More than AI: How human-in-the-loop connects healthcare

Healthcare teams are under pressure, from handling administrative backlogs to the increasing demand to provide better outcomes for patients with fewer resources. While AI has advanced rapidly, many organizations are still figuring out how to apply it in ways that truly move the needle. 

One proven approach provides a stepping stone to AI adoption: human-in-the-loop (HITL) is a model where AI supports, rather than replaces, operational decision-making. It helps build trust, enhance accuracy, and drive real-world impact as the healthcare industry gets more comfortable with AI adoption. 

In this blog, we’ll take a closer look at how HITL is providing value to AI’s role in healthcare, and how it’s helping to build healthcare’s workforce of the future. 

Why healthcare keeps a human-in-the-loop

Human-in-the-loop isn’t a new concept, but its application in healthcare has leaders talking as they explore AI use cases. 

HITL refers to a model where AI Agents automate parts of a workflow, but humans remain involved at key decision points or for validation. This approach:

1. Ensures data and decision accuracy, 
2. Increases trust in automation, and 
3. Allows staff to focus on high-value tasks while AI handles repetitive work.

HITL helps healthcare organizations scale operations while building trust in AI technology. Health systems are already seeing real-world impacts using HITL in the authorizations process, insurance verification, and patient engagement.

Automation streamlines prior-authorizations

Medicare Advantage Insurers made nearly 50 million prior authorization determinations in 2023. Virtually all enrollees in Medicare Advantage (99%) are required to obtain prior authorization for some services, most commonly inpatient hospital stays, skilled care facility stays, and chemotherapy. 

However, slow turnaround times and errors due to manual submission can cause delays and network leakage, which disrupts care continuity and results in lost revenue for hospitals and health systems. A smooth authorization process is essential for both patient satisfaction and the bottom line. 

An automated authorizations process can handle straightforward, non-clinical authorizations without human interaction, but can keep a HITL for more complex authorizations that require a clinical justification before approval, such as surgeries, advanced imaging, or specialty treatments. 

At Notable, this process involves utilizing an AI assistant tool that generates responses to payer questions and analyzes data to compile clinical documentation packets, reducing staff workload by over 50% and ensuring accurate responses to payer inquiries. Overall, using AI supported by a HITL for complex authorizations reduces denials and facilitates quicker access to vital care for patients.

Fort Healthcare achieved a success rate of 91% for prior authorizations submitted using AI, saving 15 minutes per successful submission. 

AI transformation in healthcare’s front office

Patients rely on their provider’s office to check benefits, help with registration, and answer questions throughout their care journey. While these are straightforward tasks, with limited staff and growing coordination demands, these requests can pile up into unmanageable workloads. 

AI Agents can handle a wide range of time-consuming, repetitive front-office tasks like patient registration and appointment reminders, leaving a HITL to step in when handling key details that may affect eligibility or access to care.

Here’s what that looks like in action:

1. Ahead of a patient’s appointment, an AI Agent pre-fills patient details and verifies coverage using structured and unstructured data sources. Patients can quickly review their information, confirm its accuracy, and complete registration when it is most convenient for them.
2. A human staff member reviews flagged discrepancies or missing information before finalizing the patient's registration.
3. The patient walks into their appointment with no front desk wait time and the comfort of knowing their appointment is within their insurance coverage. 

By augmenting its workforce with automation, MUSC Health has reallocated over 1,300 hours per week to higher-value patient care tasks. Its digital registration process has helped drive 98% patient satisfaction since it was implemented. Automating workflows, but keeping a HITL, has been a win for both staff and patients at the academic medical center.

Maintaining the human element in AI communications 

AI Agents can manage routine patient interactions, such as appointment reminders, registration intake, pre-operative instructions, and post-visit surveys. They can communicate with patients in their preferred language and channel, whether that’s SMS, phone call, or web portal. AI Voice can even outperform humans in many aspects, such as handling queries that span departments without having to transfer callers. 

But what happens when communications trigger escalations? 

When a patient responds to automated outreach concerning their symptoms or a negative experience, keeping a human on standby for intervention offers timely, personalized support. It bridges the gap between automation and trust in connected care. 

For example, an AI Voice Agent might handle a patient’s appointment scheduling, payment for an outstanding bill, and medication refill in a single call, but will transfer the patient to a member of human staff if they have a complex or urgent medical inquiry that requires clinical judgement or immediate attention, or if they express dissatisfaction or confusion on the call and ask to speak with a person.

Human-in-the-loop strikes a balance in AI innovation 

Providers have made some progress toward adopting AI technology as they continue to see the benefits of automation in action. Those who lean into innovation are achieving two milestones for patient care: simpler pathways to patient access and a smoother, more meaningful patient experience. And those who don’t? They risk falling behind as innovation pushes the industry forward. 

HITL does more than modernize how clinicians work with their healthcare partners. It fast-tracks automation progress that has stalled for decades. 

Ready to unlock the possibilities? Get in touch today.