Healthcare AI for Humans: Governance, Research, and Rights
Data scientist Emily Hadley on navigating AI in healthcare, offering practical advice for maintaining patient agency amid algorithmic decision-making. Summary This interview with data scientist Emily Hadley examines the intersection of artificial intelligence and healthcare through a deeply personal lens. Hadley’s journey began when her own health diagnosis coincided with her graduate studies in analytics, revealing how algorithm-driven systems often affect patient care—especially through insurance claim denials and clinical documentation. The conversation offers practical guidance for patients navigating AI-influenced healthcare, including reviewing AI-generated clinical notes for accuracy, challenging algorithmic insurance decisions, and insisting on human intervention when automated systems fail. Hadley advocates for preserving patient agency and rights within increasingly automated systems while highlighting how algorithm review boards are striving to provide governance in this largely unregulated space. The interview concludes with resources for staying informed about developments in healthcare AI, emphasizing that while AI tools are rapidly advancing, patient advocacy remains vital. Click here to view the printable newsletter with images. More readable than a transcript, which can also be found below. Contents Please comment and ask questions: at the comment section at the bottom of the show notes on LinkedIn via email YouTube channel DM on Instagram , TikTok to @healthhats Production Team You know who you are. I’m grateful. Podcast episode on YouTube No video Inspired by and Grateful to Eric Pinaud, Laura Marcia, Amy Price, Dave deBronkart, Links and references Prompt Engineering Algorithm Review Boards at RTI Dave deBronkart’s Patient’s Use AI Episode Proem This year, I switched from Medicare Advantage to Traditional Medicare. I still needed to purchase a supplemental commercial plan to cover what Medicare Part B didn’t. However, the supplemental commercial plan denied some services the previous Medicare Advantage plan covered. Why? What algorithms did each plan use to determine coverage? How can I manage this? Welcome to the third installment of Artificial Intelligence Can Work for You . We’ve explored how I use AI in my podcast productions and delved into some AI basics with Info-Tech leader Eric Pinaud. I asked Emily Hadley, a data scientist at RTI specializing in AI algorithms for insurance coverage decisions, to join us. Early in her graduate studies, Emily was diagnosed with Crohn’s disease. This led to her interest in studying insurance algorithms. A Data Scientist Awakes Health Hats: How did you gain expertise in AI? Emily Hadley: Great question. I was diagnosed right as I started a graduate program in analytics. In my undergraduate studies, I studied statistics in public policy. I liked the idea of using data to shape how policymakers make decisions, especially in the US. I had done some work with AmeriCorps and then went to grad school to really hone those skills. Being diagnosed at the same time that I was in grad school meant that I was navigating to new, informative, and educational areas. And I think that that’s when I really came to realize the power of data and the power of AI in shaping the way that organizations and people make decisions. We live in a really algorithm-fueled society. We constantly encounter technology and AI systems, even when we don’t realize it. An example I give is that I’ve faced many problems getting insurance to cover the things it is supposed to. I didn’t realize until a couple of years ago that this is due to many insurers embracing algorithm-driven decision-making systems that often automatically deny coverage for services that should be included. Instead, they might say they don’t cover it because the appropriate code was not included when billing. So, the provider claims, ‘ Oh, we don’t cover that because the code was missing, ‘ even though it should have been included. I f