Does Your Health System Need a Clinical A.I. Department?
Could the deployment of artificial intelligence lead to the same type of widespread dissatisfaction among clinicians that has happened with electronic health records? A group of clinicians writing in BMJ Health & Care Informatics argues that unless the efforts are systematic and involve relevant stakeholders, a repeat of the same experience is likely.
The authors included clinical leaders from the University of Pennsylvania, University of Virginia, University of California San Francisco, Harvard-MIT, and Beth Israel Deaconess Medical Center.
After describing some of the literature about the disappointments with EHRs, they pointed to some precedents in radiology and laboratory medicine that they say offer lessons for how to steward a new tool into the realm of safe and effective clinical use. “Such accomplishments were due, in large part, to the gathering of relevant stakeholders under a single department. This approach ensured that the necessary clinical participants took the reins rather than ceding them to third-party developers. Thus, to secure AI’s place in the annals of successful medical technologies, we propose the establishment of the first departments of clinical AI.”
The authors say that within academic medicine, algorithms are currently developed in silos by researchers interested in the intersection of healthcare and machine learning. This has led to a panoply of published models trained on health data, yet only a handful have been prospectively evaluated on patients. In fact, when models have been prospectively evaluated on clinical outcomes, the results have frequently been unimpressive.
“We would argue that the lack of clinical results is the byproduct of a lack of coherence, leadership and vision,” they write. “Hence, unless we change course, we should expect that AI deployment in healthcare will progress much the way the EHR revolution did before it, that is, mainly based on corporate and administrative benefits without requiring any demonstrable improvements in processes or outcomes for our patients or ourselves.
One role they envision an AI department to play is to remove barriers to data access, and assume partnered stewardship of the institution’s data as part of its mandate. “While the role of information technology specialists in maintaining a health system’s computational infrastructure should not be subsumed, the department would be responsible for integration, research and production databases that can support its broader mission. By centralizing this role, we would finally overcome the chasms among ideas, development and effective deployment.”
The authors close by asking who will establish the first department of clinical AI?
