Importance Of Artificial Intelligence (AI) Health Privacy

Healthcare data of patients includes a lot of sensitive information ranging from their age to sleeping habits to personal food habits or addictions to sex life to peculiar disease symptoms and so on. Along with this, these data also carry the personal identity of the patients. Now these information of various patients are stored and maintained in digital mode for efficient management and quick retrieval of datasets thereby enhancing healthcare delivery. Healthcare data can be used and shared with various stakeholders of the healthcare system to provide effective treatment, such as:

• It can be shared by the concerned doctor with clinical colleagues to provide the required standard of care and ensure diagnostic or medical care coverage

• It can be used by laboratories and scanning/X-ray centers to decide whether the results related to the patient’s condition are within the standard parameters or not and also for research and clinical trials.

• Pharmaceutical companies may also require patient health datasets for clinical trials or for discovering essential drugs needed.

• Even medical insurance firms require access to such data depending on whether the details provided to the customer were correctly informed or not, the level of insurance coverage offered and whether the company may incur any losses for the said customer.

Depending on all these purposes, healthcare datasets of individuals move from one place to another and different stakeholders have access to this information. However, it is to be remembered that personally identifiable data must be protected adopting the highest security and confidentiality standards as health data being personal sensitive data of individuals are subject to privacy and security regulations.

A. Privacy Values

‘Privacy’ is experienced at a subjective level and is usually perceived differently by different people. In contemporary times, the term is used to indicate different, but intersecting, concepts, namely, the right to bodily integrity or to be free from invasive search or reconnaissance, the right to human dirt, the right to personality and self-development and so on. The concept of ‘privacy’ is broader and includes within its ambit the right to exercise control over physical and psychological conditions. No one has the right to intrude into anyone’s mind or psychological thoughts and conditions and all data relating thereto belong to the individual alone. Constitutionalism provides protection against such intrusion, even if the intruder has the technological capability to read the minds of individuals.

Colste states that the notion of ‘privacy’ is basically based on three universal fundamental ideals. Even though cultural and social norms of individuals may differ with respect to the extent to which privacy is to be protected in order to achieve those fundamental values, such variations do not in themselves reflect a profound ethnic variance in the notion of ‘privacy’.

B. Importance of Health Privacy for Enjoying the Right to Personality

The paradigm of privacy is completely comprehensive and it rightly determines the question of who will have access to the personal information of an individual and under what circumstances. As far as health data privacy is concerned, it includes the aspect of collecting, storing and using the personal information of individuals and it examines whether such information can be collected primarily and also to examine the justification that information collected for one purpose can be handed over for another purpose. Maintaining and safeguarding the privacy of patients is considered to be the most important principle in ethical and just medical care and research. A high degree of privacy protection is expected when it comes to health data which includes, various sensitive information which is essential for one’s personal development. The health data mentioned above contains various aspects of individual life ranging from age to sexuality to major abnormalities and diseases and so on.

In case the heath data of any individual is to be used for purposes such as, for improving diagnostic methods, discovering new methods of treatment or for medical research or other legitimate purpose, it is indispensable to exercise due care and precaution while using it. If such data is not handled with due care and security, it may cause massive damage to the individual personality among all as slip of any such data, to an unwary person or for any non-consensual secondary purpose may injure the human dignity, self-confidence and personality of the individual to a great extent. Such data may have adverse repercussions on the reputation, credibility, confidence of that individual in his workplace or family or in the society as a whole. For instance, if an employed person has a serious heart disease for which he may be in a critical condition (life-threatening) at any time, he may not be preferred to hold any higher position in the office on the basis of such information. As this information raises questions about their competency which is important in relation to a higher position.

C. Role of AI in Improving Healthcare Using Personal Health Data

Deep learning, a subcategory of machine learning belonging to the domain of AI, is remarkably known for its proficiency in training powerful algorithms for a group of medical images and other high-dimensional data. Overall, these methods can provide for various benefits for patients, who are consumers, prioritizing automated screening and diagnosis of disease and effective treatment plans. For example, AI supports in the detection of diabetic retinopathy, periodontal retinopathy, and glaucoma, which can lead to early discovery and treatment. Moreover, AI is used for the prediction of future diseases and its possibilities, such as age-related macular strength deterioration and critical kidney injury for diabetic retinopathy; in the future, such predictive AI will result in betterment of precautionary treatment plans. At the same time, AI can facilitate health research by effectively managing datasets of the individual for disease diagnosis. It paves the way for detecting patterns of diseases and detecting symptoms, based on which medical research can take place effectively. It further benefits individuals, as, it enables access to new treatments, improved diagnostic methods, and a more proactive way to avert diseases and deliver appropriate care and remedies.

Public Use

Big data empowers more accurate and efficient assessments of the quality and efficacy of healthcare, which can promote treatment optimization. Big data can help to improve the quality of service delivered by hospitals,9 to formulate scientific hypotheses,10 to compare the utility and success of various interventions, and to monitor drug and device safety. AI is benefiting the heath care sector by executing cognitive techniques to unravel large amounts of medical records and facilitate in effective diagnosis. For example, Nuance, a product service provider, uses AI and machine learning to predict the intent of the particular individual. Its products are used in healthcare sectors, which basically helps to store, aggregate and improve data to enable consistent and faster access to all medical data of patients, and to learn behavioral patterns of patients to analyze or diagnose more efficiently.

The Indian government is notably moving towards digitizing the healthcare environment in India through the deployment of AI technologies. In the National Health Policy (2017) the government first codified the pen-paper based functioning of the healthcare system to digitalization. Moreover, the National Digital Health Blueprint (NDHB 2019) furthers this prediction to identify the constituent elements that impact the technological fundamentals en-routing for capacitive technological development for diverse purposes and relies on high data integrity of health in the most primary way. However, the EHR system somehow lacks behind in public health organizations for the high rate in its application and the extraordinary burden on the clinicians for the cumbrous input and maintenance tasks.

However, in 2019 India’s health minister promised to prioritise AI in healthcare to address such gaps. Where the doctor-patient ratio stands at 1:10,189, the call for technological application to accomplish efficient healthcare delivery is inevitable. For instance, an AI-based breast cancer detection tool that uses a non-invasive, economical resolution based on heat-mapping for early recognition of breast cancer is capable of noticing breast cancer five years earlier than a mammogram would with less reliance on a trained technician. Such benefits and efficiency arising from AI have generated a lot of interest from various states in India. For instance, the state of Telangana has called 2020 as the ‘Year of AI’, with the aim of promoting AI-enabled inventions in e-governance, farming, healthcare and education. Here are some of the initiatives taken by the central government to ensure the application of AI technologies in the public health sector: Imaging of Biobank for Cancer by a collaborative effort of NTI Aiog and Department of Bio-technology (DBT). Database of cancer patients including their patterns, habits and peculiar symptoms which data will be stored and processed for the purpose of future analysis and treatment.

Private Use

The private healthcare sector in India has also widely deployed AI, to advance the proficiency of the healthcare delivery system and serve its patients more efficiently. For instance, IBM Watson has been installed in Manipal Hospitals for diagnosis and treatment of various types of cancers. IBM Watson for Oncology combines the deep proficiency of leading oncologists in cancer care with the speed of IBM Watson to help physicians, to consider personalized cancer treatments for their patients. Basically, Arvind Eye Care Systems is working in collaboration with Google Brain, which formerly helped Google build its retina screening system, on the contribution of images.

Apart from the better known companies like Google and IBM, India has hosted many startup companies as well which are focusing on AI. For example, Niramai Health Analytix implements thermal analytics to detect breast cancer at an early stage, while Advenio Tecnosys detects TB from chest X-ray images and serious infections from ultrasound images. Again, BeatO, a startup founded in India in 2015, launched an app enabled with a glucometer that can be plugged into a smartphone for screening and to keep the readings saved in the app. This can be retrieved at any time to check and meet any emergency situation in a given time.

Most importantly, wearable fitness devices that are most popular among the masses nowadays are storing massive amounts of personal data on a daily basis in exchange for various social and medical benefits. Wearable fitness devices largely embrace a variety of technologies including Mobile Health (MHealth) technology to reduce the cost of healthcare; and to increase access to care by democratizing and demystifying medicine.” A medical device startup named TEN3T produces medical wearable devices, and its invention was Cicer, a palm-sized patch sticker with several embedded sensors. These devices keep track of day-to-day activities of individuals, which are regenerated at any time later to keep a record for health. This data can inform doctors of associative health patterns, for example, correlation between exercise and sleep habit patterns, and correlation between the existence of weight-related diseases in a particular location and on a local or national scale.

These technologies aid in the early detection and prevention of health issues during transportation, and even at home. Similarly, healthcare costs can also be reduced with the use of wearable fitness devices as the use of such technologies certainly reduces the number of visits to doctors. The combination of Big Databases and AI thus offers many potential benefits for healthcare systems that increase efficiency with reduced expenses.

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