Executive Summary
The United States faces projected workforce shortages of approximately 141,000 physicians, 355,000 nurses, and 423,000 behavioral health professionals by 2038. Clinicians, patients, consumers, and caregivers increasingly rely on digital health tools, including those with AI components such as clinical decision support, ambient documentation, predictive analytics, and generative AI assistants, to deliver higher-quality, more accessible, and more cost-effective care. As adoption accelerates, clinicians, health systems, and patients benefit from clearer information about how to evaluate these tools for safety, effi cacy, real-world performance, and impact on care.
The role of state governments in facilitating responsible health AI is meaningful but should be carefully calibrated; a growing patchwork of state laws risks creating compliance burdens that fall disproportionately on small and mid-sized developers, delaying patient access to beneficial tools without measurably improving safety. These principles give state policymakers a framework to evaluate interventions related to health AI across key areas including quality assurance and oversight, thoughtful design, access and affordability, transparency, ethics, and workforce development.
The Quadruple Aim, which serves as the guiding star for these principles, captures four interrelated objectives:
- Improving the patient experience of care
- Augmenting population health management
- Reducing costs, and
- Supporting the healthcare workforce
CHI believes that responsibly designed and deployed health AI, and digital health tools more broadly, can and must contribute to achieving these aims. State policy should be evaluated against whether it accelerates or impedes that contribution.
We urge state legislatures, executive agencies, and other policymakers to refer to these principles as a guide as they consider the role of state law and policy in the use of AI in the delivery and management of healthcare. CHI is committed to being a resource for state legislatures to achieve our shared goals for the responsible development and deployment of healthcare tools with AI components and we look forward to engaging in working groups, task forces, and roundtable discussions.
