Sensing the promise of augmented intelligence (AI) in medicine, physicians are working to ensure oversight and accountability in an evolving technology. Delegates to the American Medical Association’s (AMA) annual meeting today endorsed a host of policy recommendations today that would keep the focus on AI’s role in enhancing patient care, improving population health, reducing overall costs while increasing value, and supporting the professional satisfaction of physicians.
“Medical experts are working to determine the clinical applications of AI — work that will guide health care in the future. These experts, along with physicians, state and federal officials must find the path that ends with better outcomes for patients,” said Gerald E. Harmon, M.D., former chair of the AMA Board of Trustees. “We have to make sure the technology does not get ahead of our humanity and creativity as physicians.”
To achieve those goals, delegates said the AMA will advocate for:
- Oversight and regulation of health care AI systems based on risk of harm and benefit.
- Payment and coverage for all health care AI systems that are conditioned on complying with all appropriate federal and state laws and regulations, including but not limited to those governing patient safety, efficacy, equity, truthful claims, privacy, and security as well as state medical practice and licensure laws.
- Payment and coverage for health care AI systems that (a) are informed by real world workflow and human-centered design principles; (b) enable physicians to prepare for and transition to new care delivery models; (c) support effective communication and engagement among patients, physicians, and the health care team; (d) seamlessly integrate clinical, administrative, and population health management functions into workflow; and (e) seek end-user feedback to support iterative product improvement.
- Payment and coverage policies that advance affordability and access to AI systems designed for small physician practices and patients and not limited to large practices and institutions. Government-conferred exclusivities and intellectual property laws that foster innovation as well as competition, access, and affordability.
- Policies that do not penalize physicians who do not use AI systems while regulatory oversight, standards, clinical validation, clinical usefulness, and standards of care are in flux. Opposing mandates by payers, hospitals, health systems, or governmental entities mandating the use of health care AI systems as a condition of licensure, participation, payment, or coverage.
- Liability and incentives aligned so the individual or entity best positioned to know the AI system risks and best positioned to avert or mitigate harm do so through design, development, validation, and implementation. When a mandate exists to use AI, the individual or entity issuing the mandate must be assigned all applicable liability. Developers of autonomous AI systems with clinical applications (screening, diagnosis, treatment) are in the best position to manage issues of liability arising directly from system failure or misdiagnosis and must accept this liability.
In 2018, the AMA passed its first report on augmented intelligence.
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Date: June 26, 2019