Guardrails for Rapidly Advancing AI in Healthcare | Institute for Health Policy Leadership

By IHPL - August 15, 2023

Since the summer of 1956 when John McCarthy, then a mathematics professor at Dartmouth College, coined the term “artificial intelligence (AI),”¹ great advances have been made in using artificially intelligent systems across a wide range of industries: from sales and marketing in retail businesses to e-commerce, agriculture, manufacturing, traveling, banking, insurance, and healthcare.

In particular, as research in the application of AI healthcare continues to accelerate rapidly, governments, providers, and patients express excitement about its progress and benefits while remaining wary of its challenges and potential harm. On one hand, the growing use of AI in healthcare presents promise in patient diagnosis, prognosis, personalized treatment options, patient experience, patient care, population health, and administrative tasks. For example, AI classification models can now aid physicians in the diagnosis of skin cancer and other skin lesions. In fact, a 2017 study established that a deep convolutional neural network (DCNN) model using 129,450 images to classify images into different categories of diagnosis achieved performance at par to that of 21 board-certified dermatologists.²

On the other hand, challenges associated with such AI tools—lack of transparency, bias encoded in algorithms, difficulty obtaining high-quality data, potential threat to privacy and patient safety, and uncertainty over liability—quickly follow.

In recognition of such challenges, the U.S. Government Accountability Office (GAO) issued a 2020 report of six policy options that could address the risks and enhance the benefits of AI tools.³ Less than a year later, the World Health Organization (WHO) issued the first global report on AI in health cautioning against overestimating the benefits of AI for health and providing six principles to ensure that “AI works for the public interest in all countries.”⁴ These principles addressed the importance of protecting human autonomy; promoting the well-being and safety of the public; ensuring transparency of AI technology; fostering responsibility and accountability of stakeholders; ensuring inclusiveness and equity in AI’s design; and promoting AI that is responsive and sustainable.

Even more recently, on June 20, 2023, Representatives Ted Lieu, Ken Buck, and Anna Eschoo along with Senator Brian Schatz introduced a bipartisan, bicameral bill called the National AI Commission Act to create a national commission that will “review the nation’s current approach to AI regulation, make recommendations on any new office or governmental structure that may be necessary, and develop a risk-based framework for AI.”⁵ The national commission group would be comprised of experts of all different backgrounds including civil society, government, industry and labor, and technology (10 appointed by Democrats and 10 by Republicans) coming together to develop a comprehensive framework for AI regulation as technological advances develop faster than society can keep up.

In fact, as AI becomes more prevalent in society, particularly with its use in healthcare, Congress is ramping up its oversight. In March of 2023, STAT media company investigation found that Medicare Advantage insurers are using an AI proprietary algorithm to cut off care for seniors in need, denying crucial services recommended to them by their physicians and forcing patients to be discharged from medical facilities well before they are in the physical condition to leave.⁶ While the two parties do not agree on how exactly Medicare Advantage plans should be regulated, at the hearing held on May 17, 2023, lawmakers in both parties asked insurance companies such as UnitedHealth Group, Humana, and CVS Health’s Aetna for internal documents that show how decisions are made to grant or deny access to care, including how AI is being used.⁷ The idea is to increase these companies’ transparency in their decision-making and to encourage them to make medical necessity determinations based on the circumstances of specific individuals. Although the National AI Commission Act does not specifically focus on the use of AI by Medicare Advantage insurers, the bill will ensure that AI is utilized in a way that protects and secures the rights of citizens, including in the field of healthcare.

Author Bio:

Yuna Han

Yuna Han is an avid writer, a budding physician, a fervent believer, and a happy wife. She is currently pursuing a combined MD and Master’s degree in Religion and Society at Loma Linda University. Besides medicine and theology, Yuna is passionate about languages, traveling, dogs, and exercising.

Author Bio:

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