Using AI in healthcare: why we need to walk, not run

The increased development and adoption of AI in healthcare, particularly generative AI chatbots, like OpenAI’s ChatGPT model, has allowed the sector to innovate in ways that benefit patients, doctors, researchers and healthcare providers alike. However, as with any new technology, risks are abundant. We spoke with RSM UK Partner and Head of NHS Clive Makombera tohear his perspectives on AI implementation within healthcare organisations.

Based on the AI developments we have seen so far, and with platforms like ChatGPT becoming accessible in the mainstream, what are your views on how AI might impact healthcare right now?

“AI has the potential to revolutionise the healthcare industry, offering a wide range of possibilities to enhance patient care and streamline healthcare processes.

“Low-risk settings for implementing AI are already being identified and creating significant benefits for the industry – as well as opportunities to better understand the challenges. Generative chatbots, like OpenAI’s ChatGPT model, have the potential to enhance patient care and provide real-time insights into a patient's health status. Its generative nature means it is capable of creating human-like responses to a wide range of queries, making it an ideal tool for healthcare applications. From personalised treatment plans to remote patient monitoring, ChatGPT and similar applications could transform the way healthcare providers deliver care to their patients.

“While the benefits are still early in concept, there are myriad of opportunities for resource-strapped health organisations to explore - from reducing physician administrative time to bringing virtual hospital wards to fruition and even helping with diagnoses. However, caution must be exercised.”

It sounds like organisations are already tapping into some of the benefits of AI, so where are you recommending they take precautions?

“Concerns about data protection, and potential biases that might be unintentionally built into AI platforms are among some of the risks that could pose serious problems in patient care. Learning to walk before we run with AI in healthcare is essential.

“As with any nascent technology, there are often grey areas which require further understanding and clear guidance – therefore, proceeding with caution and identifying the potential hurdles posed by things like data protection, risk of disinformation, data sharing and investment risk is advisable.”

Taking these hurdles one by one, what are the key concerns around data protection?

“With the rise of ChatGPT and other AI tools, there are question marks around the potential impact on data security and privacy. In May 2021, the Health Service Executive (HSE) in Ireland experienced a data breach, with the personal details of thousands of service users extracted – resulting in disruption to the entire Irish Health System.

“Ensuring privacy is crucial for maintaining trust and mitigating potential risks associated with AI implementation, and so it is critical that any healthcare provider has clear processes and cybersecurity measures, as well as a clear agreement in place with its supplier, to protect patient data from breaches.”

These concerns must link in with your point on data sharing?

“Indeed, it does, to an extent. Interoperability is a critical component of today’s healthcare infrastructure, and this will only continue to grow in importance as technology advances. However, AI platforms might have unintended consequences such as ethical and medico-legal impacts which could make sharing data between platforms and networks and having ‘one version of the truth’ more cumbersome than it already is.

“Changes in environment and circumstance can lead to data mismatches, resulting in erroneous predictions, and AI doesn't yet have the ability to take into account false negatives or false positives. Subjective prediction can also be a factor – where AI machines are trained to detect certain illnesses, they may naturally lean toward the outcome they are designed to detect.

“Human factors must also be considered. Monitoring machines which are capable of carrying out countless jobs and activities, including multitasking, can be near impossible, meanwhile clinicians may start to trust AI tools implicitly, assuming all predictions are correct and failing to cross-check or consider alternatives.”

I suppose these circumstances are where that risk of disinformation also becomes more significant?

“Exactly – because ChatGPT gathers its information from diverse sources available on the internet, including books, articles, websites, and other textual content. It does not have direct access to specific sources of information, nor can it gather information from the internet in real-time. These limitations increase the risk of disinformation – as we know the internet does not always contain reliable sources.

“In order to maintain the highest standards of evidence in healthcare, AI must be seen as a supporting tool, rather than a leading decision maker. Information or responses provided by ChatGPT should always be verified and cross-checked with up-to-date and reliable sources, and considered in tandem with human, professional insight.”

Are there any other risks or considerations you would like to highlight?

“As a final point I’d like to cover equipment. The full benefits of AI can only be unlocked with increased interoperability across equipment. However, the costs associated with acquiring new equipment, including wearables and sensors, and the installation of high-end connections like 5G to ensure the effective, uninterrupted use of such tools, is vast. This spend must be carefully evaluated to determine the return on investment – especially if healthcare providers hope to make further investment in the future.”

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