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The promise of augmented intelligence (AI) in spurring technological innovation in medicine has generated growing interest among health care stakeholders. It also has spurred a range of concerns about the novel challenges in the design, implementation, and use - especially how AI will be incorporated into the practice of medicine and affect patients. With those varied perspectives, the American Medical Association passed its first policy addressing AI at its Annual Meeting, adopting broad policy recommendations for health and technology stakeholders on this issue.
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"As technology continues to advance and evolve, we have a unique opportunity to ensure that augmented intelligence is used to benefit patients, physicians, and the broad health care community," said AMA Board Member Jesse M. Ehrenfeld, M.D. M.P.H.. "Combining AI methods and systems with an irreplaceable human clinician can advance the delivery of care in a way that outperforms what either can do alone. But we must forthrightly address challenges in the design, evaluation and implementation as this technology is increasingly integrated into physicians' delivery of care to patients."
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The policy states the AMA will:
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Leverage its ongoing engagement in digital health and other priority areas for improving patient outcomes and physicians' professional satisfaction to help set priorities for health care AI.
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Identify opportunities to integrate the perspective of practicing physicians into the development, design, validation and implementation of health care AI
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Promote development of thoughtfully designed, high-quality, clinically validated health care AI that: a. is designed and evaluated in keeping with best practices in user-centered design, particularly for physicians and other members of the health care team; b. is transparent; c. conforms to leading standards for reproducibility; d. identifies and takes steps to address bias and avoids introducing or exacerbating health care disparities including when testing or deploying new AI tools on vulnerable populations; and e. safeguards patients' and other individuals' privacy interests and preserves the security and integrity of personal information.
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Encourage education for patients, physicians, medical students, other health care professionals, and health administrators to promote greater understanding of the promise and limitations of health care AI.
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Explore the legal implications of health care AI, such as issues of liability or intellectual property, and advocate for appropriate professional and governmental oversight for safe, effective, and equitable use of and access to health care AI.
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The AMA's ongoing engagement with digital health offers insights for understanding, from physicians' perspectives, what is at stake in integrating AI systems into the delivery of health care. A recent AMA survey of physicians about barriers to adoption of digital health technologies suggests that physicians are most receptive to digital health tools they believe can be integrated smoothly into their current practice, will improve care, and will enhance patient-physician relationships. Earlier AMA research into physician professional satisfaction found that frustrations with electronic health records (EHRs), especially usability issues, were a major source of dissatisfaction in physicians' professional lives.
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AI systems need to be developed and evaluated in keeping with best practices in user-centered design. The focus must be on users' needs, and usability should be tested by participants who are demographically representative of end users.
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"To reap the benefits for patient care, physicians must have the skills to work comfortably with health care AI. Just as working effectively with EHRs is now part of training for medical students and residents, educating physicians to work effectively with AI systems, or more narrowly, the AI algorithms that can inform clinical care decisions, will be critical to the future of AI in health care," Ehrenfeld said.
