As AI becomes more common in clinical practice, policymakers risk creating rules that benefit only large health systems unless they account for the needs of smaller providers, a Kaiser Permanente leader warned.
Daniel Yang, MD, vice president of AI and emerging technologies at Kaiser, wrote in a Nov. 19 news release that 66% of physicians currently use AI in their practice, citing an American Medical Association survey. With state policymakers and accreditation bodies such as the Joint Commission considering new regulations, Dr. Yang said the “AI haves and have-nots” — large systems with robust data and technical infrastructure and smaller hospitals with limited resources — could grow further apart.
Larger organizations, including Oakland, Calif.-based Kaiser Permanente, often have the staff and infrastructure to monitor AI tools and meet complex regulatory requirements, he said. But many rural hospitals, community clinics and smaller health systems struggle to maintain basic IT operations, making additional oversight requirements challenging.
“Without careful planning, regulations meant to improve safety can worsen the AI divide in our country,” Dr. Yang wrote.
He urged policymakers to design rules that apply to organizations of all sizes, rather than assuming advanced health systems should set the standard for the field. With multiple state proposals moving forward simultaneously — often with differing definitions and reporting requirements — even large organizations may face compliance hurdles, he said.
Dr. Yang said effective AI regulations should be simple, flexible and supported by resources to help organizations meet new expectations. He outlined Kaiser Permanente’s efforts to share its experience with the broader industry, including publishing AI testing methods, releasing research and collaborating with policymakers and accreditation groups.
Kaiser Permanente, he said, aims to make AI “safer, more transparent and more accessible” so that benefits extend beyond large systems.
Dr. Yang recommends that policymakers create consistent standards for AI use, offer technical and financial support for responsible implementation, and back large-scale clinical trials to evaluate AI’s safety and effectiveness.
“AI in healthcare is here to stay,” he wrote. “The rules we build today will determine whether its benefits reach every community.”
Dr. Yang voiced similar concerns in a 2024 interview with The Wall Street Journal.
