The AI-powered future is here, and it’s transforming the work of healthcare delivery, education and training. RFU faculty in the College of Nursing and College of Pharmacy discuss how AI is poised to revolutionize their respective areas of clinical practice.

Helix: Rapid technological advancement is driving change in both your fields. How will it impact the way you practice?

Dr. Kane: I graduated in 2010, and around that time, electronic health records (EHRs) started becoming a thing in the hospital setting. On some of my rotations, I had to read physicians’ handwriting, which now seems ridiculous — so many errors are caused by that. EHRs come with challenges but also many opportunities. AI is going to play a huge role with EHRs. The people who program EHR capabilities need to have some sense of the work we do to ensure that the AI-powered components they’re adding make sense, meet our needs and add value or quality to patient care. Conversely, we need to make sure these systems don’t detract from — but rather enhance — the humanity of the provider/patient relationship. We need people who understand how we work, how the technology works and how it can best be implemented.

Dr. Kessler: AI can help us with decision-making or getting us to the right diagnosis or treatment. But the question in psychology is why do people get better with treatment? There seems to be a general factor present that transcends treatment modality and a variety of things. And that seems probably to be the human relationship. AI will sharpen our diagnostic and planning abilities. It will help us select treatments that are appropriate for the particular patient in front of us. But we still have to think about and implement and talk to the patient about those treatments. I don’t think we’re at a point where we just turn a patient case over to the computer and whatever it says, let’s just do. Like the sci-fi movies we watched as kids, where if you were sick you would just submit yourself to a pod. There were no humans in the room. I don’t think we’re ready for that yet. I don’t know if we’ll ever be ready for that. Humans are still needed. The empathy part of the human relationship might be where we’re needed the most, because we can turn some of these other decisions over to far better decision-makers than us humans. AI configurations can process more data than anyone’s brain can handle, put it all together and come up with a diagnosis or plan. And I think, like Sean is saying, somebody’s gotta program that.

Pharmacy automation is expected to double by 2030. What does that mean for pharmacists?

Dr. Kane: The concept of automation itself is not the worrisome thing. It’s the current reimbursement model. It’s a transactional filling fee. If pharmacies are to continue as front-line healthcare delivery, the reimbursement model has to change — and that involves not fee-for-service, but reimbursing pharmacists for the cognitive ability that they’re providing, such as looking for drug interactions or catching a prescribed drug error before it reaches the patient.

In critical care, my practice area, a good number of articles have described the cost benefit of hiring a critical care pharmacist that rounds with the interprofessional ICU team. Studies suggest that every $1 spent on that pharmacist is worth nearly $25 — a savings in potential lawsuits for medication errors or failing to avoid an adverse drug event or drug interaction. There’s similar literature in other areas of pharmacy practice. It’s baffling to me that knowing the value provided, which also includes improved adherence and expanded access to care, many systems don’t reimburse for that service. Since COVID and even before, so many healthcare providers have experienced burnout. Optimizing or improving more mundane tasks with AI could be a big win. If the pharmacy reimbursement model is adjusted, pharmacists would be able to focus their time on high-yield clinical interventions, and companies would be incentivized to encourage tasks that improve patient care. This is not like a zero-sum game. I think everyone can benefit, including the patients.

How are AI and digital innovations making mental health care more effective and accessible?

Dr. Kessler: The shift to telemedicine, pushed forward by COVID, has been transformational. Many therapists are working almost exclusively via that platform. I see all of my pharmacotherapy patients exclusively online. Patients like the convenience. But there are challenges, especially for patients whose resources are limited. You need an internet connection. Another innovation is licensure. You have to be licensed in the state your patient is sitting in, so we’re seeing portable licenses that allow practice in multiple states. There’s also a growing emphasis on pharmacogenomics, which is helping us select the right medicine and dose for the condition and person. We’re able to learn more about how an individual patient processes and reacts to different medications. Hopefully, with AI, we will develop some rubric that shows which is the best treatment for a patient given their particular symptoms, whether it’s talk therapy or pharmacological, or both. We’re also seeing the emergence of text-based or asynchronous therapy. It’s not the therapy that we’re used to, where you go to the office for 45 minutes and you chat back and forth. Instead, you write to your therapist and they respond with answers or tips. And we’re seeing a lot more integration of social media-type things. Very good providers are creating YouTube videos. I often assign those to patients. You have to vet those, make sure you’re not sending them down a rabbit hole or passing along bad information. And more and more people are seeking support through smartphone apps. Just 10 years ago, we were struggling to get telemedicine covered by health insurance. Then COVID forced the issue. And here we are now, where AI and its exponential data capabilities are driving innovation in every area of the patient and clinician experience.

How are we preparing our students in the face of evolving AI?

Dr. Kane: All of the technologies have to be taught to some degree depending on how transformative they are and how likely our students will interact with them. All of our students will need to some degree to be tech savvy and data literate. Data analysis is incredibly important for nearly all areas of pharmacy practice, and AI is actually really good at analyzing data. It can also provide step-by-step instructions on how to write the code to figure out how we analyze the data. Almost every job in the future is going to require some amount of data analysis, whether it’s related to your purchaser, to HR, to patient data — literally everything. We need our graduates to be literate in terms of how they get that data, analyze it, clean it up and perhaps merge different data sets to answer a question. That’s a skill in itself that needs to be taught across the board.

Dr. Kessler: We have to teach students how to bridge both worlds — technology and practice — and how to wrestle with the challenges technology brings. A big one is the risk of bias in the data and algorithms when they don’t represent diverse populations. We have to teach students how to be good consumers and how to maintain professional boundaries, especially with emerging therapies. We can’t teach them every fact. We’ve got to teach them a way of thinking, of questioning: Is this the right thing to do? Let’s take a step back and think about this. AI is bringing us many opportunities for improvement but simultaneously new challenges and issues we have never had to consider before. Students will have to be prepared to think through those issues during their careers.