Shownotes
Ben Keneally, BCG’s Asia Pacific health care services leader, explains why AI is now many patients’ first stop — often before they see a doctor. He argues that pairing AI with personal health records improves outcomes and equity, and that health leaders, not LLMs, must shape how this shift unfolds.
You’ll Learn:
Why AI is becoming the default first step in care, especially in markets with limited access to clinicians
How pairing AI with personal health records improves treatment compliance and catches errors earlier
Why driving AI into end-to-end care pathways takes leadership, not just frontline experimentation
Learn More:
BCG’s Latest Thinking on the Health Care Industry: https://on.bcg.com/4w2MmPt
Consumers Are Ready for AI-Enabled Health Care. Health Systems Need to Be, Too.: https://on.bcg.com/4vo2ZDX
Chapters
(0:00) The Biggest Health Care Shift in Centuries
(1:47) How Is AI Being Used in Health Care Today?
(2:23) Where Is AI Adoption Highest, and What Does That Tell Us?
(3:29) Does AI Create a Two-Tier Health System?
(4:55) What's Next for AI Agents?
(6:51) Where Are the Biggest Opportunities: Diagnosis, Navigation, or Appointments?
(8:13) The Health Care System AI Could Build
(9:56) Does Your Health System Need Its Own AI?
(11:36) The Danger of Inaccurate Health Advice
(12:53) What Role Does Trust Play?
(13:52) How Are Health Care Organizations Shaping This Shift Today?
(14:47) AI Alone Won't Transform Health Care
(15:49) Who Is Responsible When AI Gets Health Care Wrong?
(17:22) Who Owns the Patient Relationship?
(18:29) Is the Shift to AI in Health Care Inevitable?
(19:49) Is It AI Plus Clinicians or AI Replacing Clinicians?
Meet the Expert
Ben Keneally, BCG Managing Director & Partner: https://on.bcg.com/4woTTbc
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Transcripts
- The use of AI by consumers
in health care is
Speaker:the biggest, fastest
change we've seen
Speaker:in hundreds of years in how
people access health care.
Speaker:So what I'm really
interested in is not just
Speaker:what it means in the short
term for consumers today,
Speaker:but what it's going to mean
for our entire health system.
Speaker:- Welcome to "The So What
from BCG," the podcast
Speaker:that explores the big
ideas shaping business,
Speaker:the economy, and society.
Speaker:I'm Georgie Frost.
Speaker:Millions are already using
large language models
Speaker:to understand symptoms,
interpret test results,
Speaker:explore treatment options,
Speaker:and decide whether to
seek medical care at all.
Speaker:In many cases, they're turning to AI
Speaker:before they speak to a doctor.
Speaker:So if AI is becoming the first touchpoint
Speaker:in the health care journey,
Speaker:who is responsible for
designing that experience,
Speaker:and how do we ensure it leads
Speaker:to better outcomes for patients?
Speaker:Joining me today is Ben Keneally,
Speaker:BCG's Asia Pacific leader
for health care services.
Speaker:Ben, welcome to you. Thank you
so much for joining us.
Speaker:Ben, I'm going to start with
telling you a little bit
Speaker:of a personal story
Speaker:because when we last spoke,
it was quite clear, I think,
Speaker:Ben, that I am a bit nervous
Speaker:about large language models being used.
Speaker:I think that's fair to say.
Speaker:My mother is a doctor,
Speaker:so that's my background.
Speaker:But since we last spoke a
week ago, unfortunately,
Speaker:my partner got very unwell,
Speaker:and a large language model
became my first touchpoint.
Speaker:And I understood really clearly how useful
Speaker:this could be to contextualize
everything that was going on.
Speaker:Now, obviously, my
concerns are still there,
Speaker:but I thought that that was
Speaker:quite an interesting perspective
Speaker:for me to understand
Speaker:how people are using these tools
Speaker:and how useful it could be.
Speaker:But just talk to me, if you would,
Speaker:not about me, but other people.
Speaker:How are they using it?
Speaker:How are they using these
tools when it comes to
Speaker:accessing health care,
Speaker:understanding all the things
that I just mentioned?
Speaker:- No, that's right. And I
think your experience is
Speaker:actually the paradigmatic
experience today,
Speaker:and that is people are using
large language models often
Speaker:to get assurance or to
get an understanding
Speaker:of what step they should take next.
Speaker:So it's, it's not a one-and-done step,
Speaker:but it is a step on a pathway to treatment
Speaker:and a step on a pathway to understanding.
Speaker:- Where are you seeing the
highest levels of adoption,
Speaker:and what do you think that that tells us?
Speaker:- Yeah, so interestingly,
we recently completed
Speaker:a global survey of, where we
looked at about 15 nations
Speaker:and spoke to thousands of people,
Speaker:all of whom were
internet-connected people.
Speaker:So obviously we're
excluding the very poorest
Speaker:of the poor when we do that.
Speaker:But when we look at that,
it is developing nations
Speaker:that are most advanced in their use of AI,
Speaker:large language models
for accessing health care.
Speaker:And it's an interesting outcome,
Speaker:and it really points to the
fact that in, you know,
Speaker:many developed countries,
there are a range
Speaker:of free-to-access and widely
available, you know, helplines
Speaker:or, you know,
government-sanctioned websites
Speaker:or even just publicly available
emergency departments,
Speaker:urgent care centers,
and general practice.
Speaker:But in developing countries,
access to that sort
Speaker:of care is more constrained,
Speaker:sometimes more expensive for the people,
Speaker:and therefore, you know, this sort
Speaker:of first step becomes even
more important for people
Speaker:to really be able to tell, is
this something that I should,
Speaker:you know, risk spending money on,
Speaker:or is this something where I should,
Speaker:where I can care for myself?
Speaker:- It's interesting because my concern
Speaker:with using large language
models was are we going
Speaker:to almost get a two-tier
system with those people
Speaker:that can afford to pay for a,
a better sort of, I suppose,
Speaker:concierge service where,
you know, your notes are,
Speaker:are remembered, et cetera,
Speaker:and it can give you a better service.
Speaker:But actually what you're suggesting is
Speaker:that it may do the opposite.
Speaker:- Yeah, no, in some ways this
democratizes health in a,
Speaker:in a very true way.
Speaker:So within developed countries,
Speaker:it's actually the wealthier
people who are using AI more.
Speaker:So rather than sort of splitting apart
Speaker:into, you know, a physical
upper-tier service
Speaker:and a, you know, artificial
lower-tier service,
Speaker:it's actually, you know,
people who have access
Speaker:and who are confident
and have the literacy
Speaker:to use those services today
are more likely to access.
Speaker:That said, one of the things
that we are seeing emerging is
Speaker:that people who have,
Speaker:you know, language challenges,
Speaker:they're recent migrants to a
country, for them the ability
Speaker:to then get their diagnosis translated
Speaker:or get their care advice
translated into their,
Speaker:into their languages
Speaker:or the opportunity to just,
you know, better understand
Speaker:what they've been told and
to therefore comply better
Speaker:with their treatment recommendations
Speaker:and so on is also a
very prominent use case.
Speaker:And so, in a way, it can
improve access to health care
Speaker:for people who are excluded
on the basis of their,
Speaker:their health literacy, for example.
Speaker:- Ben, we know that people
are using these tools
Speaker:to check symptoms, but I suppose what,
Speaker:what comes next?
What comes after that?
Speaker:- I mean, I think it's
the transition from chat
Speaker:to agents is, I think,
what's really interesting.
Speaker:So we're going to go from
a world where, you know,
Speaker:consumers are just,
you know, corresponding
Speaker:with large language models,
checking their symptoms,
Speaker:understanding their diagnoses,
et cetera,
Speaker:to a role where they have a health agent,
Speaker:an always-on health agent
Speaker:that not only can they,
you know, ask it questions,
Speaker:but they can connect it to their data,
Speaker:whether it's from their wearables
Speaker:or whether they're, you
know, grant it permission
Speaker:to have access to their, you know, results
Speaker:and their, their health
records, et cetera,
Speaker:and can create a really
sort of integrated,
Speaker:always-on health advisor that
gives you advice about diet,
Speaker:about exercise, about sleep,
about all those things
Speaker:that are actually, you know,
genuinely related to your,
Speaker:your underlying health
conditions and circumstances,
Speaker:and then, you know, potentially can move
Speaker:from there to make appointments for you,
Speaker:to, you know, arrange
health care checkups,
Speaker:to prompt you to get
your immunizations,
Speaker:prompt you and
make appointments for you
Speaker:to do things that are
important for your health.
Speaker:I think that sort
Speaker:of always-on health
advisor function is
Speaker:a really interesting one and will,
Speaker:you know, there's some really
interesting questions about
Speaker:whether that's something which, you know,
Speaker:in nationalized
health systems, is
Speaker:provided by that
national health system,
Speaker:or is it something which is,
you know, a private sector,
Speaker:you know, competitive choice
Speaker:or, you know, how
do you regulate that?
Speaker:How do you manage it?
Speaker:How do you, how do you
license and assure it?
Speaker:I think there's some
challenging questions about
Speaker:how those agents will access
private and confidential data
Speaker:and what sort of security
and confidentiality will be
Speaker:provided alongside that.
Speaker:But the future of AI
is definitely agentic,
Speaker:and so I think that, you
know, the next step is
Speaker:how people's personal health agents,
Speaker:their personal doctor in their pocket,
Speaker:will start to evolve.
Speaker:- Where do you see the
biggest opportunities here?
Speaker:Diagnosis? Navigating health
care? Booking appointments?
Speaker:- I think this point
about health literacy is
Speaker:actually the most important one.
Speaker:This fantastic research that
shows, if people have access
Speaker:to their own health care records,
Speaker:to their electronic health
record, to their, you know,
Speaker:their written health records
Speaker:and in particular,
if they can combine that
Speaker:with contextual advice
about their diagnoses,
Speaker:their treatment
recommendations, their pathways,
Speaker:their options, then they get,
Speaker:then people are much more likely
Speaker:to, firstly, identify errors
in their treatment path,
Speaker:so people reading their own,
you know, their own records
Speaker:can see something's been
recorded wrong here.
Speaker:They can raise that
with their clinicians,
Speaker:and that gives them more likely
Speaker:to get onto a good treatment pathway.
Speaker:Secondly, they can understand
Speaker:what it is and what they need to do.
Speaker:And so we see much higher
levels of compliance
Speaker:with treatment
recommendations, consistency
Speaker:of taking medication, et cetera,
Speaker:if you have access to your own records.
Speaker:And thirdly, people are
better able to understand
Speaker:what they should do if
their symptoms change
Speaker:or worsen, et cetera.
Speaker:So the idea of being able
to pair an LLM with access
Speaker:to your own health records can give you
Speaker:that contextual advice and
that better understanding,
Speaker:and we know that that leads to, you know,
Speaker:substantially better health outcomes
Speaker:and, in fact, more
equitable health outcomes.
Speaker:- If we get this right, what do you think
Speaker:this will look like in years to come?
Speaker:The biggest opportunities, the
biggest benefits, patients,
Speaker:providers, payers, everybody.
Speaker:- So I think,
you know, at the core,
Speaker:there's the opportunity here
to really make progress
Speaker:on the sort of value-based
health care agenda.
Speaker:And so moving away from,
you know, just measuring
Speaker:we did these surgeries
Speaker:or we had this number
of visits to doctors
Speaker:to actually saying, has,
have the health outcomes
Speaker:of the population as a whole been enhanced
Speaker:on the basis of what we've been doing?
Speaker:And, you know, so how does
AI contribute to that?
Speaker:Firstly, I think it allows
Speaker:a better understanding
in the hands of everyone
Speaker:about what the known
evidence-based pathways are.
Speaker:What's the modern best
practice treatment pathway?
Speaker:Secondly, I think it
helps with the collection
Speaker:and analysis of data.
Speaker:Now, you know, it's good
to collect all that data,
Speaker:but artificial intelligence,
Speaker:machine learning are
incredibly powerful
Speaker:in helping interpret
that and drive it.
Speaker:But then thirdly, you need
to serve it up in ways
Speaker:that are actionable to people
Speaker:at the point in time
when they need it.
Speaker:And I think, you know,
that starts to become more,
Speaker:more feasible and more
possible with AI.
Speaker:So that helps payers
Speaker:because they're paying
for stuff that works.
Speaker:It helps patients because
they're only, you know,
Speaker:they're getting the
best treatment pathways.
Speaker:And it helps providers
Speaker:because I think it helps them focus again
Speaker:on, on what really matters.
Speaker:It helps take toil away
from their work,
Speaker:the sort of gatekeeping exercises
Speaker:that a lot of doctors
and nurses have to do
Speaker:just to manage processes
Speaker:and order tests and, and so on.
Speaker:There's a lot of
administration that goes on.
Speaker:Again, a lot of that, they can be
Speaker:relieved of a lot of that activity.
Speaker:- Now, when we talk about AI
Speaker:and large language models--I just want
Speaker:to dig into this in a
little bit more detail--
Speaker:are we talking about the kind
of big commercial players--
Speaker:I don't need to name them,
we all know who they are--
Speaker:or are we talking about,
Speaker:and I'll use the British
example here of the NHS,
Speaker:building their own tools
that we use instead?
Speaker:- I think it's a case of both/and.
Speaker:So the large language models are
Speaker:an incredibly useful baseline
resource for a lot of people,
Speaker:and they're easy to access,
Speaker:and they are a, a very
good starting point.
Speaker:I think for the large
sort of health systems,
Speaker:they're increasingly
looking at, first question,
Speaker:how do I influence those
large language models?
Speaker:How do I make my information,
Speaker:my best practice guidelines,
Speaker:my insights about population,
health, et cetera, available
Speaker:to those models so that they
are more likely to pick up
Speaker:that information and
serve it up to people?
Speaker:So there's a lot of, lot
Speaker:of large health systems
are now looking at that.
Speaker:The second point they're
doing though is then saying,
Speaker:how do we bring large
language model capability
Speaker:behind the firewall of our system?
Speaker:What that allows them to
do is to serve up to their,
Speaker:their patients, their
citizens the opportunity
Speaker:to inspect their own health record
Speaker:and understand it using
large language models.
Speaker:It also gives them the opportunity
Speaker:to particularly train and weight
Speaker:the large language model
Speaker:so that it is providing
advice that's relevant
Speaker:to that community,
Speaker:to the health system
that's in that country,
Speaker:and to the population
health challenges
Speaker:that that country faces.
Speaker:But it's, it's both/and
Speaker:because what you want to do
is have those people
Speaker:who are using the commercial models
Speaker:also getting great advice.
Speaker:- But of course, many listeners will be
Speaker:thinking about the risks,
Speaker:which I mentioned at the start.
Speaker:We've all seen examples
where AI tools have
Speaker:provided inaccurate or even
dangerous medical advice.
Speaker:How concerned should we be about that?
Speaker:- We need to be concerned generally
Speaker:about poor advice in the health system
Speaker:and dangerous advice in the health system,
Speaker:and it happens from humans just as much
Speaker:as it happens from technology.
Speaker:So the way I, again, I like
to think about it is
Speaker:a both/and kind of approach
Speaker:that as humans augmented by AI,
Speaker:you've got two ways
of trapping error.
Speaker:You know, one of the things
we know is that on average,
Speaker:it takes 18 years to get best
practice advice from the lab
Speaker:to the majority treatment pathway
Speaker:for patients in the real world.
Speaker:That delay is a delay
that's natural and human.
Speaker:People go to university,
they train,
Speaker:they go through development
pathways in their careers,
Speaker:but they don't stay up to date
Speaker:with everything that's happening.
Speaker:And as a consequence,
Speaker:there is a translation gap
Speaker:from the best practice evidence
Speaker:that the, you know, the
researchers understand
Speaker:to what is actually
practiced at the frontline.
Speaker:AI can really help shorten that gap,
Speaker:can really help compress that gap.
Speaker:- What conversations
need to be had
Speaker:among health care leaders,
Speaker:and how much of an issue,
I suppose, is trust as well?
Speaker:- Two of the areas that we
think are most important.
Speaker:The first is, you know, as
we were talking about,
Speaker:that access behind
the firewall to AI
Speaker:so that people can, in
a trusted way, you know,
Speaker:allow AI to inspect their health records,
Speaker:to inspect their diagnoses
Speaker:and their treat,
their test results
Speaker:and their treatment plans
Speaker:and give them personalized advice
Speaker:and understanding that helps
build their health literacy.
Speaker:The second thing that
we're, that, you know,
Speaker:is being looked at and that
people are very, I think,
Speaker:passionate about is how
do we provide clinicians
Speaker:with the tools that help
them do their work
Speaker:more face-to-face
with their patients
Speaker:rather than looking at the
screen and entering it?
Speaker:How do we help them
with prompts and checks
Speaker:and additional support that
doesn't impinge on their,
Speaker:their clinical discretion,
Speaker:but which helps them get
their jobs done in a way that,
Speaker:you know, empowers the patient
relationship that they have?
Speaker:- Your report argues
health care organizations
Speaker:shouldn't try to stop this shift.
Speaker:They should try and help shape it.
Speaker:And I presume they already are.
Speaker:So what are you actually seeing?
Speaker:What examples have you got?
Speaker:- What we're seeing is
people thinking about
Speaker:what is their consumer
health experience
Speaker:of an AI augmented journey
within their health system.
Speaker:So they're designing, you
know, a tool, you know,
Speaker:digital front doors that have AI embedded
Speaker:that allow consumers
to access health care.
Speaker:So not just that first step
of getting symptom advice
Speaker:and what's the next step and
explain my diagnoses to me,
Speaker:but the whole pathway from
I have a problem through to
Speaker:I've had an appointment made,
I've received a referral,
Speaker:that the appointment with a
specialist has also been made.
Speaker:Now my pathway
Speaker:to a, a surgical procedure
has been set out,
Speaker:and my preparation for
it is AI enabled,
Speaker:and then my rehab
afterwards is AI enabled.
Speaker:- What's the unlock,
Speaker:or is it far more
complex than that?
Speaker:I think the unlock is leadership.
Speaker:So it's very easy to allow experiments
Speaker:to happen across a hospital,
across a health system.
Speaker:You know, doctors and nurses
are, are, you know, people
Speaker:who are interested in technology,
Speaker:and they get excited about it.
Speaker:And they will innovate at the frontline,
Speaker:and that's fantastic.
Speaker:What you need is leadership
saying, "That's great,
Speaker:but I want to drive
something else as well.
Speaker:I want to drive, you know,
these end-to-end processes.
Speaker:I want to organize around, you know,
Speaker:an estimated date-of-discharge system
Speaker:for our hospital.
Speaker:I want to organize
Speaker:around a seamless pathway for consumers."
Speaker:Whatever it is driving
that from the top down
Speaker:as an end-to-end pathway
requires leadership
Speaker:because you've got to
bring everybody on board.
Speaker:You've got to bring
everyone together around
Speaker:how could we reimagine this whole journey.
Speaker:Point solution innovation doesn't need
Speaker:everyone on board.
Speaker:It just, you know, it's
about unleashing individuals.
Speaker:Leadership's required to change
Speaker:a whole end-to-end process.
Speaker:- What kind of guardrails, governance,
Speaker:partnerships do you think need
to be put in place to ensure
Speaker:that these tools genuinely
improve outcomes rather than,
Speaker:well, I suppose create new risks?
Speaker:- It's as much about how
we make sure we maximize
Speaker:the opportunity as we
manage the risks.
Speaker:There's a, to me, it's a, it
would be a terrible shame
Speaker:if all we did was end up with just a tool
Speaker:that helped us check our symptoms
Speaker:and a tool that helped us
understand our results.
Speaker:The opportunity here is
so much bigger than that.
Speaker:There is a lot of, you
know, they call it waste.
Speaker:It's not that people aren't trying,
Speaker:but there's a lot of, in
the end, health investment
Speaker:that happens in health care
that doesn't end up
Speaker:influencing outcomes.
Speaker:There's a massive opportunity
to use AI to make all of
Speaker:what we invest in health care
work much more effectively
Speaker:towards better outcomes for humans.
Speaker:I do think there's a, you
know, there is a safety
Speaker:and a appropriate use
sort of risk as well,
Speaker:and I don't want to, I don't
want to, like, belittle that,
Speaker:but I think the,
Speaker:the commercial providers
have an incentive not
Speaker:to end up getting sued
for providing bad advice.
Speaker:The regulators have an
incentive for that also:
Speaker:for people to get good
advice through their systems.
Speaker:I actually think we can work
together pretty effectively
Speaker:to sort of manage
Speaker:and, you know,
minimize that risk,
Speaker:give people the right
advice when they need it.
Speaker:I think the, the stronger importance is
Speaker:about partnerships within
and across our health system
Speaker:to make sure we're getting all
of the opportunity out of AI.
Speaker:- If technology companies
are increasingly owning
Speaker:that first interaction with
patients, what does that mean
Speaker:for health care providers and payers?
Speaker:Who ultimately, I suppose,
owns the patient relationship?
Speaker:- Yeah, and I think that is a, like,
Speaker:that's a critical strategic question.
Speaker:It's not even clear yet how
consumer AI tools are going
Speaker:to be monetized in the future.
Speaker:I mean, you know, is it going to stay
Speaker:just a subscription model,
Speaker:or is it going to move to something
Speaker:where there's a, you know,
Speaker:an advertising revenue model in, in there,
Speaker:or at least in some LLMs,
Speaker:and there'll be a free version
that's got advertising in it?
Speaker:You know, regardless,
providers and payers need
Speaker:to think about what,
how do they provide
Speaker:a great consumer experience?
Speaker:How do they make sure their brand,
Speaker:their reputation is well understood?
Speaker:How do they make sure
Speaker:that when an LLM is providing
advice, it's picking up
Speaker:from their, you know,
national health system
Speaker:or their, you know, or their provider
Speaker:or payer advice when
people are seeking advice
Speaker:about who's a good payer
that I should, you know,
Speaker:get an insurance relationship with?
Speaker:- To a certain extent, I
suppose with, you know,
Speaker:people living longer and
all the sort of added issues
Speaker:that we're going to have
with, I suppose, economics,
Speaker:we're almost going to, we're going
Speaker:to need something like this, aren't we?
Speaker:I mean, you know, everywhere you look,
Speaker:there's a story about
shortages of doctors,
Speaker:shortages of nurses.
Speaker:You know, projected forward,
Speaker:we'll never have enough, et cetera.
Speaker:And so, you know, we have to find ways
Speaker:to deliver health care that are,
Speaker:that scale that individual
human relationship.
Speaker:I think the individual human
relationship is just critical
Speaker:and, you know, can't be replaced.
Speaker:People, you know, health is a, is
Speaker:a human-to-human contact service,
Speaker:but there's a lot of what we
require health workers to do
Speaker:that is not actually
Speaker:about that person-to-person relationship.
Speaker:It's administrative, it's
process oriented, and so on.
Speaker:You know, think about people
with a chronic disease.
Speaker:They often get put on a program
Speaker:of see your specialist every three months,
Speaker:and we'll check in on
how things are going.
Speaker:So I think there
are a lot of opportunities
Speaker:to sort of change models
of care that use AI
Speaker:to make the most of that
human-to-human contact
Speaker:rather than use it in a kind
Speaker:of very administrative or gatekeeping way.
Speaker:- So this is an AI plus clinicians,
Speaker:not AI versus clinicians
Speaker:or AI even taking over all the jobs
Speaker:of our, of our clinicians.
Speaker:- I do think AI can do jobs on behalf
Speaker:of clinicians, absolutely,
Speaker:but, you know, supervised, you know.
Speaker:There are a set of things
where clinicians are simply
Speaker:applying a very simple
algorithm to test results
Speaker:to consumer, you know, patient-reported,
Speaker:you know, symptoms or whatever.
Speaker:A lot of that we ought to
be able to, you know,
Speaker:make routine and automate,
but that sort of that step
Speaker:of then really talking to
someone about their needs
Speaker:and their aspirations
Speaker:and what they want to,
what they want to achieve
Speaker:and then helping them,
you know, make choices
Speaker:and then feel cared for,
Speaker:as well as just experience the care.
Speaker:I think all those things,
you know, still matter
Speaker:and, you know what I,
Speaker:but I, you know, I don't
want to create a, sort of a,
Speaker:a glorified ideal when the
reality is, around the world,
Speaker:millions of people aren't
getting the basic health care
Speaker:that they need and AI
can be a big part of,
Speaker:of actually helping them
get access to care as well.
Speaker:Ben, thank you so much, and
thank you for listening.
Speaker:If you'd like to read Ben's latest report,
Speaker:"Consumers Are Ready for
AI-Enabled Health Care.
Speaker:Health Systems Need to Be, Too,"
Speaker:you can find the link in the show notes.
