AI Could Help Bridge Rural Health Disparities — If Hospitals Plan Now

Pharmacy leaders at small and rural hospitals must decide now how they envision using artificial intelligence (AI) — or risk settling for technology that does little to meet their unique challenges, presenters said at a Sunday session of the 2024 Midyear Clinical Meeting & Exhibition.

“If you aren’t prepared, it’s going to be drinking from the fire hose,” said Kyle Johnicker, pharmacy clinical coordinator at Northwestern Medicine Kishwaukee Hospital in Illinois. “The information is coming whether you want it or not.”

Johnicker was a co-presenter at the session, Do Whatcha Wanna with Artificial Intelligence in Small and Rural Pharmacy, along with Gretchen Brummel, a former pharmacy executive director for a healthcare consulting company and a director at an academic medical center.

One in five people in the United States live in rural areas. More than 20% of counties are hospital deserts, meaning residents must drive more than 30 minutes to reach the closest hospital. And 40 percent live more than a 15-minute drive from their nearest retail pharmacy.

On top of the challenges that patients have in accessing care, rural and small hospitals often struggle to make significant financial investments and could lack the personnel and infrastructure necessary to implement the latest technology, Johnicker said.

His quick Google search of AI implementation costs ranged from $20,000 to $1 million for a plug-and-play system. But for rural and small hospitals, he said, even the lowest end can be a steep investment.

“How do you push forward the future savings and benefits for your department, facility, and patients at the expense of current spending?” he said. “I know we run into that with every program, but AI is going to be another one of those we have to have that level of conversation.”

Brummel said clinicians must play an active role in acquiring and managing AI because many questions remain about safety and efficacy of emerging technologies. She noted that a recent review found only 4% of AI healthcare tools with regulatory authorization had undergone validation through randomized controlled trials.

“We as clinicians really have to raise the bar in terms of validating these tools and asking questions,” she said.

Pharmacists and other providers must also recognize the potential of these tools and find ways to adapt them to their institutions. Brummel described several medical reviews that found existing AI tools were useful in managing such conditions as asthma, diabetes, and hypertension, as well as in helping track drug diversion activities.

Those benefits could help rural areas, which often lack specialist care, she said. The tools’ usefulness in reducing charting time could help small hospitals that lack personnel.

Brummel said she gave her first talk on AI about a year ago. Since then, she noted, participants have heard a great deal about the potential of AI in healthcare. “It does feel like there’s been a lot of talk and a lot of hype, and maybe we haven’t seen as much rolling out to direct patient care,” she said.

But Brummel shared a quote from Microsoft co-founder Bill Gates, who said people tend to overestimate the change that will occur in next two years but underestimate change in the next 10 years.

“Don’t let yourself get lulled into inaction,” she said. “Think more in the long term.”