CWRU students help draft state legislation on use of AI in healthcare

Artificial intelligence holds great promise in medicine. AI-driven tools have the potential for more accurate diagnosis, personalized treatment options, streamlined administrative tasks, and other undiscovered possibilities.

But this ever-evolving technology also introduces new challenges and uncertainties. Last year, two Case Western Reserve University students set out to understand the potential pitfalls—and their findings have made it all the way to the Ohio Statehouse.

Pre-law students Sabrina Soto and Paisley Tuel set out to explore how AI has been leveraged by healthcare organizations in the state and examine what policies regulated its usage, both in Ohio and in other states. They completed a 50-page paper for the inaugural edition of the CWRU Undergraduate Law Journal, which they co-founded and co-edited during the 2024–25 academic year. 

Completing the paper wasn’t enough. They wanted to take it further. With support from their advisor, Sharona Hoffman—the Edgar A. Hahn Professor of Law and co-director of the Law-Medicine Center—they secured meetings with Ohio lawmakers State Reps. C. Allison Russo and Christine Cockley.

“Since AI is very new, we’re still at the very beginning stages of it being implemented in the healthcare industry,” said Soto, a rising third-year student majoring in political science and psychology. “But because we’re at the very beginning, there seems to be a lack of understanding on how to mitigate a lot of the issues that come with it.”

Soto and Tuel have taken the opportunity to position Ohio as a leader in this area.

A review of AI in healthcare

To shape recommendations for the state, Soto and Tuel examined examples of AI being leveraged by healthcare organizations in Ohio. They then explored legal precedent surrounding cases of the technology being challenged and studied policies on the matter from around the country.

Despite AI being such a new technological advancement, they found several examples of legal cases that pushed for better oversight by healthcare organizations and insurance companies. In one ongoing case, they found a health insurance company is alleged to have overlooked a high error rate in their algorithm, resulting in denied claims—and two instances of premature death. They also learned about another case out of Texas that alleged a company misrepresented the error rate of one of its AI-driven diagnostic tools.

In Ohio, they found AI has been used to transcribe physicians’ conversations with patients for clinical notes, and in another instance, has been used to improve documentation in electronic health records. These uses are regulated by IT-17, a statewide policy created to guide the use of AI for statewide solutions. The framework, however, does not offer direct guidance for healthcare applications.

Before drafting their own recommendations, Soto and Tuel closely examined legislation that has been enacted in California, Massachusetts and Illinois.  

Drafting solutions

Soto and Tuel used their findings to recommend seven points the state could incorporate into potential legislation. The three main themes they hope to address are better oversight, improved training and patient rights.

They advocate for the state to:

• Establish the Ohio AI Healthcare Regulatory Commission;
• Implement a rigorous AI certification process;
• Strengthen AI-specific data privacy and security laws;
• Mandate algorithmic fairness and bias mitigation;
• Introduce an AI-powered medical malpractice liability framework;
• Encourage responsible AI innovation with incentives; and
• Enforce strict AI disclosure and explainability standards.

Alongside the recommendations, Soto and Tuel created a three-year plan the state could use to make the changes.

The duo presented their work to Ohio legislators in February and have been asked to help draft legislation. They will continue to contribute to the work, even as Tuel transfers to another university this fall.

Their slides have also been shared with legislators in Pennsylvania, extending the impact of their work.

“As an undergraduate—especially as a sophomore—you never think this little research project you’re doing is going to have any real world impact. We just kind of thought we were doing something for fun and trying to get more people excited about policy and law, and we never expected it would turn into anything like this,” said Tuel.

Read their article in the CWRU Undergraduate Law Journal to learn more about their findings.