Governance, ethics top concerns for CHIME 2023 Fall Forum panel on AI

Artificial intelligence (AI) has emerged as a transformative force in healthcare, offering both potential and risks that demand thoughtful consideration. The CHIME 2023 Fall Forum brought together a distinguished panel of experts to explore these aspects and chart a course for responsible AI integration in the healthcare sector.  

Educating clinicians, patients and other stakeholders about AI capabilities and limitations to increase understanding and adoption

For Dr. Anthony Chang, MBA, MPH, MS, Pediatric Cardiologist & Medical Director of the Heart Failure Program at the Children’s Hospital of Orange County, AI implementation must begin with clinician education.  

“How do we convey the general basic knowledge [of AI] to clinicians who are very busy?” Chang asked. Chang, who has developed AI courses for the American Board of Medicine, finds that the success or failure of all AI technology is dependent primarily on if clinicians will be able to or interested in understanding how to use them. 

While these courses are a step in the right direction, the challenge lies in ensuring that all clinicians have a basic working knowledge. That’s where Biden’s Executive Order on AI comes in. 

“On Oct. 30 of this year, President Biden signed an Executive Order demanding and instructing oversight of artificial intelligence across the entirety of the federal government,” Aaron Miri, MBA, CHCIO, FCHIME, CDH-E, SVP & CDIO, Baptist Health in Jacksonville shared. “Specific to HHS, why should we care about that?” 

 “The reality is a couple of things. Number one, convening for training. Exactly like what [Dr. Chang] said, they want to make sure the federal workforce is formally trained in AI, and especially the intersection point to healthcare.”  

The Executive Order will appoint an “AI czar” across HHS that will coordinate FDA, CMS, ONC, and other involved federal agencies to ensure that efforts aren’t duplicated. Though the Executive Order was on AI in general, healthcare was mentioned “no less than 30 times” Miri stated, showing how massive the implications are for the medical field.   

Developing AI governance policies and procedures to guide ethical and responsible AI initiatives

Beyond federal regulations, the speakers also agreed that institutions need to establish governance committees led by clinicians to help assess AI initiatives for their clinical value, ethical implications, and compliance with privacy regulations.  

“The reality is it’s up to each of us to do the true process improvement and process efficiency work first, then worry about the tech,” Miri said.  

Miri shared a noteworthy practice at Baptist Health, where an AI governance committee, primarily led by clinicians, plays a pivotal role in evaluating the effectiveness and ethical implications of AI tools.  

Piloting specific AI use cases to evaluate their clinical effectiveness and impact on outcomes

 Implementation, however, is another story.  

 “Human to AI synergy is going to be very special,” Chang said. Clinicians who believe they must go “head-to-head” with an AI model must be educated. By working with AI tools, clinicians can be stronger, Chang argues.  

Data privacy and security

When it comes to keeping patient data safe and secure, “It’s clear we have a lot of work to do in that space,” says Cleveland Clinic interim CIO Sarah Hatchett. “We have to expedite those things quickly, so that you don’t stifle innovation.” 

She added it’s important for organizations to build the right coalitions to create a working guidance on data privacy.  

Looking toward the future

Despite the formidable challenges and concerns surrounding AI adoption in healthcare, the speakers at the CHIME Fall Forum expressed optimism. 

“We have an Apollo13 moment in healthcare right now. It’s damaged. It’s looking pretty bad – to the point where a lot of senior clinicians have left or are thinking of leaving. And yet the younger generation is coming out in full force. More students applied for medical school in the last year in the US than ever before. So we owe it to the next generation to really improve on things so that they can have an easier time in practice.,” Chang shared.  

 “We can’t do it with humans alone. And we certainly can’t do it with technology alone. We need that special synergy to get us out of the Apollo13 moment. This is not going to be healthcare’s worst moment; this is actually going to be healthcare’s finest moment because we are to reverse the very concerning trends that we have now into something very special for the future.”