AI to Curb Abuses in the GeSY - Initial Checks on MRI, Medications, and Physiotherapy

The GeSY (General Healthcare System) is turning to Artificial Intelligence (AI) to curb abuses, with initial checks focusing on areas with high financial costs and large volumes of procedures, such as MRI scans, medications, and physiotherapy. The use of AI is part of a broader effort to improve the efficiency and sustainability of the GeSY. The Health Insurance Organization (HIO) will leverage AI to identify anomalies and suspicious practices in services provided through the GeSY. This will enable timely intervention and prevent further abuses, saving resources that can be used to improve the quality of healthcare services. The implementation of AI in the GeSY is expected to begin in 2026. The HIO has already initiated the necessary procedures for the procurement and installation of appropriate systems, as well as for the training of its staff in their use. The selection of the areas to be checked first was based on data analysis and risk assessment for abuses. The use of AI in the GeSY represents an innovative approach to tackling abuses and ensuring the sustainability of the system. However, it is important to ensure that the use of AI is done in a transparent and responsible manner, and that the rights of insured individuals are not violated.