Blog 4: AI and its Role in Shaping Health Policy
Advancing Full Practice Authority for Nurse Practitioners: Evidence-Based Policy and Future Opportunities
Nurse practitioners (NPs) play a critical role in addressing healthcare shortages, improving access to care, and delivering high-quality patient outcomes. However, their ability to practice to the full extent of their education and training is often limited by restrictive state regulations. Full Practice Authority (FPA)—which allows NPs to evaluate patients, diagnose, prescribe medications, and manage treatment without physician oversight—is supported by decades of research demonstrating their competence, safety, and cost-effectiveness. Yet, policy adoption across the U.S. remains inconsistent.
Current Policy Landscape and Evidence-Based Foundations
As of 2024, 26 states and Washington, D.C. grant Full Practice Authority to NPs, while others impose reduced or restricted practice regulations requiring physician oversight or collaborative agreements. These restrictions persist despite overwhelming evidence that NPs provide care comparable to physicians in terms of:
- Patient Outcomes: Multiple studies, including research published in Medical Care and Health Affairs, confirm that NPs deliver equivalent or better health outcomes in primary care, chronic disease management, and preventive services.
- Access to Care: States with FPA have higher numbers of NPs practicing in rural and underserved areas, reducing disparities in healthcare access (AANP, 2023).
- Cost Efficiency: NPs optimize healthcare spending by reducing hospital readmissions and unnecessary specialist referrals (Bauer & Bodenheimer, 2017).
The National Academy of Medicine (NAM) and the Federal Trade Commission (FTC) have both advocated for FPA, arguing that restrictive laws create artificial barriers that harm competition and patient access. The VA Health System’s adoption of FPA in 2016 further validated NPs’ ability to enhance care delivery without compromising safety.
Opportunities to Strengthen Policy Through Research and Innovation
Despite progress, gaps remain in policy adoption and implementation. To advance FPA nationwide, policymakers and advocates should leverage emerging evidence and innovative strategies:
- Expanding Research on Specialized NP Roles
While much evidence focuses on primary care, more studies are needed on NPs in specialty care (e.g., psychiatry, cardiology, neonatology) to demonstrate their impact in diverse settings. Research should also explore:
- Telehealth utilization by NPs in FPA states.
- Outcomes in value-based care models where NPs lead preventive and chronic care teams.
- Addressing Opposition with Data
Physician groups often oppose FPA, citing patient safety concerns. However, systematic reviews (e.g., Cochrane, 2018) show no increased risk under NP care. Policymakers should:
- Require state Medicaid/Medicare programs to report NP outcome data to disprove misconceptions.
- Highlight interstate comparisons (e.g., patient satisfaction in FPA vs. restricted states).
- Leveraging Technology and Workforce Analytics
Artificial intelligence and predictive modeling can help policymakers:
- Identify underserved regions where NP autonomy would most improve access.
- Simulate the economic impact of FPA adoption on state healthcare budgets.
- Strengthening Advocacy Through Patient Stories
While data is critical, personal narratives from patients in FPA states—particularly in rural areas—can humanize the policy debate. Campaigns should amplify:
- Veterans’ experiences with VA NPs.
- Stories from states that recently adopted FPA (e.g., New York in 2022).
Conclusion: A Call for Evidence-Driven Reform
Full Practice Authority is not just a professional priority for NPs—it’s a public health imperative. Existing evidence clearly supports NP autonomy, but persistent legislative barriers require continued research, stakeholder engagement, and public education. By integrating real-world data, technological tools, and patient voices, advocates can accelerate policy innovation and ensure all states recognize NPs as essential, independent providers.
The future of healthcare depends on removing outdated restrictions and empowering NPs to meet the growing demand for accessible, high-quality care. Policymakers must act on the evidence—because when NPs practice to their full potential, patients and health systems thrive.
Sources:
- AANP (2023). Fact Sheet.
- Bauer, L. & Bodenheimer, T. (2017). Health Affairs.
- National Academy of Medicine (2021). The Future of Nursing 2020-2030.
- FTC (2014). Policy Perspectives: Competition and the Regulation of APRNs.
Critique of the above AI post
Accuracy
The information in the AI generated blog accurately looked at current policies, addressed the validity of Nurse Practitioners, and discussed the supporters. The references listed were surprisingly accurate, but there were citations with unmatched references. It included AI as a benefit to help policymakers use data to identify underserved regions and future economic impact.
Completeness
It gave a comprehensive look at what Full Practice authority is. It did not give examples of states that implanted FPA successfully. It was somewhat vague and used bullet points to get the point across. The post highlights several research-backed opportunities for innovation, such as telemedicine and longitudinal study outcomes in value-based models. on Full Practice Authority, which could significantly influence policy. However, while it identifies key areas for advancement, it does not fully explore potential obstacles to implementation. For instance, telemedicine adoption may encounter challenges like regulatory restrictions or technological gaps—particularly in underserved communities.
Clarity
The blog post is well-structured and easy to follow, presenting a logical flow from how evidence shapes current policy to opportunities for future research and innovation, and finally emphasizing the value of evidence-based policymaking. Its accessible reading level makes it particularly engaging for audiences interested in health policy and improving care for underserved populations.
The American Association of Nurse Practitioners® (AANP) supports the responsible use of predictive algorithms and AI in health care, guided by data-driven, evidence-based standards that prioritize access, quality, safety, and patient-centered care.
AI in health care must uphold ethical principles, promote equity, and reflect patient diversity. Nurse practitioners must be involved in developing these technologies. While AI can enhance care, clinical decision-making should remain provider-led, with transparency to strengthen the patient-provider relationship.
Potential Harmful and Beneficial Impacts
The integration of AI in healthcare presents both potential harms and benefits for nurse practitioners (NPs) under full practice authority (FPA). On one hand, AI raises data privacy concerns due to its reliance on vast amounts of patient data, which may lead to stricter regulations and complicated FPA implementation (Koski & Murphy 2021). Additionally, biased AI algorithms could perpetuate inequalities in patient care, undermining trust in NPs' autonomy. According to Morrell et al., increased scrutiny from adoption of AI might also result in tighter regulations, potentially limiting NP independence (2022). On the other hand, AI can enhance clinical decision-making by improving diagnostic accuracy and treatment planning, thereby supporting NPs' autonomous practice (Al-Antari, 2023).
AI technologies have the potential to aid in healthcare policy by streamlining data analysis and improving healthcare delivery. AI-driven predictive analytics and personalized care could improve patient outcomes, strengthening the argument for expanding FPA. Balancing these risks and rewards will be crucial in shaping the future of NP practice.
References
AANP (2023). Artificial Intelligence
Al-Antari M. A. (2023). Artificial Intelligence for Medical Diagnostics-Existing and Future AI Technology! Diagnostics (Basel, Switzerland), 13(4), 688. https://doi.org/10.3390/diagnostics13040688
Morrell, W., Shachar, C., & Weiss, A. P. (2022). The oversight of autonomous artificial intelligence: lessons from nurse practitioners as physician extenders. Journal of Law and the Biosciences, 9(2), lsac021. https://doi.org/10.1093/jlb/lsac021
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Comments
Hi!
AI is quite impressive in its potential! In all facets of life, AI is already automating or assisting in ways we never imagined. For instance, Grammarly is an AI writing correction tool. ChatGPT by OpenAI and its competitors are on the market, changing how businesses operate, including the healthcare market.
Ruksakulpiwat et al. (2024) suggest that AI can impact the following six areas they determined: "1) Risk Identification, 2) Health Assessment, 3) Patient Classification, 4) Research Development, 5) Improved Care Delivery and Medical Records, and 6) Developing a Nursing Care Plan." Already, AI is making an impact in this setting. In my current work place, the company utilizes large language models and predictive models ascertain risk factors for each patient.
While AI is a great tool, the human factor must remain (Grandi et al., 2024). NPs, nurses, and all other health professionals work in a profession where the human touch cannot be lost to complete mechanization. While AI can assist in quicker and more accurate diagnoses, charting workflows, etc., humans retain the critical function of rational thought and personal touch.
Grandi, L. C., & Bruni, S. (2024). Will the Artificial Intelligence Touch Substitute for the Human Touch? NeuroSci, 5(3), 254-264. https://doi.org/10.3390/neurosci5030020
Ruksakulpiwat, S., Thorngthip, S., Niyomyart, A., Benjasirisan, C., Phianhasin, L., Aldossary, H., … Samai, T. (2024). A systematic review of the application of artificial intelligence in nursing care: Where are we, and what’s next? Journal of Multidisciplinary Healthcare, 17, 1603–1616. https://doi.org/10.2147/JMDH.S459946
Hi Mara,
I really enjoyed reading your blog about the scope of practice of nurse practitioners (NPs) within the hospital setting. I recently accepted my first NP job in an inpatient setting, which I did not know I could do with a Family Nurse Practitioner certification. This is why it is so important to read and understand the rules and regulations set forth by state boards of nursing to ensure that we practice to the fullest extent possible.
This discussion inspired me to look for examples of artificial intelligence within this setting and with a nurse practitioner specifically. An article by Headrick and colleagues (2024) explains how an NP partnered with a thoracic surgeon and a radiologist to create an AI-driven lung nodule clinic. The AI model reviewed the images, and any lung nodules larger than three millimeters were independently reviewed by the NP and sent to the specialists as needed (Headrick et al., 2024). Ultimately, they could differentiate between benign and malignant nodules and provide the necessary treatment. The study revealed that using AI may help identify conditions like lung cancer earlier on, thus improving patient outcomes and saving hospital systems financially (Headrick et al., 2024).
Nurse practitioners are responsible for staying up to date with technology systems such as AI to ensure the best care is provided to patients. However, as this study emphasizes, we cannot eliminate expert verification and over-rely on these tools.
Reference
Headrick, J. R., Parker, M. J., & Miller, A. D. (2024). Artificial intelligence: Can it save lives, hospitals, and lung screening? The Annals of Thoracic Surgery, 118(3), 712–718. https://doi.org/10.1016/j.athoracsur.2024.05.014
Hi Mara,
I really enjoyed your blog post with the information you were able to acquire from AI. This is a very important topic for discussion, especially with all of us graduating soon. I like how AI was able to include the importance of NPs for underserved and rural populations because this is good advocacy point to make in favor of NPs. I think a lot of the issue regarding NPs having the same function and abilities as physicians is the lack of awareness regarding the training and skills of NPs in the role of a primary care provider. Poghosyan et al. (2018) discuss the results of their qualitative study mentioning that physicians admit to not understanding what NP training looks like and their competencies. I think AI will be a good resource and bridge between physicians and NPs for future healthcare. OpenAI (2023) describes that AI can play a role helping physicians understand and appreciate NPs by increasing transparency, communication, and data driven insights, such as, EBP comparisons on patient satisfaction and outcomes.
References
OpenAI. (2023). ChatGPT (Mar 14 version) [Large language model]. https://chat.openai.com/chat
Poghosyan, L., Norful, A., & Laugesen, M. (2018). Removing restrictions on nurse practitioners’ scope of practice in New York State: Physicians’ and nurse practitioners’ perspectives. Journal of the American Association of Nurse Practitioners, 30(6), 354-360. https://doi.org/0.1097/JXX.0000000000000040