Thank you Neil Parmar for taking a dive into the AI pool (AI Holds Promise of Improving Doctors’ Diagnoses, WSJ 9/12/2017). This article is a good quick survey of how Artificial Intelligence, Deep-Learning, and Big Data are being applied in the field of radiology. AI will undoubtably improve the delivery of services and produce many positive outcomes. The radiology field has reason to be concerned as it deals with the changes to come. Of greater importance is the social impact these technologies will have. Changes in the day to day life of a radiologist will be eclipsed by the industry taking shape around this field. New challenges will emerge with regard to data collection, privacy and ownership. Ultimately, can we trust the technology and its keepers to act in the best interest of the patients in an equitable and transparent manner?
Medical Services Fuel Technology Investment
A lifetime as a radiologist will never match the potential volume of comparative records that may be accessible by AI-Driven apps. As stated in the article, ” The more data that gets fed into these systems, experts say, the better they tend to perform as they compare a patients medical information with data from thousands or sometimes millions of other patients.” Diagnostics and patient care will undoubtably be improved and, yes, the role of radiologists will adapt in unforeseen ways that may displace many in the field, but will also create many new opportunities.
While this is happening, there are a host of companies jockeying to capitalize on this technology and enormous future wealth is at stake. This is a recurring theme with emerging technology- early investments reap massive valuations before the technology solidifies while ownership of the technology rights are carved up within the private sector. Should there be regulatory mechanism for appropriating a portion of this wealth creation to mitigate the impact on those directly impacted by this technology? If not, is it the taxpayers who will pick up the tab? Are we to believe that in all cases the benefits of technology will float all boats and make us better off? There is a risk that the job base will shrink and wealth will be further concentrated at the top.
When Patient Data Becomes A Commodity
Another consideration buried in this rush to riches is the appropriation of patient records and images. Are these records being sold by health care companies to companies in the technology sector that stand to make massive economic gains from this emerging technology? What are the privacy safeguards if images require patient vital statistics to ensure proper interpretation? Should government oversight require companies to disclose the “chain of evidence” for how and where the data was collected and how it has been converted to meta-data or otherwise anonymized? Will this data leak out of the healthcare realm and into other applications? Should the public have the ability to opt out of having their personal information repackaged and sold? Can compensation be offered to patients on par with how much the industry stands to profit from the technology? In the case of the radiology business, the ship is leaving or has left the dock.
Once the data is out there and integrated into the technology, more considerations become apparent. What if after analyzing millions of images and records, the AI-Driven apps uncover patterns that present public health risks? Will the information be traceable back to patients? Here is where the dark side of AI may come into play. Will AI be truly autonomous and benevolent in diagnosing patients? Will the application developers have the ability to direct certain outcomes into treatment recommendations? Will the technology outpace our understanding of it’s decision process rendering it impossible for us to fully understand the reasoning behind the treatment recommendations? What are the risks of this data being used by malevolent organizations or artificial intelligences? See additional Humanity Beacon discussion on this topic here.
There are certainly many other questions that AI and related technologies present to our society. The rapid pace of advancement in many fields continues to out pace our ability to adapt to and control these technologies. What is playing out in the radiology field will also be playing out in many other professions and industries. More in-depth reporting to bring these issues to the public’s attention is warranted. Our state, local and federal governments need to catch-up to effectively address the economic and social changes that are upon us now. Education, awareness of where the technology is being used, and asking questions are essential to keeping these issues at the forefront of public debate.