Technology infused with artificial intelligence awaits introduction throughout America’s health care system. What that introduction will mean and what impact it will have depends on non-technological decisions, on human factors. It will depend on the intent of the leaders who guide its introduction. Artificial intelligence applied at the point of care in the form of smart devices or intelligent agents can offer the promise of augmenting and extending the work of every clinician. They promise to free clinicians from the burden of low-value, rote activity and improve clinician burnout, while improving access and quality outcomes for populations.

In order to realize the full value of this new technology, we believe that health systems need to adopt a systems-based approach to its implementation. Layering on new technology without transforming the underlying workflows, teams, roles and decision-making used to work with it will not shift the cost and value curves nearly enough in spite of mounting external pressure to reduce health expenditures. At the level of the clinical practice, intelligent devices can augment the clinician’s ability to make decisions based on complex data and play an increasing role in prediction tasks like screening and diagnosis. At the population health level, if applied as a lever to move the whole system, AI-powered devices and intelligent agents have the potential to fundamentally change the economics of health care. Screening for diabetic retinopathy provides a useful case in point.