Health artificial intelligence for all!
June 21, 2023
Artificial Intelligence (AI) is no longer just a buzzword. It has reached all of our domains in one form or other. People are very optimistic that AI will be capable of solving many of our issues. The recent resignation of Google’s AI Pioneer, Geoffrey Hinton, and his statement “He was worried about AI’s capacity to create convincing false images and texts, creating a world where people will not be able to know what is true anymore”. He is called the “God Father of AI” and warned about the dangers of AI. In a recent statement, he cautioned of danger that we'll get things smarter than us fairly soon and that these things might get bad motives and take control. This has created confusion and apprehension in the mind of people on the use of AI.
AI is defined as a system’s ability to correctly interpret external data and to use this learning to achieve specific goals and tasks through flexible adoption. AI has been rapidly expanding and has made significant inroads in almost all aspects of human life including healthcare. Some the examples of use of AI in healthcare include Computed Tomography (CT), TB screening using chest X-ray, and Mammography scanning. The introduction of AI into healthcare has the potential to be the solution for significant challenges faced in healthcare like diagnosis and screening; therapeutics; preventive care; treatment; clinical decision-making; public health surveillance; complex data analysis; and predicting disease outcomes. AI-based technology might help reduce human errors and have the potential of enhancing known methods of screening and diagnosis of disease, improving diagnostic accuracy, and guiding evidence-based treatment algorithms, predicting outcomes, identifying health system gaps, with an overall impact on human health and wellness.
Many countries including India are facing a shortage of skilled workforce. Advances in AI have opened up new opportunities to tackle this shortage. Telemedicine and self-care via interactive chatbots, and digital monitoring devices like wearable watches are alternatives. The technology can assist in self-monitoring of personal health-related parameters such as intake of nutrition, physical activity, blood pressure, glucose, and lipids for identifying high-risk groups. It provides solutions for medication non-adherence, motivation, remote, and building a care network. Chatbots and robotic assistants can empower patients in the self-management of Non-Communicable Diseases (NCDs) and improve decision-making. Chatbot is a software application that aims to mimic human conversation through text or voice interaction, typically online.
Realizing the potential of AIs, India’s Finance Minister in her budget speech for 2018-19 mandated the NITI Aayog to establish the National Programme on AI. NITI Aayog is the National Apex public policy think tank. The pilot study conducted in association with NITI Aayog has successfully demonstrated the feasibility of AI as a customized clinical decision-making tool. The study report is published as Healthcare Artificial Intelligence Catalyst (HAIC) Pilot Study: A feasibility study to assess the usability, usefulness, and adherence to standard treatment guidelines in Indian healthcare settings with the use of Elsevier’s “Arezzo” - a declarative artificial intelligence based Clinical Decision Support System (CDSS) and pathway technology. The study has convincingly proved the integration of this CDSS into local apps is usable and useful to health workers in primary and secondary healthcare settings and is preferred by over three-fourths of the users for continued adoption. We need to be careful before putting AI in clinical decision-making. Accountability in case of errors is a primary concern for safeguarding and protection. Just like any other diagnostic tool, AI-based solutions cannot be made accountable for their decision and judgment. The system should be made to have accountability and responsibility at all stages of its development and deployment of AI in health. Data safety, data sharing, and data privacy are other concerns. AI empowers the masses by permitting easy and early diagnosis and access to health facilities but unsupervised use of such tools and techniques is potentially risky.
AI is not only useful in healthcare but is equally useful in healthcare education. One major use of AI is medical simulations where students get an opportunity to practice real-world medical scenarios in a safe and controlled environment. It provides an experiential learning experience, one of the best ways of learning. AI-powered virtual patients can also provide individual feedback to the students. The individual feedback will help the students to identify the areas where improvement is needed. In short, AI has the potential to provide more effective and efficient training to healthcare students.
There are many other issues. Cheap and powerful artificial intelligence tools would allow anyone to create fake images, video, and audio that is realistic enough to fool voters and perhaps sway an election. The threat posed by AI and the so-called deep fakes seemed a year or two away. AI presents political peril for 2024 with a threat to mislead voters (United States of America). There seems to be apprehension that the application of AI will take away many of our jobs. This will not happen as long as domain interpretation exists, says an expert.
Despite potential benefits, there are several concerns: ethical, legal, and social concerns about its development and deployment. The Indian Council of Medical Research (ICMR) has recently released “Ethical Guidelines for Application for Application of Artificial Intelligence in Biomedical Research and Healthcare”. These apply to all stakeholders involved in development, validation, and deployment. It is important to protect citizens from the potential harms of AI technology by realizing its safety and accountability. AI can influence the health system or the health of the population imposing risks on society and patients. Even America has a lot of concerns. The White House has called the two CEOs: Sundar Pichai of Google and Satya Nadella of Microsoft for discussion. These two companies have huge investments in AIs. The US administration has said, “The tech giants have moral duty on AI”. Indian Institute of Technology, Madras, has recently launched a new department that blends engineering and medical science. This new department concentrates on understanding the human body from the technology lens including the use of AI in medicine. This is the testimony of our interest in AI and there is a rapid resurgence of AI in our life. But, there is also growing apprehension on the socio-political and economic implication of AI.
In Bill Gate’s version “This is the beginning of AI and is as revolutionary as mobile phone and internet. AI is filled with opportunities and responsibilities”. AI is the most remarkable new technology and it must be guarded against the risk and spread the benefits to as many as possible. AI is one of the promising technologies in years to come and healthcare is likely to have substantial benefits from integration of AI. It has enormous potential to overcome some of the biggest challenges: lack of an adequate number of health professionals and infrastructure. The Government must regulate the use of AI in all sectors including healthcare. AIs are super intelligent and there is a risk of running out of control. The NITI Aayog has recently released the discussion paper “Responsible AI - AI for All” but the government should come out with a clear policy that can guide all stakeholders of Artificial Intelligence.
PHARMABIZ.com