Automation is threatening jobs in some industries. Is health care next?

Topics: Providers, Hospitals, Public Health, Health Information Technology, Electronic Health Records

By Joe Infantino, senior staff writer

Automation is slowly gaining steam in the health care industry—but some experts say that, unlike in other sectors where it has resulted in job losses, health care providers don't have much to worry about. In fact, at least one expert said automation could open up new health care jobs.

"While automation makes health care positions more efficient and care of the patient safer, it will never be able to substitute for the professional judgment of providers or [fully] fill a shortage," Amey Hugg, director the American Society of Health-System Pharmacists' Section of Pharmacy Informatics and Technology, said. She added, "The highly skilled [health IT] workforce now includes and must include those with clinical expertise."

Automation is here, and it's costing jobs—in some industries

Automation is happening now, and it grabbed the attention of former President Barack Obama's administration, which in its final months warned about the potential effects of artificial intelligence (AI) on U.S. employment.

A White House report released late last year cautioned that AI could lead to millions of job losses, disproportionately affecting less-educated workers. That could widen the economic divide between socioeconomic groups, the report warned.

But while automation is killing some jobs, it's also a major factor in improving the efficiency of the U.S. economy. According to the White House report, automation is making "positive contributions to productivity growth."

How automation is used in health care

In health care, the focus of automation is on boosting efficiency and lowering costs, Mark Gaynor, a professor of health care management at Saint Louis University, told American Health Line. Another often-cited focus is addressing physician shortages.

Automation doesn't necessarily mean seeing robots at your next visit—although in some cases, it can. In Canada, Humber River Hospital has employed robots to complete a range of tasks from delivering medical supplies and food to patients to administering chemotherapy drugs.

In some cases, such as at the University of California at Los Angeles, automation technology is being used to supplement the provider services. While clinical decision support tools are becoming commonplace in electronic health records, Kevin Seals, a resident physician in radiology at UCLA, told Hospitals & Health Networks the hospital is the first to harness AI to create a "chatbot" virtual consultant who can respond to a clinician's question regarding patient care via text message.

As another example, of AI in health care, Charles Koontz, president and CEO of GE Healthcare IT and chief digital officer of GE Healthcare, in an interview with Becker's Health IT & CIO Review pointed to work by GE Healthcare and the University of San Francisco. There, he said, researchers are "developing a library of deep learning algorithms," such as one that screens X-rays for a collapsed lung, or pneumothorax, to help "hospital workers quickly identify the presence of pneumothorax and alert the radiologist to prioritize the read in the worklist queue."

But automation also can be as low-tech as a checklist that appears on a doctor's computer and prompts them to go through certain steps during a visit—a valuable tool when thousands of patients annually are harmed by avoidable medical errors, Gaynor said.

Automated systems even are helping the shift to pay-for-performance models, Gaynor said. Now that hospitals have EHR systems that can collect information and look at outcomes on an aggregated basis, the data are being used to determine whether providers are meeting quality metrics and thus help determine their payments.

For consumers, automation could be a scale that automatically records your weight information in your EHR so your doctor can better identify health trends.

"Technology and automation in health care are wide-ranging depending on the place of practice. Therefore, there are thousands of examples," Hugg said. In the pharmacy setting, she noted, automation can be applied to communication systems, electronic-prescribing, and dispensing, to name a few.

The next wave of automation and its effect on health care jobs

While there is clear evidence that AI and automation are being adopted in the health care industry, experts predict that use will increase in the coming years.

Greg Kuhnen, senior director of Research at Advisory Board, which publishes American Health Line, told Becker's in the next few years, "[w]e expect AI agents to be deployed as integrated assistants suggesting diagnoses; tailoring order sets to a patient's unique circumstances; projecting risks and potential interventions; and taking over laborious patient monitoring and data interpretation tasks entirely."

McKinsey estimates that about 36 percent of the health care industry has the technical potential for automation, though that potential is lower for health care professionals whose clinical expertise are needed in their daily interactions with patients. Looked at another way, McKinsey estimated that less than 30 percent of a registered nurse's daily activities could be automated, compared with 13 percent of a dental hygienist's daily activities.

But that doesn't mean those workers will become obsolete, if anything, experts predict that AI will supplement rather than replace workers in the health care industry.

That's because errors are inevitable, and the industry is "always going to need a human being who has expertise in the area" to prevent them, Gaynor said.

"It may not be often, but machines can just be so drastically wrong," he said. In cases when an automated system "makes an egregiously wrong diagnosis, you'll need to have somebody there to catch it," Gaynor said.

And while some industry experts warn that automation will ultimately cost thousands of health care jobs, Hugg suggested that automation might even be increasing the number of health care jobs—and also shifting the skills employers are seeking. For example, she said clinical informatics positions are growing as the industry works to ensure that automated systems "are appropriately functional."

Regarding students at SLU, Gaynor said, "Our students get jobs." He added, "They get a masters in health administration, and they get jobs. I think the market is good out there."

* Editor's note: This story was updated Jan. 10, 2018