Efficacy of Artificial Intelligence for Gatekeeping in Referrals to Specialized Care

Human evaluators (mostly physicians) review referrals and determine, based on established protocols, whether they should be authorized.

An AI algorithm was developed to perform the first evaluation (triaging) of the referrals inserted in the electronic referral system from the Rio Grande do Sul Health Department.

After the first evaluation of a referral, several subsequent rounds of interaction between gatekeepers and primary care physicians can be conducted to further detail patient needs and urgency.