AI in healthcare - How to keep the genie in the bottle?

Artificial Intelligence (AI) will revolutionise healthcare bringing great benefits to patients and citizens, but ethical concerns need to be addressed to keep the genie in the bottle.

I appreciate the emotional support I was given the most. Vigo provided great practical information on how to deal with the consequences of stroke and what I can do to cope better. Overall, I did not feel so depressed” – said a 50-year-old stroke survivor of Vigo. In case you were wondering, Vigo is not a doctor but an app that features AI to provide personalised treatment guidance at home.

Recovering from stroke can take up to 18 months and it requires daily intensive therapy. Most healthcare systems, however, lack medical personnel and rehabilitation facilities so patients are often left alone for some part of the recovery process. Doctors at the Latvian start-up – which was a finalist at the EIT Health InnoStars Awards 2019 – prescribe a personalised plan based on each person’s physical and emotional condition. It includes emotional support, a physiotherapy plan and education materials. Patients don’t have to repeat their medical history because it adapts after each usage.

This is just one of many ways AI can revolutionise healthcare. EIT Health has supported several start-ups that build on artificial intelligence: BrainScan improves the efficiency of interpretations of Brain CT Scans; PatchAi communicates with patients through empathic conversations; Abtrace provides doctors with the information they need to pick the correct antibiotic and dosage for every patient and every prescription; FRADE designed a wearable sensor to monitor falls and to provide a continuous estimation of fall risk, based on movement analysis; GRAID software, an AI-supported structured reporting system for cross-border teleradiology that helps radiologists and aims to decrease reporting time and improve diagnostic quality.

We can see that AI can be used in a variety of fields from disease prevention through early detection to personalised treatment and medicine. Scientists are hopeful that it could even help develop cures to some types of cancer. It could also help healthcare systems all around the world: the global workforce is already straining to meet demand and this pressure is set to increase – according to EIT Health’s new AI report from its Think Tank –, but AI can facilitate automation of routine, repetitive and administrative tasks for healthcare professionals to help them free up about 70% of their time that is spent on administration.

The field is growing rapidly, according to the International Data Corporation (IDC), worldwide spending on artificial intelligence is expected to reach 110$ in 2024. While there is heavy investment in AI, voices of concern are getting louder. Although the roots of the technology go back to the ‘70s – when researchers at Stanford University developed Mycin, that helped doctors better diagnose and treat bacterial infections – there are several questions to which science does not yet have satisfactory answers.

One of the main worries regarding AI and automation is the possible workforce reduction. What is going to happen with the livelihoods of the professionals whose work will be replaced by AI? Well, it is true that in healthcare some routine tasks may be replaced by AI but we should think of artificial intelligence as a means to ease the burden on professionals who thus will be able to focus more on the most important issues and make better decisions.

What if a system is designed poorly and misdiagnose patients? Is artificial intelligence smart enough to adapt quick enough to humans’ behavioural change? What if a system reflects the cultural biases of their designers – it should not be forgotten that those who feed the system with large amounts of data are humans – and already disadvantaged groups become more marginalised in healthcare systems? Is it possible that AI – which is often referred to as a ‘genie in the bottle’ – will eventually outsmart humans as the algorithms learn and improve their performance? How can we safeguard basic ethical norms through the various application of artificial intelligence?

There is no simple answer or solution to these questions, but scientists agree that the constant monitoring of the systems and the training of professionals – including the scientists who will write life-changing algorithms – is of key importance. They need to have a solid foundation. That is why EIT Health kicks off another edition of its HelloAI RIS Online training programme which upskills healthcare professionals in the field of AI. lt provides the missing pieces of understanding AI's role and its endless healthcare industry opportunities. Through the programme students get prepared for the terms and application possibilities of AI in healthcare and gain insights into how AI is becoming the new superpower of medical professionals.

Not only medical professionals need training though. People need to be ready for the use of AI too. “We need to make sure that citizens’ needs are at the centre of data-driven healthcare innovation and that citizens themselves are in control of their own health data. Citizens need to trust that their personal data is protected and that their privacy is assured”, said Roberto Viola, Director General of DG CONNECT in an interview to EIT Health.

When it comes to ethics, training, alone, is not enough. We need guidelines and regulations. An expert group set by the European Commission prepared The Ethics Guidelines for Trustworthy Artificial Intelligence. According to this pioneering document, Trustworthy AI has three components, which should be met throughout the system's entire life cycle: it should be lawful, ethical and robust. The Commission is also monitoring the regulatory frameworks dealing with data protection, cybersecurity, safety and liability to see whether and where they may need to be adapted in line with developments in AI.

“The pandemic has shown us that health care systems are very fragile and under enormous strain. It is not an exaggeration to say that AI has the potential to save the future of healthcare and can bring significant benefits to patients. It is true, however, that there are valid ethical concerns regarding artificial intelligence which need to be addressed. There is an ongoing discussion not only on a European level but at EIT Health as well and our goal is to support and upskill professionals who will be responsible leaders of future changes in the healthcare field” – said Mónika Tóth, EIT Health InnoStars RIS Programme Manager.