Saved in:
Bibliographic Details
Main Authors: Pandey, Himanshu, Amod, Akhil, Shivang
Format: Preprint
Published: 2024
Subjects:
Online Access:https://arxiv.org/abs/2404.17977
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1866917713684725760
author Pandey, Himanshu
Amod, Akhil
Shivang
author_facet Pandey, Himanshu
Amod, Akhil
Shivang
contents Prior Authorization delivers safe, appropriate, and cost-effective care that is medically justified with evidence-based guidelines. However, the process often requires labor-intensive manual comparisons between patient medical records and clinical guidelines, that is both repetitive and time-consuming. Recent developments in Large Language Models (LLMs) have shown potential in addressing complex medical NLP tasks with minimal supervision. This paper explores the application of Multi-Agent System (MAS) that utilize specialized LLM agents to automate Prior Authorization task by breaking them down into simpler and manageable sub-tasks. Our study systematically investigates the effects of various prompting strategies on these agents and benchmarks the performance of different LLMs. We demonstrate that GPT-4 achieves an accuracy of 86.2% in predicting checklist item-level judgments with evidence, and 95.6% in determining overall checklist judgment. Additionally, we explore how these agents can contribute to explainability of steps taken in the process, thereby enhancing trust and transparency in the system.
format Preprint
id arxiv_https___arxiv_org_abs_2404_17977
institution arXiv
publishDate 2024
record_format arxiv
spellingShingle Advancing Healthcare Automation: Multi-Agent System for Medical Necessity Justification
Pandey, Himanshu
Amod, Akhil
Shivang
Artificial Intelligence
Multiagent Systems
Prior Authorization delivers safe, appropriate, and cost-effective care that is medically justified with evidence-based guidelines. However, the process often requires labor-intensive manual comparisons between patient medical records and clinical guidelines, that is both repetitive and time-consuming. Recent developments in Large Language Models (LLMs) have shown potential in addressing complex medical NLP tasks with minimal supervision. This paper explores the application of Multi-Agent System (MAS) that utilize specialized LLM agents to automate Prior Authorization task by breaking them down into simpler and manageable sub-tasks. Our study systematically investigates the effects of various prompting strategies on these agents and benchmarks the performance of different LLMs. We demonstrate that GPT-4 achieves an accuracy of 86.2% in predicting checklist item-level judgments with evidence, and 95.6% in determining overall checklist judgment. Additionally, we explore how these agents can contribute to explainability of steps taken in the process, thereby enhancing trust and transparency in the system.
title Advancing Healthcare Automation: Multi-Agent System for Medical Necessity Justification
topic Artificial Intelligence
Multiagent Systems
url https://arxiv.org/abs/2404.17977