The Standard

Innovators worldwide invited to demonstrate how HL7 standards and
AI can revolutionize healthcare

HL7 is proud to announce the launch HL7 AI Challenge 2025, a global innovation competition designed to spotlight the transformative potential of artificial intelligence (AI) when powered by open health data standards. Selected winners will be recognized on stage during HL7’s 39th Annual Plenary, Working Group Meeting, September 13-19, 2025, in Pittsburgh.

The HL7 AI Challenge is open to any individual, team or organization across academia, industry, and government using HL7 standards to power AI applications that solve real-world clinical, operational or equity-focused problems. HL7 membership is not required, and there is no cost to participate.

 The competition builds on HL7’s long-standing commitment to enabling interoperable, standards-based healthcare innovation and reflects growing global interest in aligning AI adoption with ethical, explainable and secure data practices.

“As AI becomes more deeply embedded in healthcare, we must ensure it advances—not undermines—trust, transparency, and patient outcomes,” said Dr. Charles Jaffe, CEO of HL7 International. “The HL7 AI Challenge invites technologists, researchers and clinicians worldwide to showcase how open standards can anchor responsible, scalable AI innovation, bridging the health IT and AI communities for the benefit of all.”

New publication outlines opportunities for accelerating and improving the use of AI to support payment integrity and reduce fraud, waste, and abuse

Last week, HL7 International released a new report outlining the actions needed to fully realize the benefits of artificial intelligence (AI) in improving payment integrity and reducing fraud, waste, and abuse. Reducing Fraud and Improving Payment Integrity in Healthcare Through the Use of AI brings together insights from payers, providers, and technology experts to define AI opportunities and emerging solutions, current challenges, implementation strategies, and standards needed to increase transparency and trust.

“The U.S. spends more than $900 billion annually on administrative complexity, waste, and improper payments,” said Charles Jaffe, MD, PhD, CEO of HL7 International. “This publication identifies practical and standards-based approaches to harnessing AI for one of healthcare’s most persistent and costly challenges.”

Key recommendations from the report include:

• Developing standards for explainable AI in healthcare with specific transparency requirements and bias mitigation protocols.
• Creating standards and infrastructure for trust and verification of AI-generated results.
• Establishing frameworks for human-in-the-loop validation that balance automation with clinical expertise.
• Implementing pilot programs focused on provider-payer collaboration that create mutually beneficial scenarios for all stakeholders.

How AI for Deterministic Approaches Can Fix PA Denials

A recent survey by the American Medical Association (AMA) revealed a growing concern among physicians: over 60% believe that unregulated AI tools are systematically denying necessary patient care. “Emerging evidence shows that insurers use automated decision-making systems to create systematic batch denials with little or no human review, placing barriers between patients and necessary medical care,” said AMA President Bruce A. Scott, MD, reacting to the survey results.

This alarming trend exacerbates the already burdensome prior authorization (PA) process in the US, delaying essential treatments and placing undue strain on providers, payers and patients alike.

At Smile Digital Health, we believe that AI should support—not override—good medical judgment. That’s why we developed KALM Services (Knowledge Authoring Lifecycle Management), with AI capabilities designed to exponentially accelerate the creation of deterministic computable policies for prior authorization workflows and other use cases like clinical reasoning and quality measure evaluations.