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Thursday, June 27, 2024
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artificial intelligence in healthcare

Coalition for Health AI publishes stakeholder guide, proposes 6-stage AI lifecycle

Those who have been thinking healthcare could use a detailed framework on the responsible use of healthcare AI just got their wish. The Coalition for Health AI, or “CHAI,” has drafted an in-depth guide that fits the bill. And the nonprofit is inviting interested parties to help refine the document, called simply the CHAI Assurance Standards Guide, before it’s finalized.

Announcing the draft’s release June 26, CHAI emphasizes that the framework represents a consensus view based on the expertise and knowledge of stakeholders from across U.S. healthcare. Contributors included patient advocates, technology developers, clinicians and data scientists.

The drafters angled their approach less on conceptual brainstorming than on real-world concerns and practices, hoping the draft framework will be reviewed and tweaked by people involved in the design, development, deployment and use of healthcare AI.

The purpose of the framework—which includes companion checklists of stakeholder to-do’s—is to offer “actionable guidance on ethics and quality assurance.”

In a 16-page executive summary of the draft framework, which tips the scale at 185 pages, the authors present a brief description of the AI life cycle. This, they suggest, consists of six consecutive but sometimes overlapping stages:

1. Define problem and plan.

Identify the problem, understand stakeholder needs, evaluate feasibility and decide whether to build, buy or partner.

“In this stage, the goal is to understand the specific problem an AI system is addressing,” the authors write. “This involves conducting surveys, interviews and research to find root causes. Teams will then decide whether to build a solution in-house, buy it or partner with another organization.”

2. Design the AI system.

Capture technical requirements, design system workflow and plan deployment strategy.

“During design, the focus is on specifying what a system needs to do and how it will fit into a healthcare workflow. This involves defining requirements, designing the system, and planning for deployment and monitoring to make sure it meets the needs of providers and users.”

3. Engineer the AI solution.

Develop and validate the AI model, prepare data and plan for operational deployment.

“This stage involves building an AI solution. The team will collect and prepare data, train AI models and develop an interface for users. The goal is to create a functional AI system that can be tested and evaluated for accuracy and effectiveness.”

4. Assess.

Conduct local validation, establish a risk management plan, train end users and ensure compliance.

“The assessment stage tests AI systems to decide if they’re ready for a pilot launch. This includes validating the system, training users and ensuring it meets healthcare standards and regulations. The aim is to confirm that the system works correctly and is safe to use.”

5. Pilot.

Implement a small-scale pilot, monitor real-world impact and update risk management.

“In this stage, the AI systems are tested in real-world settings at a small scale. The goal is to evaluate its performance, user acceptance and overall impact. Based on the results, the team will decide whether to proceed with a larger-scale deployment.”

6. Deploy and monitor.

Deploy the AI solution at scale, conduct ongoing monitoring and maintain quality assurance.

“The final stage involves deploying AI systems at a larger scale and monitoring their performance. This ensures systems stay effective and can be adjusted as needed, maintaining high quality and reliability in healthcare.”

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Industry Watcher’s Digest

Buzzworthy developments of the past few days.

  • Sharper teeth to bite health insurers using AI to decide whether or not to pay claims. That’s what legislators at both the state and federal levels—and in both parties—seem to want. This week several dozen members of U.S. Congress wrote to CMS on the concern. Among other things, they ask the agency to spell out how it distinguishes between uses of AI that account for individual circumstances and those that do not. “Such information is needed not only for AI tool oversight purposes,” they point out, “but also to allow Medicare beneficiaries to make better informed decisions when comparing plan options.” Meanwhile some state legislatures are making parallel moves to cuff insurers’ ability to tap AI for coldly denying care, as Bloomberg Law details. And all of this comes as class-action suits await hearings against Humana, Cigna and UnitedHealth. Something’s got to give here.
     
  • 3 MDs are proposing a 5-level path to AI automation in healthcare. The doctors base their levels on the degree of risk associated with AI products of increasing involvement. At the least risky end are algorithms used for administrative tasks (minimal risk) and clinical process automation (low risk). At the high end are clinical decision support via software as a medical device (high risk) and “digital doctor” software as a medical device (highest risk). Fleshing out their idea in Health Affairs, the trio state their scale can help “foster a culture of responsible AI adoption in healthcare” and can be adopted across stakeholder groups, from providers to payers to life-science firms and other healthcare orgs. “By using this five-level framework as a scaffold upon which to build more detailed and specific criteria for healthcare AI at each level,” they write, “we can realize the benefits of AI while minimizing its risks.” They might do well to read today’s lead story and then do a mind meld with the likeminded people at CHAI.
     
  • Rural healthcare providers are coming around to AI. They’re motivated by the realization that what they do won’t change—but how they do it must. The president and CEO of one of the biggest rural health systems in the U.S. thinks through the paradigm shift in a piece he wrote for STAT. “It makes sense to be cautious about AI in healthcare, no matter where one lives or practices medicine,” writes the health exec, Bill Gassen of Sioux Falls-based Sanford Health. “But some healthcare providers, including those in the most remote and rural locations in our nation, have already crept over the mountain and have seen a new world of promise.” Read the rest.
     
  • A millennial with a lot of experience in therapy has put an AI mental health counselor through its paces. After spending a week under the care of Therapist GPT and journaling her impressions day by day, freelance writer Ayana Herndon makes a judicious call. “I would recommend the chatbot for a quick pick-me-up between sessions,” she shares in PopSugar. AI therapy, she concludes, “serves as a great barometer for what concerns to bring up to my real therapist when our next meeting comes along.”
     
  • Another Big Tech player enters the healthcare AI fray in a pretty big way. Oracle says its newly available clinical digital assistant combines clinical automation, note generation, integrated dictation and proposed actions “in a single unified experience.” The company adds that the offering is aimed at ambulatory clinics, based on its existing digital assistant platform and designed to integrate with Oracle Health EHR as well as Oracle Health Care Management. Announcement.
     
  • Consumer trust is the skeleton key that will open many a healthcare door to generative AI. The observation isn’t new, but it gets a fresh airing out by a contributing writer at Forbes. “By addressing privacy concerns, engaging clinicians, being transparent and collaborating with community partners, healthcare organizations can foster trust and increase the adoption of gen AI,” writes Rajeev Ronanki, CEO of the healthcare AI company Lyric. “This trust will be instrumental in transforming gen AI from a promising tool into a trusted ally in achieving better health outcomes and more affordable healthcare.”
     
  • Did you know that almost half the counties in the U.S. have no cardiology practice? Or that 60% of cardiologists are at or near retirement age? I didn’t. And I appreciate these factoids enough to not mind their having reached me through a bit of a promotional spot. Especially since the spot is about how AI can help solve those problems. “[A]s one of the few doctors who have made house calls in recent years,” writes Ben Green, MD, “I know from experience that having portable, easy-to-use tools would have dramatically improved the kinds of care I could offer patients in their homes.” Green is senior VP of services for AliveCor, marketer of AI-enabled ECG devices. Newsweek published the piece June 26.
     
  • Elon Musk’s brain-computer interface has made Neuralink’s first patient really, really good at gaming. How good? So good that he almost feels guilty about the edge he now has over the competition. Spilling the beans on the Joe Rogan podcast, quadriplegic Noland Arbaugh said some games may be “too far out of reach” for his newfound expertise—but others have become a snap. “I basically have an aimbot in my head,” he explained. “They’ll probably have different leagues for people like me because it’s just not fair.” Futurism’s Neoscope site has the story.
     
  • Recent research roundup:
     
  • Funding news of note:
     
  • From AIin.Healthcare’s news partners:
     

 

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