How AI can play a major role in navigating the Silver Tsunami
Healthcare organizations need to harness technology to prepare for the influx of America’s aging Baby Boomers into the healthcare system.
Demographic shifts have an outsize impact on healthcare, and few shifts are more dramatic than what has come to be known as the Silver Tsunami – the arrival of America’s 73 million Baby Boomers to geriatric care. There are almost 10,000 Baby Boomers turning 65 every day, and healthcare must be prepared to receive an increasing group of elderly patients with chronic conditions.
Further, AVIA's proprietary analysis of demographic and Truven disease prevalence data indicates that the middle tier of disease burden (stable chronic and progressive multi-chronic), which constitute 15 percent of those populations now, will nearly double in size to 28 percent. In other words, not only will the geriatric population grow by 44 percent, it will be sicker than it has ever been.
Luckily, the arrival of artificial intelligence (AI) and related technologies such as robotic process automation (RPA) has considerable potential for closing the gap.
Closing the capacity gap
Because the Baby Boomers may have a higher life expectancy than previous generations, the concomitant increase in long-term chronic conditions such as obesity, diabetes and COPD will threaten capacity to an even greater degree. These conditions already represent 86 percent of all healthcare spending in the U.S., presenting new and complex challenges for every level of the healthcare system, even as it now exists.
The need to dramatically increase capacity to address this will be no small feat to accomplish. In fact, there is literally no way to do so under current models of care delivery. There will be a shortage of more than 3 million healthcare workers by 2026, according to the American Hospital Association, and raw demographics indicate that the labor pool in general will shrink by almost 30 percent by 2033.
There are only two ways to address this rising demand with a shrinking workforce. The first involves changing how care is delivered, who does it and where it’s done. The second approach is to use advanced technology to augment what only humans can do, and automate what they don’t need to. The synergy between these two approaches will be essential to the solution.
To be clear, this does not involve replacing the clinical front line with robots. Providers are already under-resourced with humans, leading to burnout, attrition and rising costs, and the demand curve discussed above will drive the need to retain and grow the clinical workforce even more. Rather, an effective solution involves elevating what decision-makers and hands-on caregivers do while reducing the substantial drudgery currently being experienced.
There are many ways in which AI-enabled automation and tools offer enormous potential for reducing the workload of individual caregivers and thereby increasing meaningful capacity. But while there will initially be some easier wins, the full promise of technology will be achieved only if we are also prepared to address care model transformation with agility.
At the less ambiguous end of the adoption curve is the potential of ambient documentation. A 2016 study in the Annals of Internal Medicine found that ambulatory physicians spend nearly 50 percent of their time on paperwork, including time working in an EMR — twice as much time as they spent interacting with patients. Ambient voice technology using natural language processing (NLP) and generative AI will soon be used to generate documentation in real time during patient interactions, structuring conversational interactions into essential forms and metrics, and intelligently suggesting appropriate coding.
For acute nurses and other front-line clinicians, multiple studies have shown that as much as 37 percent of tasks could be automated, and that both vocal and visualized activity can be captured on the hospital floor as easily and accurately as it is done now in manufacturing. Because documentation activities are also a leading cause of doctor burnout, this sort of AI-enabled automation also will have the side-effect of increasing job satisfaction and reducing turnover.
Navigating complex care
But caring for a senior population is not just about documentation; it also presents challenges in care coordination and patient communication outside the hospital and clinic, and is another area where AI could soon be able to help.
Managing an interdisciplinary care team across multiple environments, including the home, is essential for positive geriatric care outcomes, but larger care teams place additional burdens on providers, patients and families. Providers must devote time and attention to the actual coordination of cases, while patients and families must navigate the complexities of engagement with a shifting team of professionals.
For providers, AI-enabled tools soon will make it possible to intelligently surface and prioritize key information from disparate care team members and other sources quickly and accurately, to notify physicians of potential diagnoses, risks and opportunities in real-time, enabling them to respond to evolving clinical challenges earlier and more effectively communicate with the rest of the care team. This will make interdisciplinary coordination across large care teams faster, easier and more effective, while improving patient experience and reducing risk.
For patients and their families, AI-enabled personalization of care journeys holds enormous promise for simplifying the vast complexity of modern American healthcare. More than 60 percent of Americans report that the healthcare system feels “designed to be confusing,” according to a poll commissioned by Change Healthcare, and the challenges in navigating a potentially bewildering array of specialists, appointments and tests can place an even greater burden on senior patients and their families.
AI-enabled capabilities could make it possible to proactively offer scheduling options personalized to a patient’s particular availability, communicate outcomes and updates more intelligently and accessibly, or even recommend transportation, translation and other collateral services to help patients stay on top of their care, all based on their individual needs.
The horizons of digital care
Virtual care and telehealth have grown sharply in the past several years. A 2022 poll conducted by PYMENTS found that 46 percent of healthcare consumers use at least one in-person and one digital healthcare experience each month.
In addition to augmenting and improving traditional modes of care, AI may soon be an integral part of these emerging digital care experiences. Such experiences are becoming increasingly essential to caring for senior patients, especially as 93 percent of seniors express an interest in “aging in place,” rather than transitioning to dedicated care facilities such as nursing homes.
Today’s seniors are more technologically savvy than ever before, with 62 percent of people age 70 and older now owning a smartphone. Additionally, the use of telehealth visits among seniors has grown to 21 percent as of 2022, up from just 4 percent before the COVID pandemic.
AI-enabled “digital front doors” can help seniors better understand when and how to access virtual care, guiding them to the services that can best serve them while personalizing their experience and ensuring that their treatment remains well-integrated with their typical care team, remote monitoring and patient education. AI-enabled capabilities in virtual care tools already help virtual nurses and other caregivers increase their efficiency and impact while reducing burnout, just as they can for in-person care.
Digital geriatric care
The capabilities of AI and related technologies offer enormous potential to transform the face of geriatric care and open a healthcare future that is paradoxically more human, more efficient and more effective for today’s senior patients and for those of tomorrow.
But creating “solutions” using these technologies will require far more than technology adoption – it will require that healthcare systems prepare to absorb more change over the next 10 years than they have over the past 50 years; the skills, processes and cultures of these organizations must transform to fully exploit the promise of the technology as it evolves.
The path to a digitally enabled future for the patients of the Silver Tsunami is not an easy one. But by using AI with an agile, innovative spirit, the industry has the opportunity to not only democratize excellence broadly, but to create more patient-centered and equitable health systems of the future.
Scott Cullen, MD, is executive vice president of strategic innovation and chief clinical officer for Avia.