4 Essentials to Developing a Successful Healthcare AI Solution

While augmented intelligence (AI), often referred to as artificial intelligence, holds great promise for streamlining healthcare if done right, there is no shortcut to its implementation, according to a doctor who works in healthcare AI field for 30 years.

The IDx-DR Diabetic Retinopathy Diagnostic Exam Solution created by physician-researcher and AMA member Michael Abramoff, MD, PhD, is the first stand-alone AI system authorized by the Food and Drug Administration. It is autonomous insofar as it is a computer that makes the diagnosis, not a human.

It was an eight-year journey to FDA approval for Dr. Abramoff, an ophthalmologist specializing in diseases of the retina who was troubled by how long it often took diabetic patients to see a specialist. eye care for a diabetic retinopathy examination. He was also bothered by how specialist schedules are often filled with routine eye exam visits that don’t require their level of expertise.

“For other technologies it may not take that long, but it’s really, in a way, upsetting because it’s not a human but rather a computer making a medical decision,” said Dr. Abramoff. “Looking back, I don’t think it could have been done any differently, because we had to start the right way.”

Dr Abramoff is Professor of Ophthalmology at the Carver College of Medicine, University of Iowa, and practices ophthalmology with University of Iowa Hospitals and Clinics (UIHC), a member of the AMA Health System program. He spoke at an AMA Insight Network virtual meeting that discussed how to set up a healthcare AI program and how to use it properly.

The AMA Insight Network helps AMA Health System program members quickly access innovative ideas, gain peer feedback, network, and learn about pilot opportunities.Learn more.

For those looking to follow the same path, Dr Abramoff recommended following these steps.

“We had to start with ethical principles and a lot of things resulted from that – and it continues to develop -” he said, explaining that this means ensuring patient autonomy and fairness, and mitigating, rather than exacerbating any racial or ethnic bias that may find its way into the program.

“The more you have put in place this ethical framework, the more you are able – or we were able, at least – to convince all stakeholders, patient organizations, regulators, payers like CMS [Centers for Medicare & Medicaid Services], private payers, doctors, nurses, technicians all say, “yes, this is something we trust,” said Dr Abramoff.

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“Ask: Are you really doing something that improves patient outcomes or population outcomes? Said Dr Abramoff. “If the AI ​​can’t help with this, why are we doing it?”

Otherwise, the technology becomes what Dr Abramoff calls “glamorous AI”. This is when the technology seems exciting to implement, but has no real benefit for the patient.

“We should really focus on patients and populations and on improving their health, removing health inequalities, improving access and improving the quality of care,” a- he declared.

Dr. Abramoff does not use his solution in his own clinic. It is designed for use where people with diabetes receive their care, other than eye care. “It needs to fit into the workflow of primary care, endocrinology and internal medicine,” he said, adding that orders, billing and complaints were all done automatically.

“It’s all about the workflow,” said Dr. Abramoff. “If that slows down the clinic, if it causes more clicks for the doctor, then they’ll be hesitant to use it.

“Anything you can do to make it easier for those managing the patient’s diabetes to make it easier to do the eye exam, the better for the patient,” he added.

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CMSs and private payers will pay for the practices for using autonomous AI. “You can bill and get paid,” Dr. Abramoff said. “It really helps with adoption.”

When it comes to medical liability, “you are responsible for your medical decisions, and rightly so,” said Dr Abramoff. But, he explained, primary care physicians and endocrinologists using his system essentially outsource the medical decision of the eye exam of diabetics to AI and, therefore, should not be required. responsible for its performance – the creator of the AI ​​should be. This is the position his company took in the beginning, and he noted that he is now WADA Policy.

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