At a Boston Consulting Group (BCG) event in San Francisco during the JPM Healthcare Conference taking place this week, panelists discussed the government's role in advancing AI technology and government oversight of the technology with the changing administration. 

Micky Tripathi, assistant secretary for technology policy, national coordinator for health IT and chief AI officer for the U.S. Department of Health and Human Services (HHS), who will hold the role until noon on Monday when the Trump administration will take over, said health information technology has been a decade-long journey we have been on in the U.S. 

"Ten to 15 years ago, there was very low adoption of electronic health records, so we had a paper-based healthcare delivery system on the payer side and provider side. HIPAA transactions were electronic … but the vast majority of the landscape did not have electronic health records," Tripathi said. 

"Then we embarked on the Meaningful Use program, the HITECH Act, where the federal government essentially provided incentives to providers across the country to turn that paper-based system into one that now has 97% of hospitals and 80% of physician offices using electronic health records that are certified by my office." 

These programs allow for EHRs that have basic capabilities related to interoperability, data standards and decision support. 

Tripathi highlighted the benefits of AI but also the importance of oversight of the technology in healthcare, stating that last week, HHS released its AI Strategic Plan, which provides recommendations related to research and discovery, basic research, drug development, medical product development, safety and effectiveness, and more. 

"What we've done is looked at that as the high-level value chain, and then broke it down in each of those areas into a more granular type of value chain, where it looks explicitly at where is AI enablement going to do something that will help further healthcare and what role does the federal government play in each of those areas," Tripathi said.

He highlighted how the Biden administration released a set of regulations related explicitly to AI use in healthcare, which requires every certified EHR vendor to provide transparency about AI technologies in their products to allow healthcare providers to understand what they are implementing in their systems. 

"There's a pretty continuous thread that you see in the health IT space that I don't see it being really overturned in the next administration," Tripathi said.

"Yes, it is a public strategic plan, and yes, it's a Biden administration strategic plan, but if you actually look at the details, none of it is really political. It's really saying we have been on a 15- to 20-year journey here, and this is just moving the ball forward to the next set of things, and that's why we hope they will pick it up."

The panel's moderator, Ashkan Afkhami, who is BCG's managing director and senior partner and digital and analytics leader for healthcare, reiterated the importance of the federal government continuing the trajectory of co-creation.

"Taking a step back and seeing the journey, especially from the federal government, I think the point for me is always that there's a co-creation that has been really surging, and it has continued to evolve. So, it's really nice to see that, irrespective of who is in the White House, that there is that underlying theme of co-creation with industry. And hopefully, that continues," Afkhami said.

Still, Tripathi said there is a lot of uncertainty about the incoming administration. 

"The reality is that if you look at this historically, political juices are always flowing in the period between the administration change on both sides, but then the new administration comes in and then they recognize the government's responsibilities and the real constraints on what they are able to do that then start to guide what they're going to do," Tripathi said. 

He expresses that only time will tell what the real priorities are that the administration will set.

"There's been a lot of talk about vaccinations, about public health, about CMS, and a whole bunch of things, but at least my experience – now, maybe they will be superhuman – but my experience is that you could only do a certain set of things in the moment you have, and you really need to prioritize, because every single one of those things has just got this thicket and this long tail of statutory requirements and restrictions," Tripathi said. 

"And you might think that you're going to come in and just blow it all up, but in our country, you can't actually just blow all that up. You actually have to follow down the path. So I think seeing how that settles and what those priorities are and how those unfold, I think will be one thing to really look at, where they end up spending more of their attention. On the other side of it, though, is that I personally have my list of things that it would be great to selectively blow up, and as of Tuesday, I'm happy to share that list." 

He said he hopes the new administration is surgical in their decision-making and focuses on the "right things."

"As we think about the frontier here of these new technologies, what we are always bumping up against is that there is a transformative potential of this technology. LLM is just one representation of that underlying technology that could be unbelievably transformative, but in the U.S., it is absolutely constrained and bottled by the business conventions and the regulatory conventions that restrict how far that can go," Tripathi said. 

"So, we'll look to see if there are opportunities that the new administration can focus on, to say, how does that allow us to unlock the abilities of these technologies together?" 

Sara Vaezy, executive vice president and chief strategy and digital officer at Providence, a large not-for-profit Catholic healthcare system, said monitoring of AI will also be necessary as the new administration comes in.

"Even with the incoming administration saying that they're focusing on self-governing, there is still going to be a need to do monitoring around AI, whether it is from a civil liability standpoint, from a state regulatory standpoint, or from … court of public opinion type of things," Vaezy said. 

Vaezy said she hopes for the potential creation of open standards in AI, which are publicly accessible guidelines and specifications that allow transparency and allow different AI systems to work interoperably. 

"The potential creation of open standards so that we can all innovate, that's one of the things that we've struggled with," Vaezy said. "Some of our legacy providers have fought that in the past, but we really think that there's potential to unlock some of the constraints that all these point solutions have through the creation of open standards."