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Artificial intelligence is becoming increasingly integrated into medical review workflows, offering new efficiencies and improvements. At SiftMed, we see reviewers ask smart, practical questions about using AI in their processes - and that caution is both appropriate and necessary.
Medical file review teams handle complex information that influences care decisions, legal outcomes, and compensation. Any new tools must support accuracy, maintain privacy, and enhance established workflows.
We’re here to uncover the most important considerations when incorporating AI into your medical file review. Here's what to consider when using AI in your workflow:
Accuracy and Clinical Judgement
AI can accelerate document review with remarkably accurate outcomes - but it’s still smart to be cautious. Even great tools can miss nuance, and missing or misinterpreting information can affect your credibility. The best approach is combining AI insights with your professional judgement to avoid omission. If AI highlights or extracts information, it’s essential to verify exactly where it came from. That’s why SiftMed links everything back to the original page, letting reviewers validate data and stay confident in their reports.
Privacy, Confidentiality, and Data Protection
Medical records contain extremely sensitive information, and your patients or clients rely on you to protect their data. When using AI to process these records, organizations must ensure systems are secure and compliant with privacy regulations such as HIPAA and PIPEDA. Strong security protocols, access controls, and encryption are key to preventing breaches and meeting privacy requirements. The aim is to keep the same level of confidentiality assessors already uphold - simply with more efficient tools.
Transparency
Patients and claimants should understand how their information is being processed. While there’s no requirement to explain the technology in-depth, users should be clear that AI-assisted tools are a part of the workflow.
Practical transparency steps:
Include a simple disclosure in client contracts
Explain that professionals will always review and validate final outputs
Clarity builds trust and creates smoother interactions with patients, claimants, and clients.
Accountability and Critical Thinking
AI can surface information quickly, but your critical thinking is what ensures the final assessment is accurate. Every AI-generated insight should be reviewed and validated to confirm it reflects the case correctly. Technology should support your work, not replace your judgment - AI outputs must be checked before they influence key decisions, keeping human expertise at the center of the review process.
Best Practices for Implementing AI
Validate Tool Performance
When implementing a new AI tool, it’s important to thoroughly evaluate its outputs. Compare AI-generated summaries with human-produced reports to confirm accuracy and clarity. Proper validation ensures the tool can perform consistently and reliably for your needs.
Leverage Human Oversight
Artificial intelligence can draft and organize information, but human involvement is essential to maintain the integrity of the report. Reliable use of AI depends on active human involvement, which safeguards quality and accuracy.
Be Transparent
Don’t keep the use of AI hidden - inform clients when their records may be processed with AI and highlight the value it brings to your workflow. You don’t need to name the specific platform, but including a disclosure or consent statement in client agreements helps protect both the organization and the patient.
Protect Patient Data
Use systems with robust security controls, encryption, and security compliance to ensure safe handling of personal health information. Consider tools that are HIPAA and PIPEDA compliant or tools that have security certifications like SOC2 and ISO.
Always align AI tools with professional standards, medical and legal regulations. Follow the same duty of care expected in any clinical process, and ensure that AI tools enhance rather than judgment, expertise, and outcomes.
