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Recently, many readers expressed their concerns about the impact of the artificial intelligence revolution in health care. Tom from Vermont shared, “My doctor already spends the entire visit with eyes glued to a computer. I don’t want the next step to be the computer doing the talking.” Jennifer from Virginia added, “Call me old-fashioned, but no thanks. I prefer human interactions to a robot doctor.”
I understand these worries about potential interference with the patient-doctor relationship, although I believe Tom’s and Jennifer’s scenarios are unlikely in the near future. Medicine is a conservative field that adopts change slowly, and health-care providers are generally cautious when it comes to implementing AI.
Many current uses of AI in health care are quite ordinary. Adam Landman, an emergency physician and chief information officer for Mass General Brigham in Boston, shared examples of how his hospitals have integrated AI technology to improve efficiency.
One example is in staff training videos. Previously, actors would be hired to read a script, and if edits were necessary, actors would have to be brought back. Now, they have piloted an AI product that allows users to choose an avatar and digitally enter the script. This way, videos can be created instantly, and edits can be made seamlessly at a fraction of the original cost.
Another example is in call routing. Instead of putting callers on hold to manually direct them to patient rooms or schedule appointments, Landman’s hospitals use software with natural language understanding. This change has benefited patients by connecting them faster, while also freeing up operators to handle more complex calls.
Landman assesses these cases in terms of value and risk. While he acknowledges the potential benefits of AI in clinical triage and diagnosis, he also recognizes the associated risks. If AI were to make a diagnostic error, it could potentially harm a patient. While AI has the potential to serve as an initial screening tool to advise patients on whether to go to the ER, urgent care, or wait to see their primary care physician, Landman believes the technology is not yet advanced enough for this application.
Interestingly, several hospitals, including Mass General Brigham, implemented AI triage mechanisms at the start of the pandemic for patients with suspected covid-19. Patients were able to enter their symptoms into a chatbot, which helped them determine whether they needed to visit the ER or could self-isolate at home. However, once the acute crisis subsided, the risk-benefit analysis changed, and the hospitals discontinued the use of the AI screening tool.
Covid-19 has also accelerated the adoption of AI in other areas. Irene Dankwa-Mullan, a physician and former chief health equity officer at IBM Watson Health, discussed AI’s role in epidemic tracking. Through AI-powered analysis of large data sets, associations between covid-19 mortality and social determinants of health, such as median household income, non-English speaking populations, and homeownership rates, were identified. AI also proved useful in pinpointing areas with spikes in covid-19 cases, prompting targeted preventive measures from health officials.
Maya Reiser, a radiologist in Maryland, shared her experience using AI to assist with mammograms. AI helps identify areas of concern with varying probabilities of malignancy. It serves as a second set of eyes, helping to highlight areas that may have been missed. However, Reiser emphasizes that AI still requires human expertise and interpretation.
AI-assisted mammography, similar to AI-augmented colonoscopies, as mentioned in my previous column, holds great value and poses relatively low risks. Personally, I would inquire about my providers’ use of AI for my next mammogram. Having a second pair of eyes that can reduce the chances of missed cancer diagnoses seems like a valuable asset.
Let me make it clear that I am not dismissing potential future concerns about the use of AI in medicine. I believe it is crucial to approach AI implementation slowly and cautiously. In my opinion, the best applications of AI in medicine should aim to free up physicians’ time, allowing us to focus on what drew us to this profession in the first place: providing compassionate and high-quality care to our patients.
If you are a health-care provider incorporating AI into your practice or a patient who has experienced AI-augmented care, I would love to hear from you. Your insights could be featured in future newsletters.
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