As with the introduction of any new technology, implementing artificial intelligence in healthcare comes with certain risks and challenges that must be carefully considered and addressed. Some of the major risks and challenges that could arise include:
Privacy and security concerns – One of the biggest risks is around privacy and security of patients’ sensitive health information. As AI systems are collecting, analyzing, and having access to massive amounts of people’s personal health records, images, genetic data, there are risks of that data being stolen, hacked, or inappropriately accessed in some way. Strict privacy and security protocols would need to be put in place and constantly improved to mitigate these risks as threats evolve over time. Consent and transparency around how patient data is being used would also need to be thoroughly addressed.
Bias and unfairness – There is a risk that biases in the data used to train AI systems could negatively impact certain groups and lead to unfair, inappropriate, or inaccurate decisions. For example, if most of the data comes from one demographic group, the systems may not perform as well on other groups that were underrepresented in the training data. Careful consideration of issues like fairness, accountability, and transparency would need to be factored into system development, testing, and use. Oversight mechanisms may also need to built-in to identify and address harmful biases.
Clinical validity and safety – Before being implemented widely for clinical use, it will need to be thoroughly determined through testing and regulatory review that AI tools are in fact clinically valid and deliver the promised benefits without causing patient harm or introducing new safety issues. Clinical effectiveness for the intended uses and patient populations would need to be proven through well-designed validation studies before depending on these systems for high-risk medical decisions. Unexpected or emergent behaviors of AI especially in complex clinical scenarios could pose risks that are difficult to anticipate in advance.
Overreliance on and trust in technology – As with any automation, there is a risk that clinicians and patients could become overly reliant on AI tools and trust them more than is appropriate or advisable given their actual capabilities and limitations. Proper integration into clinical workflow and oversight would need to ensure humans still maintain appropriate discretion and judgment. Clinicians will need education around meaningful use of these technologies. Patients could also develop unreasonable trust or expectations of what these systems can and cannot do which could impact consent and decisions about care.
Job disruption – There are concerns that widespread use of AI for administrative tasks like typing notes or answering routine clinical questions could significantly disrupt some healthcare jobs and professions. This could particularly impact low and middle-skilled workers like medical transcriptionists or call center operators. On the other hand, new high-skilled jobs focused more on human-AI collaboration may emerge. Health systems, training programs, and workers would need support navigating these changes to ensure a just transition.
Accessibility – For AI healthcare technologies to be successfully adopted, implemented, and have their intended benefits realized, they must be highly accessible and useable by both clinical staff and diverse patient populations. This means considering factors like user interface design, multiple language support, accommodations for disabilities like impaired vision or mobility, health literacy of patients, digital access and divide issues. Without proper attention to human factors and inclusive design, many people risk being left behind or facing new challenges in accessing and benefitting from care.
Lack of interoperability – For AI systems developed by different vendors to be effectively integrated into healthcare delivery, they will need to seamlessly interoperate with each other as well as existing clinical IT systems for things like EHRs, imaging, billing and so on. Adopting common data standards, application programming interfaces and approaches to semantic interoperability between systems will be important to overcome this challenge and avoid data and technology silos that limit usefulness.
High costs – Initial investment and ongoing costs of developing, validating, deploying and maintaining advanced AI technologies may be prohibitive for some providers, particularly those in underserved areas or serving low-income populations. Public-private partnerships and programs would likely need to help expand access. Reimbursement models by payers will also need to incentivize appropriate clinical use of these tools to maximize their benefits and cost-effectiveness.
For AI to reach its potential to transform healthcare for the better it will be critical to have thoughtful consideration, planning and policies around privacy, safety, oversight, fairness, accessibility, usability, costs and other implementation challenges throughout the process from research to real-world use. With diligence, these risks can be mitigated and AI’s arrival in medicine can truly empower both patients and providers. But the challenges above require a thoughtful, evidence-based and multidisciplinary approach to ensure its promise translates into real progress.