ArticleJournal of the American Medical Informatics Association : JAMIA2023
Could an artificial intelligence approach to prior authorization be more human?
Article in Journal of the American Medical Informatics Association : JAMIA, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
10 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Artificial intelligence in prior authorization and coverage decisions: A systematic review of methods, evidence gaps, and future implications for patient access.Journal of managed care & specialty pharmacy · 2026Pooled it
- The Triple Burden of Administrative Tasks Among US Family Medicine Physicians-A Cross-sectional Study.Journal of general internal medicine · 2026Article
- Disparities in AI-Based Prior Authorization for Head and Neck Reconstruction: A Large Language Model Analysis.World journal of otorhinolaryngology - head and neck surgery · 2026Article
- Integrating Prior Authorization Into Clinical Workflows for Care Access and Practitioner Experience.JAMA network open · 2025Article
- Guidelines From the American Society of Pain and Neuroscience for Using Artificial Intelligence in Interventional Spine and Nerve Treatment.Journal of pain research · 2025Article
- Artificial Intelligence (AI) and Men's Health Clinic Efficiency and Clinic Billing.Current urology reports · 2024Review
- Applications of ChatGPT in Heart Failure Prevention, Diagnosis, Management, and Research: A Narrative Review.Diagnostics (Basel, Switzerland) · 2024Review
- Generative artificial intelligence, patient safety and healthcare quality: a review.BMJ quality & safety · 2024Review
- Black Box Warning: Large Language Models and the Future of Infectious Diseases Consultation.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2024Article
- Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors.
Funding
Abstract
Prior authorization (PA) may be a necessary evil within the healthcare system, contributing to physician burnout and delaying necessary care, but also allowing payers to prevent wasting resources on redundant, expensive, and/or ineffective care. PA has become an "informatics issue" with the rise of automated methods for PA review, championed in the Health Level 7 International's (HL7's) DaVinci Project. DaVinci proposes using rule-based methods to automate PA, a time-tested strategy with known limitations. This article proposes an alternative that may be more human-centric, using artificial intelligence (AI) methods for the computation of authorization decisions. We believe that by combining modern approaches for accessing and exchanging existing electronic health data with AI methods tailored to reflect the judgments of expert panels that include patient representatives, and refined with "few shot" learning approaches to prevent bias, we could create a just and efficient process that serves the interests of society as a whole. Efficient simulation of human appropriateness assessments from existing data using AI methods could eliminate burdens and bottlenecks while preserving PA's benefits as a tool to limit inappropriate care.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.