Transforming Utilization Management: HL7 FHIR and Generative AI
Transforming Utilization Management: HL7® FHIR® and Generative AI - AHIP
AHIP hosted a webinar to examine the operational challenges and administrative burden in Utilization Management using FHIR and Generative AI.
Summary
This webinar addresses operational challenges and administrative burdens faced by health plans, exploring how new technologies like HL7 FHIR-compliant APIs and generative AI can modernize complex utilization management workflows while supporting compliance with evolving regulatory requirements such as CMS-0057-F.
Key Players
Details
The session examines the operational challenges and administrative burden facing health plans today. Emerging technologies—including HL7 FHIR-compliant APIs and generative artificial intelligence—offer new opportunities to modernize complex utilization management workflows, ensuring support for evolving regulatory requirements like CMS-0057-F. The discussion will cover practical strategies for meeting the forthcoming Prior Authorization API mandate, including implementation timelines. Furthermore, it addresses the capabilities and limitations of large language models (LLMs) and outlines MCG Health’s strategic approach to developing responsible, scalable generative AI solutions. Attendees will learn about necessary components for the CMS-0057-F mandate, how LLMs can streamline utilization review, and methods for integrating clinical expertise into generative AI to enhance accuracy.
Technology Note
FHIR（Fast Healthcare Interoperability Resources）は医療データ交換の国際標準。このエントリの関連技術: HL7
Original content copyright by respective publishers