AI in healthcare
Healthcare AI tends to sit in the record, the coverage decision, and the conversation with the patient. The Intelligence Audit reads those uses from the inside, including the rules that bind a covered entity or a business associate.
How AI shows up
A note is drafted while the clinician talks. A coding or prior-authorization tool suggests what to submit. Imaging and diagnostic tools rank what a person should look at next. Scheduling, call centers, and patient chat answer before a person does. Coverage and utilization tools shape what is approved.
Staff also adopt scribes, summarizers, and coding helpers outside the approved inventory, because the official path is slow. A vendor may run the model while the organization's name stays on the chart, the claim, or the denial. The audit starts from those uses, not from a policy binder.
Rules the audit looks at
The names below are examples the Regulatory and Compliance part and the Sector Controls part look at with your counsel. Listing one is not a determination that it applies to you, and it is not legal advice.
- HIPAA, for protected health information and business associate agreements
- FDA guidance on AI-enabled software, where a tool is a device or clinical decision support
- The Colorado AI Act, where a system makes or strongly shapes a consequential decision about a person
A wellness chatbot is not the same problem as a tool that recommends a diagnosis or a denial. The audit says which is which, and what record would have to exist before the line moves. Your counsel confirms which duties actually bind you.
What the audit checks
Sector Controls tests industry controls against real records, read-only and with permission. In healthcare that means patient data, business associate agreements, and the path from a model output to a chart, a claim, or a coverage decision. Regulatory and Compliance draws the jurisdiction map with your counsel, including state privacy and insurance rules where you operate, employ people, or serve patients.
Go-to-Market covers how AI is used to find and reach patients or members: lead scoring, call and chat bots, content tools, and the claims made in advertising. The TCPA and the FTC are examples of the rules involved, not a legal opinion. Shadow AI, vendor terms, decision rights, and the security and rollout review still apply, because a scribe adopted by one clinic can outrun the inventory the technology group keeps.
Before we walk you through it, every Intelligence Audit is reviewed with our counsel. The review is ours, and it is not legal advice to you. The next step after the Assessment report is the Discovery Call.
Questions about this sector
Is a HIPAA program the same as an AI audit in healthcare?
No. A HIPAA program is the privacy and security duty around protected health information. The Intelligence Audit asks where AI already touches a chart, a claim, a denial, or a conversation, and whether the owner, the record, and the stop exist. HIPAA is one example Sector Controls and Regulatory and Compliance look at with your counsel. It is not the whole review, and it is not legal advice.
Does FDA guidance apply to every clinical AI tool?
No. FDA guidance on AI-enabled software matters where a tool is a device or functions as clinical decision support. A scheduling bot is a different question from a model that recommends a diagnosis. The audit separates them. Your counsel confirms which guidance applies. We do not issue a device determination.
What does Sector Controls check in a hospital or a health plan?
It tests the controls against real records: who can see patient data, what a business associate is allowed to do with it, and how a model output reaches a chart, a claim, or a coverage decision. The check is read-only and with permission. It is part of the eleven-part Intelligence Audit, and our counsel reviews the audit before we walk you through it.
How an engagement with us works
- 01
Intelligence Assessment
A short written read from your answers and what is public
Read - 02
Discovery Call
We talk through the organization and the decision in front of you
Read - 03
Scope and Agreement
Scope is agreed in writing before the audit begins
Read - 04
Intelligence Audit
Eleven parts of work from the inside, and the architecture sits inside that work
Read - 05
Roadmap Preparation
The implementation plan for 90 days, 6 months, and 12 months
Read - 06
Counsel Review
Our counsel reviews the audit before we walk you through it. It is not legal advice to you.
Read - 07
Audit Delivery
The report, the architecture map, the plan, and a leadership readout
Read - 08
Ongoing Advisory
We stay when a capability or a rule changes
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