Navigating AI in Healthcare: Insights from KPMG's Ash Shehata

Navigating AI in Healthcare: Insights from KPMG's Ash Shehata

In the bustling halls of the ViVE 2025 digital health conference in Nashville, Ash Shehata, KPMG’s U.S. sector leader for healthcare, shared his unique perspective on the evolving role of artificial intelligence (AI) in healthcare. As he moderated a session on claims management, Shehata delved into the excitement and uncertainties surrounding AI's integration into healthcare systems.

Shehata's discussions highlighted the dual nature of AI's promise and the challenges it faces. "Gen AI is a really big topic right now," he noted, emphasizing the industry's eagerness to harness AI's potential. However, the question remains: where will AI make the most significant impact? The session underscored the importance of using AI to streamline processes, such as submitting clean claims by integrating electronic health records (EHR) data.

Despite AI's potential, Shehata cautioned against viewing it as a cure-all. "Engage physicians, fix processes," he advised, warning that without proper integration, AI could complicate rather than simplify healthcare processes. This sentiment reflects a broader industry understanding that AI should enhance, not burden, existing systems.

The conversation also touched on the financial landscape, with investors showing cautious optimism. While AI's promise is undeniable, the flow of investment funds remains tentative, influenced by broader economic and political factors. Yet, the anticipation of AI's transformative power keeps stakeholders hopeful.

In clinical settings, AI's role is expanding, albeit cautiously. Shehata observed a growing comfort with AI in academic medical centers, where governance structures are evolving to manage risks. These centers are at the forefront of AI-driven research, leveraging decades of data to advance precision medicine.

However, the integration of AI in healthcare is not without its challenges. Hospitals face frustrations with AI-driven denials from insurers, highlighting a zero-sum game where improvements in claims submissions are met with increased scrutiny from payers. Shehata advocates for collaboration between payers and providers to create a more efficient and less adversarial system.

In summary, Shehata's insights at ViVE 2025 paint a picture of an industry on the brink of transformation. The key takeaways include:

1. AI holds significant promise for streamlining healthcare processes, particularly in claims management.
2. Effective AI integration requires engaging healthcare professionals and refining existing processes.
3. Investment in AI is promising but currently cautious, with broader economic factors at play.
4. Academic medical centers are leading the charge in AI-driven research and clinical applications.
5. Collaboration between payers and providers is essential to overcoming current challenges in AI integration.

As the healthcare industry continues to navigate the complexities of AI, the insights from leaders like Ash Shehata provide valuable guidance for a future where technology and healthcare work hand in hand.