understood, acted on, monitored, and improved over time.

For example:

The connected system begins by extracting data from external documents to create a patient history while simultaneously verifying insurance and financial clearance.

During the encounter, ambient listening documentation is directly fed into partially autonomous coding agents, with appropriate validation, auditability, and oversight when risk, ambiguity, or compliance requirements require it.

After the visit, the system triages the inbox, manages prescription refills, and ensures clean claims are sent to payers. All of this occurs while maintaining visibility into the reasoning and actions taken.

Hold partners accountable for outcomes

The shift to an integrated system of action can be highly transformative. When an organization connects the entire patient journey, including the administrative tasks that add friction, into a single orchestration layer, compounding value can be realized. But healthcare organizations cannot blindly adopt innovation models that promise value without building accountability into their plans.

In a world of value-based care and outcome-linked performance, too many healthcare technology and services models still reward vendor activity more than client outcomes. This conflict makes no sense in the current environment. When vendor compensation links to revenue performance and operational improvement, incentives begin to align with the outcomes healthcare organizations need most. This is what makes transformation sustainable. Connected workflows create the operating model. Explainable AI makes the model trusted and scalable. Accountable partnerships ensure that the work delivers measurable value.

The intelligence layer of our industry has matured, but it’s clear that healthcare cannot outrun systemic pressures by simply throwing technology at the problem. Even the most advanced AI models will struggle to deliver measurable gains without a connected operating environment and partners held accountable for results. What healthcare needs now is a connected, deeply integrated system of action that works with the system of record to complete work across the enterprise, supported by accountable partners willing to stand behind the outcomes they create. Then healthcare can move from fragmented activity to sustainable performance, reducing avoidable burden, strengthening financial resilience, and creating a better healthcare experience for everyone.

Picture: CifoTart, Getty Images Sachin K. Gupta Sachin K. Gupta is Founder and Chief Executive Officer of IKS Health, a global leader in care enablement solutions. Gupta founded IKS Health in 2007 and has pioneered its emergence as the leading care enablement platform in the United States. Fueled by Gupta’s blend of entrepreneurial spirit, executive acumen, and strategic vision, IKS Health has grown to 12,000+ employees, serving more than 600 healthcare organizations. Gupta continues to steer the organization toward rapid growth and success, including taking IKS Health public in December 2024 on the National Stock Exchange of India.

Gupta believes IKS Health serves as an accountable advisor to healthcare organizations, guiding them through the complexities of modern healthcare in order to achieve sustainable growth. His priorities include delivering a comprehensive care enablement platform that combines pragmatic AI-driven technology with dedicated expertise to alleviate administrative, clinical, and financial burdens, helping clinicians and staff to focus on delivering high-quality patient care.

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原始信源MedCity News