Home Medizin Wissen Patienten, wann KI im Gesundheitswesen hilft?

Wissen Patienten, wann KI im Gesundheitswesen hilft?

von NFI Redaktion

On February 27, 2024, when you send a message to your doctor about an appointment, a prescription refill, or answering a question, is it actually artificial intelligence or a human responding? In some cases, it’s hard to tell.

AI can now be involved in your healthcare without you even realizing it. For example, many patients inform their doctor through an online portal about their medical records.

„And there are some hospital systems that are experimenting with AI generating the first draft of the response,“ said I. Glenn Cohen during a webinar hosted by the National Institute of Health Care Management Foundation.

Assigning administrative tasks is a relatively low-risk way to introduce the use of artificial intelligence in healthcare, said Cohen, a lawyer and director of the Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School in Boston. The technology can save staff time that is currently spent on answering calls or messages for routine tasks.

But should patients know that AI is generating the initial response when the technology answers clinical questions? Do patients need to fill out a separate consent form, or is that going too far?

What if a doctor gives a recommendation that is partly based on AI?

Cohen shared an example. A patient and a doctor decide which embryos from in vitro fertilization (IVF) should be implanted. The doctor makes recommendations based in part on molecular images and other factors determined by AI or a machine learning system but does not disclose this information. „Is it a problem that your doctor did not inform you?“

Where do we stand on liability?

Lawsuits can be a good way to gauge the acceptance of new technologies. „There have been surprisingly few cases on liability for medical AI,“ said Cohen. „Most of the ones we’ve actually seen have revolved around surgical robots, which may not really be the AI causing the problems.“

It is possible that cases will be settled out of court, said Cohen. „But overall, I think people probably overestimate the importance of liability issues in this area given the data. But still, we should try to understand it.“

Cohen and colleagues analyzed the legal issues surrounding AI from a 2019 perspective in the Journal of the American Medical Association. The bottom line for doctors: as long as they adhere to the standard of care, they are likely safe, said Cohen. The safest way to use medical AI in terms of liability is to use it for confirming decisions rather than trying to use it to improve care.

Cohen warned that the use of AI could eventually become the standard of care in the future. If this happens, there may be a liability risk not with AI.

Insurers Embracing AI

Insurance company Guidewell/Florida Blue is already incorporating AI and machine learning models into their interactions with members, said Svetlana Bender, PhD, Vice President of AI and Behavioral Science at the company. Models are already identifying plan members who could benefit from tailored education, redirecting patients to medical care at other health facilities as needed, instead of the emergency room. AI can also enable faster prior authorization.

„We were able to optimize the reviews of 75% of prior authorization requests with AI,“ said Bender.

The increased efficiency of AI could also lead to cost savings for the overall health system, she said. „It is estimated that we could see savings of $200-$360 billion per year.“

Handling Complexity

Beyond managing administrative tasks and recommending more personalized interventions, AI could help providers, patients, and payers deal with an influx of health data.

„The amount and complexity of medical and scientific data, as well as the amount and complexity of patient data themselves, has simply increased exponentially and enormously,“ said Michael E. Matheny, MD, Director of the Center for Improving the Public’s Health through Informatics at Vanderbilt University Medical Center in Nashville.

„We really need help managing all this information,“ said Matheny, who is also a Professor of Biomedical Informatics, Medicine, and Biostatistics at Vanderbilt.

In most current applications, humans review the outputs of AI, whether it’s assisting in drug discovery, image processing, or aiding in clinical decisions. But in some cases, the FDA has approved AI applications that can function without a doctor’s interpretation, said Matheny.

Integration of Health Equity

Some experts are relying on AI to accelerate efforts towards a more equitable healthcare system. For example, when developing algorithms, the training data input into AI and machine learning systems must better represent the US population.

And then there is the pursuit of fairer access. „Do all patients contributing data to the model derive its benefits?“ asked Cohen.

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