{"id":"https://openalex.org/W4321435592","doi":"https://doi.org/10.1093/jamia/ocad016","title":"Could an artificial intelligence approach to prior authorization be more human?","display_name":"Could an artificial intelligence approach to prior authorization be more human?","publication_year":2023,"publication_date":"2023-02-21","ids":{"openalex":"https://openalex.org/W4321435592","doi":"https://doi.org/10.1093/jamia/ocad016","pmid":"https://pubmed.ncbi.nlm.nih.gov/36809561"},"language":"en","primary_location":{"id":"doi:10.1093/jamia/ocad016","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocad016","pdf_url":"https://academic.oup.com/jamia/advance-article-pdf/doi/10.1093/jamia/ocad016/49286075/ocad016.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"type":"article","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":true,"oa_status":"hybrid","oa_url":"https://academic.oup.com/jamia/advance-article-pdf/doi/10.1093/jamia/ocad016/49286075/ocad016.pdf","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5040777053","display_name":"Leslie Lenert","orcid":"https://orcid.org/0000-0002-9680-5094"},"institutions":[{"id":"https://openalex.org/I153297377","display_name":"Medical University of South Carolina","ror":"https://ror.org/012jban78","country_code":"US","type":"education","lineage":["https://openalex.org/I153297377"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"Leslie A Lenert","raw_affiliation_strings":["Biomedical Informatics Center, Medical University of South Carolina , Charleston, South Carolina, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Biomedical Informatics Center, Medical University of South Carolina , Charleston, South Carolina, USA","institution_ids":["https://openalex.org/I153297377"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5084825146","display_name":"Steven Lane","orcid":"https://orcid.org/0000-0002-8050-6209"},"institutions":[{"id":"https://openalex.org/I4210131031","display_name":"Gorilla Doctors","ror":"https://ror.org/036nvwz98","country_code":"US","type":"nonprofit","lineage":["https://openalex.org/I4210131031"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Steven Lane","raw_affiliation_strings":["Health Gorilla , Mountain View, California, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Health Gorilla , Mountain View, California, USA","institution_ids":["https://openalex.org/I4210131031"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5069913933","display_name":"Ramsey M. Wehbe","orcid":"https://orcid.org/0000-0003-0599-7957"},"institutions":[{"id":"https://openalex.org/I153297377","display_name":"Medical University of South Carolina","ror":"https://ror.org/012jban78","country_code":"US","type":"education","lineage":["https://openalex.org/I153297377"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Ramsey Wehbe","raw_affiliation_strings":["Department of Cardiology, Medical University of South Carolina , Charleston, South Carolina, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Cardiology, Medical University of South Carolina , Charleston, South Carolina, USA","institution_ids":["https://openalex.org/I153297377"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":["https://openalex.org/A5040777053"],"corresponding_institution_ids":["https://openalex.org/I153297377"],"apc_list":{"value":3967,"currency":"USD","value_usd":3967},"apc_paid":{"value":3967,"currency":"USD","value_usd":3967},"fwci":0.5482,"has_fulltext":true,"cited_by_count":16,"citation_normalized_percentile":{"value":0.73469192,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":90,"max":99},"biblio":{"volume":"30","issue":"5","first_page":"989","last_page":"994"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.996399998664856,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11636","display_name":"Artificial Intelligence in Healthcare and Education","score":0.996399998664856,"subfield":{"id":"https://openalex.org/subfields/2718","display_name":"Health Informatics"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T11930","display_name":"Cardiac, Anesthesia and Surgical Outcomes","score":0.9724000096321106,"subfield":{"id":"https://openalex.org/subfields/2705","display_name":"Cardiology and Cardiovascular Medicine"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13702","display_name":"Machine Learning in Healthcare","score":0.9666000008583069,"subfield":{"id":"https://openalex.org/subfields/1702","display_name":"Artificial Intelligence"},"field":{"id":"https://openalex.org/fields/17","display_name":"Computer Science"},"domain":{"id":"https://openalex.org/domains/3","display_name":"Physical Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/computer-science","display_name":"Computer science","score":0.7055001854896545},{"id":"https://openalex.org/keywords/authorization","display_name":"Authorization","score":0.6376601457595825},{"id":"https://openalex.org/keywords/artificial-intelligence","display_name":"Artificial intelligence","score":0.534457802772522},{"id":"https://openalex.org/keywords/computer-security","display_name":"Computer security","score":0.25894296169281006}],"concepts":[{"id":"https://openalex.org/C41008148","wikidata":"https://www.wikidata.org/wiki/Q21198","display_name":"Computer science","level":0,"score":0.7055001854896545},{"id":"https://openalex.org/C108759981","wikidata":"https://www.wikidata.org/wiki/Q788590","display_name":"Authorization","level":2,"score":0.6376601457595825},{"id":"https://openalex.org/C154945302","wikidata":"https://www.wikidata.org/wiki/Q11660","display_name":"Artificial intelligence","level":1,"score":0.534457802772522},{"id":"https://openalex.org/C38652104","wikidata":"https://www.wikidata.org/wiki/Q3510521","display_name":"Computer security","level":1,"score":0.25894296169281006}],"mesh":[{"descriptor_ui":"D000078482","descriptor_name":"Prior Authorization","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000078482","descriptor_name":"Prior Authorization","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D000078482","descriptor_name":"Prior Authorization","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D001185","descriptor_name":"Artificial Intelligence","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D003695","descriptor_name":"Delivery of Health Care","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D010820","descriptor_name":"Physicians","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true}],"locations_count":3,"locations":[{"id":"doi:10.1093/jamia/ocad016","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocad016","pdf_url":"https://academic.oup.com/jamia/advance-article-pdf/doi/10.1093/jamia/ocad016/49286075/ocad016.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},{"id":"pmid:36809561","is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/36809561","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association : JAMIA","raw_type":null},{"id":"pmh:oai:pubmedcentral.nih.gov:10114030","is_oa":true,"landing_page_url":"https://www.ncbi.nlm.nih.gov/pmc/articles/10114030","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC10114030/pdf/ocad016.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"submittedVersion","is_accepted":false,"is_published":false,"raw_source_name":"J Am Med Inform Assoc","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/jamia/ocad016","is_oa":true,"landing_page_url":"https://doi.org/10.1093/jamia/ocad016","pdf_url":"https://academic.oup.com/jamia/advance-article-pdf/doi/10.1093/jamia/ocad016/49286075/ocad016.pdf","source":{"id":"https://openalex.org/S129839026","display_name":"Journal of the American Medical Informatics Association","issn_l":"1067-5027","issn":["1067-5027","1527-974X"],"is_oa":false,"is_in_doaj":false,"is_core":true,"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Journal of the American Medical Informatics Association","raw_type":"journal-article"},"sustainable_development_goals":[],"awards":[{"id":"https://openalex.org/G1546048904","display_name":null,"funder_award_id":"TR001450","funder_id":"https://openalex.org/F4320337472","funder_display_name":"National Center for Advancing Translational Sciences"},{"id":"https://openalex.org/G5133843276","display_name":null,"funder_award_id":"TR001450","funder_id":"https://openalex.org/F4320332161","funder_display_name":"National Institutes of Health"}],"funders":[{"id":"https://openalex.org/F4320332161","display_name":"National Institutes of Health","ror":"https://ror.org/01cwqze88"},{"id":"https://openalex.org/F4320337472","display_name":"National Center for Advancing Translational Sciences","ror":"https://ror.org/04pw6fb54"}],"has_content":{"grobid_xml":false,"pdf":true},"content_urls":{"pdf":"https://content.openalex.org/works/W4321435592.pdf"},"referenced_works_count":32,"referenced_works":["https://openalex.org/W2111522864","https://openalex.org/W2396881363","https://openalex.org/W2535589725","https://openalex.org/W2787659535","https://openalex.org/W2905810301","https://openalex.org/W2925863688","https://openalex.org/W2945539778","https://openalex.org/W2955653438","https://openalex.org/W2981869278","https://openalex.org/W2983174390","https://openalex.org/W2989512989","https://openalex.org/W2990768863","https://openalex.org/W2997204042","https://openalex.org/W3004062836","https://openalex.org/W3004409643","https://openalex.org/W3029881688","https://openalex.org/W3037480398","https://openalex.org/W3046113390","https://openalex.org/W3091997966","https://openalex.org/W3093671002","https://openalex.org/W3103089229","https://openalex.org/W3160137267","https://openalex.org/W3172898611","https://openalex.org/W3184252732","https://openalex.org/W4310568840","https://openalex.org/W4312220150","https://openalex.org/W4313182274","https://openalex.org/W6761260114","https://openalex.org/W6773475376","https://openalex.org/W6797205659","https://openalex.org/W6798709065","https://openalex.org/W6846764525"],"related_works":["https://openalex.org/W4391375266","https://openalex.org/W2899084033","https://openalex.org/W2748952813","https://openalex.org/W2390279801","https://openalex.org/W4391913857","https://openalex.org/W2358668433","https://openalex.org/W4396701345","https://openalex.org/W2376932109","https://openalex.org/W2001405890","https://openalex.org/W4396696052"],"abstract_inverted_index":{"Prior":[0],"authorization":[1,92],"(PA)":[2],"may":[3,79],"be":[4,80],"a":[5,67,137,149,173],"necessary":[6,18],"evil":[7],"within":[8],"the":[9,41,51,89,115,144],"healthcare":[10],"system,":[11],"contributing":[12],"to":[13,24,64,113,131,175],"physician":[14],"burnout":[15],"and":[16,103,124,139,166],"delaying":[17],"care,":[19],"but":[20],"also":[21],"allowing":[22],"payers":[23],"prevent":[25,132],"wasting":[26],"resources":[27],"on":[28],"redundant,":[29],"expensive,":[30],"and/or":[31],"ineffective":[32],"care.":[33,178],"PA":[34,47],"has":[35],"become":[36],"an":[37,76],"\"informatics":[38],"issue\"":[39],"with":[40,70,109,126],"rise":[42],"of":[43,91,117,146,153],"automated":[44],"methods":[45,63,87,111,162],"for":[46,88,101],"review,":[48],"championed":[49],"in":[50],"Health":[52],"Level":[53],"7":[54],"International's":[55],"(HL7's)":[56],"DaVinci":[57,59],"Project.":[58],"proposes":[60,75],"using":[61,83,160],"rule-based":[62],"automate":[65],"PA,":[66],"time-tested":[68],"strategy":[69],"known":[71],"limitations.":[72],"This":[73],"article":[74],"alternative":[77],"that":[78,96,120,142],"more":[81],"human-centric,":[82],"artificial":[84],"intelligence":[85],"(AI)":[86],"computation":[90],"decisions.":[93],"We":[94],"believe":[95],"by":[97],"combining":[98],"modern":[99],"approaches":[100,130],"accessing":[102],"exchanging":[104],"existing":[105,158],"electronic":[106],"health":[107],"data":[108,159],"AI":[110,161],"tailored":[112],"reflect":[114],"judgments":[116],"expert":[118],"panels":[119],"include":[121],"patient":[122],"representatives,":[123],"refined":[125],"\"few":[127],"shot\"":[128],"learning":[129],"bias,":[133],"we":[134],"could":[135,163],"create":[136],"just":[138],"efficient":[140],"process":[141],"serves":[143],"interests":[145],"society":[147],"as":[148,172],"whole.":[150],"Efficient":[151],"simulation":[152],"human":[154],"appropriateness":[155],"assessments":[156],"from":[157],"eliminate":[164],"burdens":[165],"bottlenecks":[167],"while":[168],"preserving":[169],"PA's":[170],"benefits":[171],"tool":[174],"limit":[176],"inappropriate":[177]},"counts_by_year":[{"year":2026,"cited_by_count":3},{"year":2025,"cited_by_count":6},{"year":2024,"cited_by_count":6},{"year":2023,"cited_by_count":1}],"updated_date":"2026-07-01T08:55:40.977307","created_date":"2025-10-10T00:00:00"}
