@inproceedings{pandey-etal-2024-advancing,
title = "Advancing Healthcare Automation: Multi-Agent System for Medical Necessity Justification",
author = "Pandey, Himanshu Gautam and
Amod, Akhil and
Kumar, Shivang",
editor = "Demner-Fushman, Dina and
Ananiadou, Sophia and
Miwa, Makoto and
Roberts, Kirk and
Tsujii, Junichi",
booktitle = "Proceedings of the 23rd Workshop on Biomedical Natural Language Processing",
month = aug,
year = "2024",
address = "Bangkok, Thailand",
publisher = "Association for Computational Linguistics",
url = "https://aclanthology.org/2024.bionlp-1.4",
pages = "39--49",
abstract = "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.",
}
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<abstract>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.</abstract>
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%0 Conference Proceedings
%T Advancing Healthcare Automation: Multi-Agent System for Medical Necessity Justification
%A Pandey, Himanshu Gautam
%A Amod, Akhil
%A Kumar, Shivang
%Y Demner-Fushman, Dina
%Y Ananiadou, Sophia
%Y Miwa, Makoto
%Y Roberts, Kirk
%Y Tsujii, Junichi
%S Proceedings of the 23rd Workshop on Biomedical Natural Language Processing
%D 2024
%8 August
%I Association for Computational Linguistics
%C Bangkok, Thailand
%F pandey-etal-2024-advancing
%X 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.
%U https://aclanthology.org/2024.bionlp-1.4
%P 39-49
Markdown (Informal)
[Advancing Healthcare Automation: Multi-Agent System for Medical Necessity Justification](https://aclanthology.org/2024.bionlp-1.4) (Pandey et al., BioNLP-WS 2024)
ACL