The Possibilities and the Pitfalls of AI in Health Care

 

The healthcare landscape is changing and one of the most important drivers today is artificial intelligence (AI). AI is transforming healthcare, offering a multitude of benefits to patients, medical systems, and healthcare providers. The ground-breaking technology has the potential to revolutionize how we approach healthcare by enhancing efficiency, accuracy, and overall patient outcomes.  

 So what is AI?

AI is a term that describes a machine’s ability to perform functions that are usually associated with tasks that only humans can do. AI programs have the ability to make decisions. They can provide solutions or actions based on the information it has within their database. Machine learning (ML) is a form of artificial intelligence—a subfield—that uses algorithms to review structured data. Algorithms are a process or a set of rules that the computer program has to follow.  

 And sometimes those algorithms go awry. When trying to use machine learning to diagnose certain skin cancers, the researchers learned that AI would be more likely to say that a lesion (spot) on a patient’s skin was cancerous if someone had placed a ruler or set of markings on the patient’s skin next to the lesion before taking a photo. Doctors often use rulers or markers so you can judge how large a lesion is. Obviously, a ruler has no bearing on whether a patient has cancer or not. So, a human engineer had to review the data to determine that the algorithm had come to an incorrect decision branch and the program had to be modified. 

 Another subset of AI is called deep learning (DL). DL can take unstructured data like documents, images, or texts, and use artificial neural networks to mimic the learning process of the human brain.

And, of course, you may have heard of ChatGPT. The GPT stands for Chat Generative Pre-trained Transformer. This is a deep learning program created by openAI that is now available to the general public for free as ChatGPT3.5 or for a fee as ChatGPT4. Google and Microsoft released similar programs: Bard (Google) and Bing (Microsoft). There are many new programs, both free and paid, that were developed for specific purposes like summarizing a novel as well.   

 Enhanced diagnostics and early detection

 AI-powered algorithms can analyze vast amounts of medical data, including imaging scans, lab results, and patient histories, with unparalleled speed and precision. This capability allows for early detection of diseases, such as cancer, before they reach advanced stages. This significantly improves the chances of successful treatment. AI has also been used to predict which patients are at risk for worsening infection or inflammation. This study shows the use of AI using CT scans to detect which patients with COVID-19 were likely to progress from mild to severe disease.  

Personalized treatment plans

AI-driven predictive analytics can generate personalized treatment plans based on your unique health profile. This tailored approach increases treatment efficacy and minimizes adverse effects, ultimately leading to better patient experiences. There have been interesting findings about the early detection of Alzheimer’s disease and protocol development to slow the progression of the illness.

Streamlined administrative tasks

 AI can be a big help for healthcare providers. It can automate administrative tasks like appointment scheduling, billing, insurance pre-approvals for treatments or medications, and medical record keeping. This reduces the administrative burden on the staff, allowing providers to spend more time and resources on patient care. Of course, an important consideration when using AI this way is to ensure patient privacy.  

Improved patient engagement

AI-powered chatbots and virtual assistants are found all over the internet now, offering 24/7 support. This may work in healthcare too as AI can answer questions, provide medication reminders, and offer general health guidance. This constant connectivity may enhance patient engagement and help them keep on track with their treatment plans.  

 This review of the use of chatbots in medicine showed how patient engagement increased when used to help patients stop smoking or using certain substances. A colleague of mine began using ChatGPT while in the examining room with patients. With their approval (and no personal identifiers), the patients enter signs and symptoms, and the physician supplements them with relevant medical history. They then review the ChatGPT results together.

Caveat: It is extremely important to realize that once medical information has been entered into a public AI system, it is no longer private. So, the users must verify that no data that could identify the patients has been included in their search. This could be challenging for people who may have a rare diagnosis. For example, there was a recent publication where a concerned mother was searching for answers for her child’s intractable pain. She had seen 17 doctors over 3 years. In frustration, she then entered all of her child’s medical records into ChatGPT to help facilitate his diagnosis.  

Seeing her success, I decided to start gingerly with ChatGPT, asking if it could help me prepare for my next provider visit. This is what ChatGPT answered:  

ChatGPT can help you prepare for your doctor’s visit

There are many ways ChatGPT can help you, like:

1. Information Gathering: You can ask ChatGPT for general information about the symptoms or conditions you’re experiencing. It can provide explanations and descriptions to help you better understand your health concerns.

2. Preparing Questions: ChatGPT can assist you in brainstorming and formulating questions to ask your doctor during the appointment. This ensures that you address all your concerns and get the information you need.

3. Understanding Medical Jargon: If you come across medical terms or jargon that you don’t understand, ChatGPT can explain them in plain language. This makes it easier for you to discuss your condition with your doctor.

4. Medication Information: ChatGPT can provide information about medications, including dosages, potential side effects, and how to take them. This can help you have a more informed discussion with your healthcare provider.

5. Preparing Medical History: You can use ChatGPT to help organize and summarize your medical history, including past diagnoses, surgeries, allergies, and current medications. Having this information ready can save time during your appointment.

6. Understanding Test Results: If you’ve had recent medical tests or lab work, ChatGPT can explain what the results mean. This can help you interpret the information before discussing it with your doctor.

7. Follow-Up Questions: After your doctor’s visit, you may have follow-up questions or need clarification about the treatment plan or recommendations. ChatGPT can provide additional information to support your understanding.

8. Mental Health Support: If you’re dealing with mental health concerns, ChatGPT can offer information about common conditions, coping strategies, and resources available to you. It can also help you frame questions for discussing mental health with your doctor.

9. Healthy Lifestyle Tips: ChatGPT can provide tips on maintaining a healthy lifestyle. This can include tips on diet, exercise, and stress management, which can complement your doctor’s recommendations.

10. Emergency Information: In case of emergencies or urgent situations, ChatGPT can provide guidance. It can suggest what to do while waiting for medical help, including first aid tips and when to call 911.  

But beware

I think that ChatGPT’s reply provided a great introduction to some effective ways AI can enhance the patient and provider relationship. However, ChatGPT has been known to “hallucinate,” or as I like to refer to it, confabulate. In the past, it has created false resources or answers for questions that do not have any basis in fact. This is due to the fact that ChatGPT is a prediction algorithm. If, for example, it combed its database on a particular topic, but doesn’t have a match, it will try to predict what the next word to try to complete the task. 

I asked ChatGPT to create a poem explaining what a Physician Order for Life Saving Treatment (POLST) was to a layperson.  The POLST is a legal document that a physician signs when (in discussion with the patient or the patient’s legal guardian) they decided, for example, whether a patient would want CPR, artificial nutrition, and/or potentially life-prolonging invasive therapies such as a ventilator or blood transfusion. ChatGPT generated a poem talking about how this document leads to life saving procedures, rather than its typical use today as a method for patients to say that they do NOT want life saving procedures and, instead, would like to die naturally.  

In another case, ChatGPT showed that it can’t yet teach effective CPR. Based on this experience and others, ChatGPT should not be used independently.  However, it can help optimize the increasingly limited time that patients and providers have to help interpret AND enhance health. Hopefully, your health care provider will appreciate your curiosity to use AI and will join you as you discover new tools to help you decipheryourhealth.