Undoubtedly, the key consideration in any type of medical procedure is patient safety. There are growing concerns about the ethical and medico-legal implications of the use of Artificial Intelligence (AI) in healthcare. Some important clinical safety questions must be considered to ensure success when using these technologies.
a) Identification of new disease or symptom: Over time, disease patterns may change, leading to disparities between training and operational data. In such cases, the new disease or new symptom of a disease will not be identified by Artificial Intelligence (AI). The main reason for this is that most uses of Artificial Intelligence (AI) are based on retrospective models on which the algorithms were built. Only through prospective studies will we begin to understand the true utility of Artificial Intelligence (AI) systems, as performance is likely to deteriorate when faced with real-world data that differs from the data the algorithm encountered in training.
b) Reinforcing old practice: Changes in medical policy and any other structural changes require recalibration of models. Sometimes this will even require a completely new/complementary model. The introduction of a new predictive algorithm may lead to a change in behaviour, resulting in a new distribution different than the one used to train the algorithm. Hence, methods to identify drift and update the model in response to deteriorating performance are important.
c) Insensitivity to impact: Artificial Intelligence (AI) driven models/processes may still require some manual support, especially in case of false positives or sensitive cases. Artificial Intelligence (AI) makes diagnoses based on information, however insufficient. It is driven by the confidence in the model driving the process. Hence in case of some models, which may suggest high confidence, it is important to develop and set up trigger-based monitors.
While the doctor patient ratio in India is improving and stands at 1.34 doctors per 1000, in rural India it is still 0.4 per 1000.33 The lack of trained and skilled health care service providers has led to unskilled or semi-skilled health workers working in rural India, which is one of the reasons for poor healthcare. Even though physicians working in rural areas have adequate knowledge and skills, they lack the support of other skilled health providers and generally have to provide a wide range of services. This professional isolation and varying scope of practice reduces the quality of medical services. Factors such as poor general economic conditions, inconvenient transportation also lead to poor healthcare in the rural setting.
The revolution in communication technology has led to increased smartphone usage in India, including rural areas. This is a boon for the delivery of technology such as Artificial Intelligence (AI). Most smartphones are user-friendly, they can be used not only to improve the expertise of rural doctors but also to communicate with patients and provide medical advice. Artificial Intelligence (AI)-powered portable devices can run some tests including blood pressure, electrocardiograph and routine urine/blood analysis. Smartphones can also act as a platform for the use of Artificial Intelligence (AI)-powered healthcare applications supported by some additional specialized machines. Predictions, early diagnosis suggestions and lifestyle management are some of the key areas where AI-powered systems can help establish effective, low-cost rural healthcare systems.
There are many different Artificial Intelligence (AI) techniques available that are capable of solving a variety of clinical problems and are currently being used. It must be remembered that Artificial Intelligence (AI) is not intended to replace physicians; it only assists. Artificial Intelligence (AI) is a boon in realizing WHO’s goal of “Health for All” as it provides instantaneous access, especially in rural India. There is strong evidence that medical Artificial Intelligence (AI) can play a vital role in assisting physicians to efficiently deliver healthcare in the 21st century. There is no doubt that these technologies will serve to enhance and complement the ‘medical intelligence’ of future physicians and revolutionize healthcare over time.
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