MedCity Influencers, Artificial Intelligence

Accommodating and adopting AI will be an ongoing challenge for healthcare providers

As the industry faces challenges such as an aging population, physician shortages and burnout, AI presents a unique opportunity to alleviate the impacts of some of these issues.

AI, machine learning

In 2019, investors poured billions of dollars into artificial intelligence (AI) startups, with healthcare being a major focus. Tech giants like Apple, Google and Microsoft are spending huge sums on software, as well as hardware like wearables, with the hope of redesigning how we think about healthcare.

As AI becomes more prevalent in all healthcare settings, millions of data points will be created and collected on patients and the population as a whole. The healthcare industry is already advancing at a pace that stretches beyond the ability of providers to keep up; medical knowledge is projected to double every 73 days by the end of the year. How will these millions of data points be managed by professionals who already feel stretched thin?

Without the ability to gather meaningful clinical insights from these data points, they’re effectively useless. Healthcare leaders and providers need to prepare for this influx of data by ensuring that physicians can seamlessly work alongside AI. If we don’t capitalize on AI’s potential to improve provider efficiency, effectiveness and patient safety, physicians and patients will suffer.

AI presents an incredible opportunity to the healthcare industry — diagnosing ailments more quickly and accurately (or catching a physician’s diagnostic omissions), monitoring patients’ health, creating new efficiencies when it comes to the administrative tasks that burn physicians out — but it’s important to consider the implementation process, the associated benefits and risks, and its impact on how we train the physicians of tomorrow.

Becoming a vital tool in a physician’s arsenal
While AI has received plenty of hype around its ability to detect cancer and read some X-rays better than radiologists, the technology is very much in its infancy, and a trial-and-error period should be expected. Instead of jumping at headlines about the possibilities of AI in the hospitals of the future, healthcare leaders should look to their physicians and find out what they would like to see from an AI system.

Rather than being an additional system that requires hours of painstaking data entry, AI should be used as a tool that alleviates the administrative burdens on physicians and gives them more time with patients. This is critical because, despite technological advancements, patients are still reluctant to put their well-being in the hands of AI systems.

More palatable to patients, however, is a scenario in which AI would serve to augment the physician. As another tool in a physician’s arsenal, AI can assist with decision making and diagnoses as needed. Constantly ingesting and processing a wealth of information, AI will arm providers with a better understanding of their patients’ unique situations. This could range from algorithms that identify symptoms and diagnose diseases to creating patient-specific care plans that draw on personal data such as medical history, genetics and national databases of constantly updated medical research.

AI’s impact on physician training
The next generation of physicians is already feeling the effects of burnout and they haven’t even completed their residency. Physicians feel devalued as they take on more administrative tasks required by EHR systems, which distract from face-to-face interactions with patients and their fellow clinicians. AI poses a potential solution to this problem by eliminating or reducing some of those tasks while also helping physicians make more informed decisions.

But how will this dynamic affect the training of physicians? Will AI impact physicians’ clinical skills? What if these systems crash? How will physicians deliver care? Even with proper vigilance, a potentially unhealthy dependence on AI systems may develop.

The argument could be made that advancements in technology have already hindered diagnostic skills. By relying too heavily on AI systems and their capabilities, healthcare organizations could be setting themselves up for disaster. When each second has an impact on patient care, it’s vital that physicians are equipped with the knowledge, skills and experience necessary to deliver it. Regardless of (and because of) the advanced technology at our disposal, providers must always train and practice in a manner that challenges us academically and intellectually.

Benefits and risks of AI in the healthcare setting
As the United States population continues to age and the national physician shortage grows — it is expected to reach 122,000 by 2032 — artificial intelligence could play a vital role in bridging the gap in physician availability. Emerging AI capabilities could reduce patient wait times, overcrowding in health systems and unnecessary patient visits.

In this scenario, AI will be able to provide an accurate diagnosis and treatment plan for a unique individual. Such functionality ideally will result in decreased length of stay, decreased post-discharge morbidity, and fewer subsequent readmissions, which in turn would expand physician and facility bandwidth. In addition, AI applied to simplify and personalize administrative tasks, such as hospital admission and discharge, and clinical documentation could transform what was once mundane and generic into more specific and valuable activities that involve less physician time, allowing physicians to spend more time at the patient bedside. When administrative tasks become more thoughtful and less rote, they yield greater value to both the patient and the provider. After being trained on massive amounts of patient data and conditioned over millions of simulations, AI has the potential to assist physicians in delivering consistently high quality of care regardless of location, specialty, provider, or case load. Like a rising tide, AI has the potential to lift all boats in the healthcare ocean.

However, while AI could transform healthcare, there are ethical issues that must be considered. Patient data, privacy and unintended biases should all be evaluated before wide-scale implementation is undertaken. AI depends on pooling large volumes of data (data lakes) which requires sharing of information. Patients will need to feel confident in sharing their unique de-identified data with national databases, which means trust (in the system and the technology) is a prerequisite.

The industry should take the lessons learned from the past 11 years of the Health Information Technology for Economic and Clinical Health (HITECH) Act as a roadmap to implementation. Rather than rushing to release a new product, developers should seek input from healthcare organizations, physicians, patients and IT teams to build a thoughtful and practical AI system.

Overall, I believe the potential benefits of AI in healthcare outweigh the risks and will contribute significantly to the emerging reality of a “learning healthcare system.” But success hinges on the employment of intelligent workflows and instinctive user interfaces that increase efficiency, allow providers to practice at the top of their license and optimize safety. Physicians are at their best when they are at the bedside, caring for patients, not when they are held captive by the EHR.

It is clear that healthcare is in the midst of a technological revolution that will change the ways in which care is delivered. As the industry faces challenges such as an aging population, physician shortages and burnout, AI presents a unique opportunity to alleviate the impacts of some of these issues. It is up to healthcare organizations and leaders to take advantage of this opportunity and implement AI capabilities that deliver meaningful benefits to physicians and patients.

Photo: ANDRZEJ WOJCICKI, Getty Images

Christopher Maiona, M.D., SFHM, is PatientKeeper’s Chief Medical Officer, responsible for providing clinical leadership across the company. Maiona helps guide PatientKeeper customers in how they can improve their physician experience and clinical outcomes utilizing PatientKeeper products, and brings a clinical voice to the product design and implementation processes.

Maiona has devoted much of his career to hospital medicine, both as a practicing physician and executive at provider organizations. Prior to joining PatientKeeper, Maiona was national medical director at Team Health and IPC Healthcare, focused on performance improvement, patient experience and quality. Previously, he was in charge of hospital medicine at several multi-site practice groups in the Boston area and Maine. He began his career as a hospitalist in Macon, Georgia.

Maiona received bachelor’s degrees from Boston College and University of Massachusetts/ Amherst, and his medical degree from St. George’s University School of Medicine. He has served as an instructor in medicine at Tufts University School of Medicine and Harvard Medical School, and is active in the Society of Hospital Medicine, where he is a Senior Fellow Hospital Medicine (SFHM). Maiona is board certified in Internal Medicine.

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