Associate Professor Liu Nan is expanding his focus from AI modelling to include regulatory and ethical considerations
The clinician-in-the-loop future
For the clinicians interviewed, the end goal of AI in healthcare is not replacement. AI is a tool, and the justification of the outcomes remains a burden shared by clinicians and their patients.
Being assisted by an AI can help free the clinician to focus on the patient. That’s why for Shannon, the prospect of patients first being seen by an AI-powered healthcare assistant akin to StarTrek Voyager’s Emergency Medical Holographic programme, Dr Zimmerman, is a welcome thought.
“You can start the consult already having the information you need at baseline. So it can fast-track some of that process, including—importantly—the amount of time you spend looking at a computer screen to gather that information,” he said.
To ensure that safeguards are in place to manage the widespread use of AI, countries are racing to draw up regulations and frameworks. Singapore, for example, added a new licensing category specifically to capture AI-powered tools to the list of healthcare interventions that need to be tested and approved.
But like with any intervention, post-marketing studies and regular reviews of side effects need to be incorporated here too. And for Savulescu, these require society as a whole to agree on the values that go into AI programmes.
“We need to be assessing how AI is performing over time, and ensuring that the pattern of the distribution of benefits and burdens is ethical,” he said. “So, we need ethics to set up AI, set the values and because we can never be sure—particularly with black box AI and deep learning—that we’re maximising those values, we also need ethics to evaluate the outcomes.”
This view is shared by many clinicians and has led AI advocates like Liu to review their role as creators: “Many efforts focus on building a model without considering the negative impact on society. So, I’ve started to look beyond developing a score or model to look into the ethics and the governance of AI.”
Agreeing, Ong observed, “It has a lot of potential to address some of the problems we are facing like the shortage of trained healthcare manpower. We just must do it thoughtfully.”
He added: “When elevators were first introduced, people worried that we would forget how to climb stairs. But you are not going to climb 100 floors to get home, are you?”