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The responsible use of AI in healthcare

Health Plans

The responsible use of AI in healthcare

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      The modern front door to healthcare is just one click away

      KEY TAKEAWAY

      AI streamlines healthcare access, accelerates treatment planning, and lowers operating costs for payers and health systems. In a recent survey of American healthcare systems, 100% of respondents said they already use AI to manage medical documentation. 

      While AI is an effective tool with numerous medical applications, it must be used responsibly to ensure positive patient outcomes and shield healthcare organizations from liability.

      AI applications in clinical operations

      Counsel’s responsible approach to AI starts from the bottom up. Our platform is built and trained solely on verifiable, trustworthy resources, including:

      • Peer-reviewed medical guidelines
      • An approved list of reliable sources
      • Clinically validated protocols

      The result is an intelligent, robust medical AI platform focused on quality of care, accuracy, and regulatory compliance. 

      To implement effective AI safety guardrails, solutions like Counsel leverage a multi-agent framework combined with physician oversight.

      In order to safely and effectively answer a range of user health queries, medical AI systems Counsel use approaches such as task-specific agents, oversight agents, and counsel-of-experts. Agents used to triage care include:

      • A context-retrieval agent reviews a patient’s relevant medical history, lab results, prior conversations, medications, and more.
      • An emergency detection agent then uses this information to determine whether a patient should go to the emergency room.
      • A doctor de-escalation agent then determines if a patient should seek in-person care.
      • A history taking agent then responds to the patient with initial guidance and collects any additional information needed before recommending connecting with a physician.

      The contextualization from the context-retrieval agent mirrors the way medical professionals approach diagnoses, yielding more informed and actionable insights for both physicians and patients. Specifically, these insights help formulate an effective care plan that aligns with the patient's overall health and needs.

      Automatic, detailed insights likewise optimize clinical workflows for physicians and other medical professionals. This information is surfaced to providers through Counsel’s Clinician Cockpit, a proprietary EHR. While Counsel handles the majority of patient concerns without escalating to a human provider, The Clinician Cockpit displays a summarized, accurate snapshot of a patient’s medical history, expediting decision-making and care when a licensed physician is needed.

      These analytical insights and tools further improve patient care by enhancing diagnostic precision. This represents just one responsible use of AI in healthcare, but many more are expected to emerge as technology continues to develop. With Counsel, all AI usage is governed via professional medical oversight, meaning only applications that benefit patients, physicians, and payers make their way onto the platform. 

      These features enable continuous, scalable virtual care, reduce the burden on busy emergency rooms or urgent care centers, and maintain regulatory compliance within a shifting AI landscape.

      Governance and compliance frameworks for AI

      Counsel’s multi-agentic framework enhances platform security, especially for enterprise organizations. By leveraging different AI agents, Counsel more closely and accurately adheres to patient care guidelines and regulatory frameworks. Several independent safeguard agents run in every member interaction, ensuring every exchange meets clinical, legal, and enterprise-level standards for safety and compliance. 

      In addition to AI guardrails, Counsel maintains strict adherence to:

      • The Health Insurance Portability and Accountability Act (HIPAA): HIPAA is perhaps the most prominent and far-reaching regulatory framework in the healthcare industry. It’s designed to safeguard Protected Health Information, a major concern for AI platforms, as fault for data breaches and leaks falls on healthcare organizations. Counsel maintains HIPAA compliance to shield users against persecution, fines, and reputational damage.
      • System and Organization Controls (SOC 2): SOC 2, a product of the American Institute of Certified Public Accountants, outlines organizational standards for data integrity, confidentiality, and reliability. It outlines effective security protocols, allowing users to feel secure when outsourcing operations and providing sensitive information to third parties. Counsel maintains SOC 2 compliance by upholding strict security practices across the platform.

      Counsel also employs clinician supervision on every patient interaction to ensure reliable security. Healthcare organizations are obligated to uphold a minimum standard for care quality. While Counsel AI can assess patients and respond to their inputs, it can’t resolve every medical query a user may have. 

      Counsel’s clinician oversight maintains both patient safety and legal defensibility. In uncertain situations, the platform defers to a real doctor for further assessment and analysis. This prevents automated misdiagnoses and upholds the quality of care, enabling organizations to responsibly utilize medical AI without concern for regulatory non-compliance. 

      Benefits of using responsible medical AI to drive your innovation strategy forward

      Healthcare organizations worldwide are reaping the benefits of responsible AI integration. Two-thirds of physicians already use AI for tasks like:

      • Medical documentation
      • Creating discharge instructions and care plans
      • Translation
      • Medical research summaries
      • Assistive diagnostics 
      • Chart summary generation
      • Patient communication
      • Treatment recommendations

      By automating part or all of these tasks, healthcare organizations can improve network efficiency, save on operational costs, and free up more time to commit to patient care. 

      In fact, by handling patient correspondence and initial assessment, Counsel has helped healthcare organizations:

      • Improve resolution rates without escalation: Counsel resolves 96% of patient issues without escalation or claim submission. Fewer claims and clinical consultations mean lower operational costs for payers. In addition, doctors don’t spend as much time dealing with less complex issues, allowing them to commit more energy to difficult conditions or patients that require their expertise.
      • Replace nurse lines and other telehealth services: Modern AI’s capabilities rival the care patients receive from nurse lines. Over three-quarters of callers only need a review or verbal advice when they phone in, which advanced AI platforms can now replicate. With AI adoption rapidly rising, the cost savings, versatility, and immediacy of automated systems pose a serious challenge to the continued use of nurse lines and similar telehealth services.
      • Reduce unnecessary Emergency Room (ER) visits: Intelligent, capable healthcare AI leads to more accurate diagnoses and care plans, boosting patients’ peace of mind and trust in medicine. When patients trust their platform, diagnoses, and treatment, they’re less likely to rush to the ER and more likely to follow their care plans. Patients’ satisfaction and trust in Counsel reduces ER visits by 24% versus regular, consumer-facing AI tools.
      • Minimize healthcare costs: Clinical space, staff salaries, and medical resources are all costly, especially when they’re unnecessary for diagnosing and treating patients. By automating assessment and care plans for less complex conditions, you reduce medical payments, lower operational costs, and free up clinical time for patients who need it.
      • Enhance member experiences: 64% of patients wish healthcare providers took more time to understand them. 66% feel they're more rushed than in the past, and only 10% of patients give their healthcare experiences an A grade. Doctors often do not have the time to fully address a patient’s concerns, but AI isn’t bound by human limitations. 

      The upsides of responsible AI use in healthcare are clear: Lower costs, higher resolution rates, enhanced patient satisfaction, and more. So, how can you implement AI at scale to realize these benefits in your organization? 

      Implementing responsible AI at scale

      Responsible medical AI usage is critical for health plans and health systems. The more patients on a platform, the more opportunities for a data breach, allegations of malpractice, or a HIPAA violation. 

      Counsel’s platform has been designed to deliver:

      • Audit-ready documentation: Counsel’s traceable chain of evidence includes actions, inputs, and reasonings from each patient interaction. This digital paper trail maintains defensibility in case of legal allegations or external audits.
      • Tight security practices: End-to-End Encryption scrambles data sent between your patients and your AI platform. Even if malicious actors are able to intercept it, they won’t be able to make sense of it without the proper key. Other security measures, like Role-Based Access Controls and secure messaging, ensure patient data remains within privileged parties, and every interaction is with an approved representative.
      • Physician oversight: With clinical supervision available for every interaction, patients can rest assured that the diagnoses and care plans they receive are based on accurate, trustworthy medical advice.
      • Continuous monitoring: Counsel routinely asks our physicians and partners how to improve and further align the platform with medical best practices. Similarly, Counsel keeps an eye on advancements in AI security and hacking techniques to ensure the latest, most robust protocols are in place.  

      These safeguards enable healthcare organizations to scale their operations to meet patient demands, regardless of their size. 

      Leverage AI responsibly and with confidence

      With Medical AI from solutions like Counsel, organizations can expand access to care cost-effectively.

      The added benefit from partnering with Counsel as a payer is the ability to deploy its platform via an embedded, white-labeled option. Counsel fits into any portal or member applications, enabling brand continuity while extending clinical workflows and enterprise healthcare platform capabilities to any organization.

      Partner with Counsel to bolster your patient experiences with the power of medical AI.

      The modern front door to healthcare is just one click away

      Sources
      Counsel Health Editorial Team
      Counsel Health Editorial Team

      The Counsel Health editorial team is a multidisciplinary group of writers and editors dedicated to delivering clinically grounded, evidence-based health information. Their work is informed by real-world care delivery and guided by physician expertise, ensuring content is accurate, accessible, and trustworthy. By translating complex medical topics into clear, practical guidance, the team helps readers understand their health, explore care options, and make informed decisions in a rapidly evolving healthcare landscape.

      Counsel Health Editorial Team
      Dr. Cían Hughes
      Chief Scientific Officer

      Dr. Cían Hughes is a physician-scientist with over a decade of experience in health AI research. He began his career as an academic surgeon and, in 2015, joined Google DeepMind as its first Clinical Research Scientist, helping to found the DeepMind Health team. Prior to DeepMind, he was an NIHR Academic Clinical Fellow in Otolaryngology at University College London, working across the UCL Ear Institute and the Farr Institute while maintaining clinical practice.

      Our content is created for informational purposes and should not replace professional medical care. For personalized guidance, talk to a licensed physician. Learn more about our editorial standards and review process.

      Counsel raises $25M Series A. Access now open to all.learn more