It’s more critical for U.S. healthcare to get medical AI right than to get it adopted far, wide and ASAP.
That’s the view of two people who’ve thought both scenarios through—a U.S. Congressman who happens to be a practicing physician and a data scientist who teaches at a leading medical school.
Of utmost importance in deploying the technology, the duo emphasizes, is “applying the principles that guide clinical research, including the respect for the human person, maximization of benefits and avoidance of harms to patients, just distribution of benefits, meaningful informed consent and protection of patient confidential information.”
The writers are Representative (and urologist) Greg Murphy, MD, (R-North Carolina) and Michael Pencina, PhD, professor of biostatistics and bioinformatics at Duke University School of Medicine. The politics and policy outlet The Hill published their commentary March 19.
“The emergence of artificial intelligence is reminiscent of the great Gold Rush, a frenzied time bursting with unlimited potential yet filled with uncertainty, speculation and unforeseen consequences,” Murphy and Pencina write. In fleshing out this perspective, the two make several strong points. Consider these five:
1. It remains to be seen how medical professionals and patients will interact with and utilize healthcare AI.
Noting two glaring AI weaknesses already out in the open—algorithmic bias and automated claims denials—Murphy and Pencina highlight the inadequacy of human-in-the-loop touches to counterbalance such failings:
We must not merely be one dimension of the progressive machine learning system; humans must remain atop the hierarchy. We need to control AI, not the other way around.
2. Facilitating broad innovation while guarding against unacceptable risk is a massive challenge—one that the federal government cannot handle unilaterally.
Other parts of the world may try “top down” approaches all they like, but the quality of life we expect in the U.S. calls for public-private partnerships, Murphy and Pencina contend. To develop guidelines and guardrails—and to validate the value and trustworthiness of healthcare AI here—we need to create independent assurance laboratories, they add. These labs would be charged with evaluating AI models according to “commonly accepted principles.” In a nutshell:
We need more than one hen guarding the chicken house.
3. Avoiding missteps like those that hindered the integration of now-mature technologies—we’re looking at you, EMRs and EHRs—is paramount.
It’s right and good to expect federal offices to help anticipate such trip-ups and course-correct for them. In fact, denizens of D.C. have a key role to play in this endeavor—that of a convener and enabler for those creating national standards, Murphy and Pencina state. However, they add, the implementation of such standards “should be deferred as much as possible to the local governance at the health system level with federal authorities intervening only when necessary.” More:
Progress will not be free, but we must learn from past mistakes.
4. As we pursue the mainstreaming of AI across U.S. healthcare, we must make sure ethical considerations reign supreme.
Patients in rural or low-income communities must have access to the benefits of this technology, Murphy and Pencina underscore. “Further, it is imperative AI used on or by [underserved] communities is as trustworthy as AI used by premier health systems.” More:
Just as access to healthcare is not a guarantee of quality, access to artificial intelligence systems will not certify the capacity or reliability of what is available.
5. The advancement of AI brings medicine to the precipice of truly transformational change.
The technology can “help reduce existing burdens and inefficiencies while at the same time improving patient care and experience,” Murphy and Pencina reiterate, citing examples “from ambient voice transcription tools to diagnostic devices—and the list is growing daily.” More:
[Healthcare AI’s] applications are nearly limitless; a new revolution has arrived.
Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.