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AMA Advances New Principles to Put AI into Practice


 
Gerald E. Harmon, MD

AHIP isn't the only national organization focused on how AI might be effectively deployed to improve patient engagement, care and interaction with the broader healthcare system. Last month, the American Medical Association endorsed a series of policy recommendations during the House of Delegates meeting during the physician organization's annual meeting in Chicago that recognized the potential benefits of AI when coupled with human skill and judgement.

"Medical experts are working to determine the clinical applications of AI - work that will guide healthcare 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, MD, 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 healthcare AI systems based on risk of harm and benefit.
  • Payment and coverage for all healthcare 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 healthcare 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 healthcare 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 healthcare 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.

Additionally, the AMA also adopted a new policy to integrate AI into medical education to help further efforts to transform the way future physicians are trained. "To realize the benefits for patient care, physicians must have the skills to work comfortably with augmented intelligence in healthcare. Just as working effectively with electronic health records is now part of training for medical students and residents, educating physicians to work effectively with AI systems, or more narrowly, the AI algorithms that can inform clinical care decisions, will be critical to the future of AI in healthcare," said AMA Board Member S. Bobby Mukkamala, MD.

 
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AI, Artificial Intelligence
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