GenAI and Patient Choice: A New Era of Informed Healthcare

By Dr. Peter Bonis and Dr. Jim Weinstein

Health insurance premiums are expected to increase close to 6% in 2025, adding further pressure on employers and consumers. While healthcare was not a key topic in the last election cycle, consumer frustration with health services delivery may drive the new administration to examine ways to improve the consumer experience while reducing costs. This begs the question, what are the best ways to trim costs and improve quality—and can you successfully do both?

U.S. healthcare is a $4.5 trillion industry with at least 25% of spending considered to be wasted on costs that do not directly translate into better care. The waste comes in different buckets such as improper care, overtreatment, poor care coordination, noncompetitive pricing, administrative complexity and fraud and abuse. Ideally, the waste could be extracted and turned into better, cost-effective, and less frustrating care.

Informed choice, unlike informed consent, considers a given patient’s values and preferences in their care/treatment decisions. By better informing patients of their options leveraging emerging technology, healthcare organizations can begin to trim unnecessary spending and improve healthcare experiences to help achieve the triple aim of healthcare.

Streamlining care delivery starts with covering the right care

That goal has been elusive. Care delivery is filled with well-intentioned people, yet at its core, it is a big business. Meaningful change occurs when a business model aligns with clinical and financial goals, gaining enough momentum to overcome commercialization barriers like inertia, competition, and workflow integration.

New, advanced technology such as generative AI (GenAI) provides novel opportunities to achieve those objectives. While there is a target-rich landscape for improvement, the spoils will belong to the entrepreneurs who find the happy nexus between better care and a business model that is sufficiently compelling to permit the new approaches to muscle their way into the machinery of existing care delivery models and money-flow. With discussions already underway on potential changes to payment models, Medicare coverage and value-based care, now may be an opportune time for technology adoption amid this disruption.

Empowering patient choice with GenAI

Here is one such opportunity. Unwarranted care variation has been documented for more than 50 years. It means that the care you receive varies depending on where you live, who you see, your race, and many other factors that no one would wish has an influence on clinical decision-making.

Rates of back and joint surgery, for example, vary substantially across geographies in the U.S. And what’s interesting is people who are well-informed about options for management more often choose non-surgical options compared with less informed people. Many organizations have advanced tools to help with shared decision-making, but the problem persists.

Generative AI (GenAI) has the potential to significantly enhance the way patients make decisions about their healthcare. Traditionally, patients give “informed consent,” which means they agree to a treatment after being informed about its risks and benefits. However, this process can sometimes be limited in scope and understanding.

With GenAI, the concept shifts to “informed choice,” where patients are provided with more comprehensive, personalized, and easily understandable information. This allows them to make more informed and autonomous decisions about their healthcare options.

GenAI can use chatbots, AI-derived multimedia, and analysis of large data sets to deliver tailored information that respect factors like education level and language, helping patients understand their choices and likely outcomes better.

Bringing promise to reality

GenAI is already transforming our daily lives: from how consumers search for information on Google to quick summaries of work meetings and even generating grocery lists. What’s to stop it from bringing this same ease to the complexity of informed consent?

While it sounds promising, it’s much easier said than done. However, organizations and entrepreneurs bold enough to tackle the complex challenges of healthcare delivery can help achieve better and more equitable care for everyone and potentially reduce wasteful spending.

With the right guardrails in place, essentially ensuring these platforms are only leveraging evidence-based information that has been clinically vetted, we have the potential to improve patient comprehension of their health. This will lead to better outcomes and lower cost, consistent with informed patient preferences.

Dr. Peter Bonis is Chief Medical Officer of Wolters Kluwer Health and Adjunct Professor of Medicine at Tufts University School of Medicine. Dr. Jim Weinstein is Head Global Access and Equity at Microsoft. He was formerly CEO of Dartmouth Health, the Inaugural Director and Peggy Thompson Chair of the Dartmouth Institute, and Professor at Dartmouth and Clinical Professor Northwestern University (Kellogg School of Management).