You're Literally Operating on Trust | Asra Ali

Asra Ali has spent nearly two decades in healthcare compliance and privacy, and she's the founder and principal consultant of Ali Healthcare Consulting here in San Juan. When a hospital or a health tech company wants AI anywhere near patient data, she's the one checking what could go wrong (the industry calls it governance, risk and compliance, GRC for short, and healthcare loves an acronym almost as much as I do).

AI isn't a new thing at hospitals, so we started back in what I called olden timey days, by which I mean 2022. She says the early uses were billing codes on the finance side and note-taking on the clinical side, for physicians who spend hours and hours catching up on their charts. My contribution was explaining billing codes. If a patient comes in for a cold and you decide to remove their liver, the insurance company is going to have some questions. (I did stop halfway through to admit I know that's not actually possible, so please, no letters from surgeons.) Her biggest concern right now is whether the data going into these AI systems is really what it says it is.

I remember seeing a list back in 2023 of the medical jobs AI was most likely to disrupt, and radiology was number one. Asra says the opposite is happening. AI helps a radiologist get through more images (she figures maybe 500 patients instead of 100), and she says it's almost like a net for whatever a doctor on a long shift might miss. She doesn't think the medical coders who are scared right now are losing their jobs either, since some AI companies are hiring coders to build that expertise into their tools.

Then I asked about something tens of millions of people are doing: uploading their health information to an AI and asking what it all means (and if you've done it, you're in good company, because Asra admitted she has too). Personally, she's skeptical, and her advice is to proceed at your own risk. She cringes a little whenever a tool tells her it's HIPAA compliant, because HIPAA compliant "is not a badge." When she mentioned that a picture of a tattoo can identify you, I said that's why I don't allow photos of any of my tattoos online. (I also had to get the face tattoo finally removed.)

Even if you stay away from the chatbots, it's vendors on top of vendors on top of vendors. When I had my gallbladder removed, the hospital made me sign 65 papers, and one of them let non-medical people, like salespeople for tech companies, into the operating room. Asra calls that third-party risk management, and she says as a patient you're operating on trust. She also wants organizations to go back to vendor contracts signed 10 years ago, because those vendors probably added AI and the contracts never caught up.

Breach letters came up too (I get one about once a week at this point), so I asked who actually wants my medical records. It's mostly about money, she says. Hackers get in, then demand a million dollars to keep the data off the dark web, and she says the weakest point is usually an employee who gives away access by accident.

Asra's on the AI in Healthcare & Life Sciences panel at the Caribbean AI Summit on Friday, October 9, 3:00 to 3:45 PM in Room 208, with Frances Heredia and Wilfredo De Jesús-Monge. A lot of people see governance, risk and compliance as a bottleneck, and she's out to change that: "It's not a matter of saying no, it's a matter of saying how." At plenty of companies the governance committee is the department of no, where ideas go to die, and what I like about her approach is it's more "yes, if." (I told her I think hers will be one of the strongest panels at the event, and as the Summit's co-chair I'm not supposed to have favorites, so let's keep that between us.)

I'm Edward Roske, and this is Asking Good Questions. New conversations with the people figuring out the human side of AI. If one of these questions stuck with you, subscribe and send it to someone who'd take the other side.

LINKS
Caribbean AI Summit (Oct 9-10, San Juan): https://CaribbeanSummit.AI
Ali Healthcare Consulting: https://alihealthcareconsulting.com
Asra on LinkedIn: https://www.linkedin.com/in/asraali/
My episode with Andres Andreu on data brokers: https://youtu.be/O0l9MUH6fuU

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